Tongue Strength Exercise and Swallowing in Oral Cancer

描述（由申请人提供）：口腔癌的治疗可能导致毁灭性的吞咽问题。高剂量放化疗已被用作口腔和口咽部肿瘤的主要治疗方法，以保护器官功能。然而，生活质量，可以成为显着降低后，主要治疗与放化疗，在进食能力显着递减。对口腔和口咽的放射治疗可引起吞咽的变化，特别是吞咽的口腔阶段，导致通过口腔推进食物和液体的能力降低。此外，似乎存在口腔舌强度和口腔相吞咽之间的关系。这项初步研究的主要目的是检查舌头加强练习与传统的吞咽治疗（实验组）与传统的治疗（对照组）单独对舌强度和吞咽的口腔癌患者接受放化疗治疗的影响。我们的假设是，实验组将改善舌头的力量和口咽吞咽功能，改善舌头的力量将与吞咽功能。第二个目的是检查运动计划对生活质量的影响，利用头颈部癌症清单，一种健康状况评估工具，由患者评定社会破坏，美学，言语和饮食领域。这项随机研究将检查两个为期6周的锻炼计划对52名接受过原发性放化疗的癌症患者的舌强度和吞咽的影响。两组患者在放化疗后一个月将接受为期6周的运动计划。所有患者将接受基线（放化疗后4周）和基线后（放化疗后10周）视频荧光吞咽研究（VFSS）、舌强度、口干评估和生活质量问卷。相关变量包括最大舌强度、口腔和咽部通过时间的暂时吞咽测量值、丸剂体积和粘度、口咽吞咽效率（OPSE）测量值和生活质量评分。

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.