Improving Functional Oral Intake in Head and Neck Cancer Survivors with Chronic Radiation-Associated Dysphagia - The...

Area of Science:

• Oncology
• Rehabilitation Medicine
• Neuroscience

Background:

• Chronic radiation-associated dysphagia (CRAD) is a common and debilitating side effect for head and neck cancer (HNC) survivors.
• Current treatment options for CRAD often focus on symptom management, with limited evidence for home-based, high-volume exercise interventions.
• Understanding the comparative efficacy of different training modalities is crucial for optimizing patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of home-based treatment programs for CRAD in HNC survivors.
• To compare high-volume strength training with combined strength-skill training, with and without High-Definition transcranial Direct Current Stimulation (HD-tDCS).
• To determine the most effective intervention for improving functional oral intake and swallowing function.

Main Methods:

• A randomized controlled trial involving 54 HNC survivors with CRAD.
• Three groups: 1) strength training only, 2) combined strength-skill training, 3) combined strength-skill training with real HD-tDCS.
• All groups exercised 4 times/week for 8 weeks; Group 2 received sham HD-tDCS.

Main Results:

• All groups demonstrated significant improvements in oral intake, swallowing function, and muscle strength.
• Combined strength and skill training (Groups 2 & 3) showed significantly higher odds of improved oral intake compared to strength training alone (Group 1).
• No additional benefit of real HD-tDCS was observed compared to sham stimulation.

Conclusions:

• High-volume strength and skill-based training is an effective home-based intervention for CRAD in HNC survivors.
• Combining strength and skill training is the most efficient approach to enhance functional oral intake.
• HD-tDCS did not provide additional benefits when combined with strength and skill training for CRAD.