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Jun 18, 2019

MASCC/ISOO Annual Meeting on Supportive Care in Cancer

10 - EFFECTIVENESS OF A GUIDED SELF-HELP HEAD AND NECK EXERCISE PROGRAM FOR PATIENTS TREATED WITH TOTAL LARYNGECTOMY: RESULTS OF A MULTI-CENTER RANDOMIZED CONTROLLED TRIAL

;

Jansen;

F.;

Eerenstein;

S.E.J.;

Cnossen;

I.C.;

Lissenberg-Witte;

B.I.;

de Bree;

R.;

Doornaert;

P.;

Halmos;

G.B.;

Hardillo;

J.A.U.;

van Hinte;

G.;

Honings;

J.;

van Uden-Kraan;

C.F.;

Leemans;

C.R.;

Verdonck-de Leeuw;

I.M.

Abstract

Abstract

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Keywords

Abstract

Introduction. This study aimed to investigate the effectiveness of a guided self-help Head and Neck exercise program on swallowing, speech, and shoulder problems in patients treated with total laryngectomy (TL). Methods. This randomized controlled trial included patients treated with TL in the last 5 years. Patients randomized into the intervention group received a self-help exercise program and a self-care education program, whilst the control group received a self-care education program only. Both groups completed patient-reported outcome measures before randomization, at 3 and at 6 months follow-up. The primary outcome was swallowing problems (SWALQOL). Secondary outcomes were speech problems (SHI), shoulder problems (SDQ), patient activation (PAM) and health-related quality of life (HRQOL: EORTC QLQ-C30/H&N35). Adherence was defined as moderate to high in case the patient exercised >1 per day. Linear mixed model analyses were conducted to investigate the effectiveness of the intervention group compared to the control group and to investigate whether severity of problems and neck dissection surgery moderated the effectiveness. Results. Adherence to the exercise program was moderate-high (59%). Patients randomized to the intervention group (n=46) reported less swallowing problems over time compared to the control group (n=46) (p-value two-way interaction=0.013). Also, less communication problems were reported over time (p-value two-way interaction=0.004). No difference was found in speech, shoulder problems, patient activation and HRQOL. Severity of problems and neck dissection surgery did not moderate the effectiveness of the exercise program. Conclusions. The guided self-help exercise program improves swallowing and communication in TL patients.

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© Copyright 2019 Morressier GmbH.
All rights reserved.