Tongue Strength Exercise and Swallowing in Oral Cancer

描述(由申请者提供)：口腔癌的治疗会导致严重的吞咽问题。大剂量放化疗已被用作口腔和口咽部肿瘤的主要治疗手段，以保护器官功能。然而，在接受放化疗的初步治疗后，生活质量可能会显著降低，进食能力也会显著下降。对口腔和口咽部的放射治疗会引起吞咽的改变，特别是吞咽的口部阶段，从而降低食物和液体通过口腔的能力。此外，口舌强度和口相吞咽似乎也有关系。这项初步研究的主要目的是观察传统吞咽疗法(试验组)与单纯传统疗法(对照组)配合强化舌操对接受放化疗的口腔癌患者的舌力和吞咽功能的影响。我们的假设是，实验组的舌头强度和口咽吞咽功能将有所改善，舌头强度的改善将与吞咽功能相关。第二个目的是利用头颈部癌症调查表来检查锻炼计划对生活质量的影响，这是一种健康状况评估工具，由患者根据社交干扰、美学、言语和饮食等领域进行评级。这项随机研究将考察两个为期6周的锻炼计划对52名接受过癌症治疗的初级放化疗患者的舌力和吞咽能力的影响。两组患者在放化疗后1个月将接受为期6周的锻炼计划。所有患者都将接受基线(化疗后4周)和基线后(化疗后10周)的视频透视吞咽研究(VFSS)、舌力、口干症评估和生活质量问卷调查。依赖变量包括最大舌力、口腔和咽部转运时间的时间吞咽测量、丸量和粘度、口咽吞咽效率(OPSE)测量和生活质量评级。

DESCRIPTION (provided by applicant): Treatment for oral cancer can result in devastating swallowing problems. High-dose chemoradiotherapy has been utilized as primary treatment for tumors of the oral cavity and oropharynx to preserve organ function. Quality of life, however, can become significantly reduced after primary treatment with chemoradiotherapy, with significant decrements in ability to eat. Radiotherapy to the oral cavity and oropharynx can cause changes in swallowing, particularly the oral phase of the swallow, resulting in reduced ability to propel foods and liquids through the oral cavity. Further, there appears to be a relationship between oral tongue strength and oral phase swallowing. The primary objective of this pilot study is to examine the effects of tongue strengthening exercises with traditional swallow therapy (experimental group) vs. traditional therapy (control group) alone on tongue strength and swallowing in oral cancer patients treated with chemoradiotherapy. Our hypothesis is that the experimental group will improve in tongue strength and oropharyngeal swallow functioning, and that improved tongue strength will correlate with swallow functioning. A secondary aim is to examine the effects of the exercise programs on quality of life, utilizing the Head and Neck Cancer Inventory, a health status assessment instrument that is patient-rated with domains of social disruption, aesthetics, speech, and eating. This randomized study will examine the effects of two 6-week exercise programs on tongue strength and swallowing in 52 patients who have undergone primary chemoradiotherapy for cancer treatment. Patients in both groups will undergo a 6-week exercise program one month post-chemoradiotherapy. All patients will undergo baseline (4 weeks post-chemoradiotherapy) and post-baseline (10 weeks post-chemoradiotherapy) videofluoroscopic swallow study (VFSS), tongue strength, xerostomia assessment, and quality of life questionnaire. Dependant variables include maximum tongue strength, temporal swallow measures of oral and pharyngeal transit times, bolus volume and viscosity, the Oropharyngeal Swallow Efficiency (OPSE) measure, and quality of life ratings.