Adherence to Home-Based Swallowing Therapy Using a Mobile System in Head and Neck Cancer Survivors.

Area of Science:

• Oncology
• Rehabilitation Medicine
• Digital Health

Background:

• Dysphagia treatment adherence in head and neck cancer (HNC) patients is poorly understood, with current tracking relying on self-reports.
• A significant knowledge gap exists regarding objective adherence measures and quality of life outcomes in HNC dysphagia management.

Purpose of the Study:

• To assess weekly adherence rates and dysphagia-specific quality of life in HNC patients undergoing home-based swallowing therapy.
• To evaluate the efficacy of a mobile health (mHealth) system with surface electromyography (sEMG) biofeedback for swallowing exercises.

Main Methods:

• A quasi-experimental pretest-posttest design was employed with 20 HNC patients post-treatment.
• Participants engaged in a 6-week home exercise program using an mHealth sEMG biofeedback system, targeting 72 daily swallows.
• Adherence was calculated as the percentage of prescribed trials completed, and the M. D. Anderson Dysphagia Inventory (MDADI) assessed quality of life.

Main Results:

• Adherence remained high, ranging from 84% in Week 1 to 72% by Week 6.
• Factors like radiation therapy, time since treatment, and technical issues predicted lower adherence.
• Statistically significant improvements were observed in composite, emotional, and physical MDADI subscales.

Conclusions:

• Home-based swallowing therapy using mHealth and sEMG biofeedback demonstrates sustained adherence (≥72%) over 6 weeks in HNC patients.
• This intervention leads to significant improvements in dysphagia-specific quality of life.