一种新型吞咽训练方案对长期头颈癌幸存者慢性吞咽困难的疗效
Efficacy of a novel swallowing exercise program for chronic dysphagia in long-term head and neck cancer survivors.
作者信息
Kraaijenga Sophie A C, Molen Lisette van der, Stuiver Martijn M, Takes Robert P, Al-Mamgani Abrahim, Brekel Michiel W M van den, Hilgers Frans J M
机构信息
The Netherlands Cancer Institute, Department of Head and Neck Oncology and Surgery, Amsterdam, The Netherlands.
The Netherlands Cancer Institute, Department of Physical Therapy, Amsterdam, The Netherlands.
出版信息
Head Neck. 2017 Oct;39(10):1943-1961. doi: 10.1002/hed.24710. Epub 2017 Aug 2.
BACKGROUND
The efficacy of rehabilitative exercises for chronic dysphagia treatment in head and neck cancer survivors has not been studied extensively and is ambiguous.
METHODS
A prospective clinical phase II study using an intensive strength training program was carried out in 17 head and neck cancer survivors with chronic dysphagia. Both swallow and nonswallow exercises were performed for 6-8 weeks with a newly developed tool allowing for progressive muscle overload, including chin tuck, jaw opening, and effortful swallow exercises. Outcome parameters were feasibility, compliance, and parameters for effect.
RESULTS
Feasibility in terms of the program completion rate was 88%. Compliance with the exercises was 97%. After the training period, chin tuck, jaw opening, and anterior tongue strength had substantially improved. All but 1 patient reported to benefit from the exercises.
CONCLUSION
Feasibility and compliance were high. Some objective and subjective effects of progressive load on muscle strength and swallowing function could be demonstrated.
背景
康复训练对头颈癌幸存者慢性吞咽困难的治疗效果尚未得到广泛研究，且尚不明确。
方法
对17例患有慢性吞咽困难的头颈癌幸存者进行了一项前瞻性临床II期研究，采用强化力量训练方案。使用一种新开发的工具进行吞咽和非吞咽训练6 - 8周，该工具可实现渐进性肌肉超负荷，包括收下巴、张口和用力吞咽训练。结果参数包括可行性、依从性和效果参数。
结果
就项目完成率而言，可行性为88%。训练的依从性为97%。训练期结束后，收下巴、张口和舌前肌力量有显著改善。除1例患者外，所有患者均报告从训练中获益。
结论
可行性和依从性较高。可以证明渐进性负荷对肌肉力量和吞咽功能有一些客观和主观影响。
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