Expiratory muscle strength training for radiation‐associated aspiration after head and neck cancer: A case series

Objective/Hypothesis Expiratory muscle strength training (EMST) is a simple, inexpensive, device‐driven exercise therapy. Therapeutic potential of EMST was examined among head and neck cancer survivors with chronic radiation‐associated aspiration. Study Design Retrospective case series. Methods Maxi...

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Bibliographic Details
Published in:The Laryngoscope 2018-05, Vol.128 (5), p.1044-1051
Main Authors: Hutcheson, Katherine A., Barrow, Martha P., Plowman, Emily K., Lai, Stephen Y., Fuller, Clifton David, Barringer, Denise A., Eapen, George, Wang, Yiqun, Hubbard, Rachel, Jimenez, Sarah K., Little, Leila G., Lewin, Jan S.
Format: Article
Language:English
Subjects:
Aged
Aspiration
Deglutition Disorders - physiopathology
Dysphagia
Exercise Therapy - methods
Exhalation - physiology
expiratory muscle strength training
Female
Head & neck cancer
head and neck cancer
Head and Neck Neoplasms - physiopathology
Head and Neck Neoplasms - radiotherapy
Humans
Male
Muscle Strength - physiology
radiation
Respiratory Muscles - physiopathology
Retrospective Studies
Sports training
Strength training
Treatment Outcome
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Summary:Objective/Hypothesis Expiratory muscle strength training (EMST) is a simple, inexpensive, device‐driven exercise therapy. Therapeutic potential of EMST was examined among head and neck cancer survivors with chronic radiation‐associated aspiration. Study Design Retrospective case series. Methods Maximum expiratory pressures (MEPs) were examined among n = 64 radiation‐associated aspirators (per penetration–aspiration scale score ≥ 6 on modified barium swallow). Pre–post EMST outcomes were examined in a nested subgroup of patients (n = 26) who enrolled in 8 weeks of EMST (25 repetitions, 5 days/week, 75% load). Nonparametric analyses examined effects of EMST on the primary endpoint MEPs. Secondary measures included swallowing safety (Dynamic Imaging Grade of Swallowing Toxicity [DIGEST]), perceived dysphagia (M.D. Anderson Dysphagia Inventory [MDADI]), and diet (performance status scale for head and neck cancer patients [PSSHN]). Results Compared to sex‐matched published normative data, MEPs were reduced in 91% (58 of 64) of aspirators (mean ± standard deviation: 89 ± 37). Twenty‐six patients enrolled in EMST and three patients withdrew. MEPs improved on average 57% (87 ± 29 to 137 ± 44 cm H2O, P 
ISSN:0023-852X
1531-4995
DOI:10.1002/lary.26845