Abstract
Context: Dysphagia is a common complication in Head and Neck Cancer patients which is often ignored affecting the quality of life. Shaker’s Exercise has shown to be beneficial in strengthening the muscles of the head and neck, opening of the throat thereby improving the swallowing function. Hence, the study was taken up.AIM: This clinical trial aimed to evaluate the swallowing efficiency using Shaker’s Exercise in Head and Neck Cancer patients.
Settings and Design: The experimental study was undertaken in a tertiary care referral hospital over a period of three months.
Methods and Materials: A total of twenty (20) all adult subjects males and females with head and neck cancer were instructed to perform Shaker’s Exercise for swallowing dysfunction during the hospitalisation phase. M.D. Anderson Dysphagia Inventory (MDADI), Functional Assessment for Cancer Therapy- Head and Neck (FACT H&N), and Cervical Range of Motion were assessed prior to and after one week of intervention.
Stastical Analysis Used: Statistical Analysis was done using SPSS Version 0.21. Students dependent and independent‘t’ test was used to analyse the difference in all outcome measures.
Results: The study demonstrated improvement in the swallowing efficiency in the post scores of MDADI, Quality of Life, and Cervical Ranges of Motion. (p≤0.05)
Conclusions: The present clinical trial has demonstrated improvement in swallowing efficiency in terms of MDADI, Quality of Life and Cervical Range of Motion suggesting similar trials in large sample size with longer duration.
Keywords: Head and Neck Cancer, Dysphagia, Shaker’s Exercise, M.D. Anderson Dysphagia Inventory, Functional Assessment for Cancer Therapy- Head and Neck, Cervical Range Of Motion.
Key Message: Early physical therapy intervention n the form of swallowing/non-swallowing exercises in Head and Neck Cancer patients has proved beneficial in terms of swallowing efficiency. Hence, there are few clinical trials to demonstrate the same. The present study was an attempt to prove the efficiency of simple and cost effective exercises as Shaker’s Exercise which would help patients in long term and improve the Quality of Life.
References
- Logemann J, Pauloski B, Rademaker A, Lazarus C, Gaziano J, Stachowiak L et al. Swallowing disorders in the first year after radiation and chemoradiation. Head Neck. 2008; 30(2):148-158.
- Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia After Stroke: Incidence, Diagnosis, and Pulmonary Complications. Stroke. 2005; 36(12):2756-2763.
- Caudell J, Schaner P, Meredith R, Locher J, Nabell L, Carroll W et al. Factors Associated With Long-Term Dysphagia After Definitive Radiotherapy for Locally Advanced Head-and-Neck Cancer. International Journal of Radiation Oncology*Biology*Physics. 2009; 73(2):410-415.
- Schindler A, Ginocchio, G Ruppolo. What we don't know about dysphagia complications? Revue de laryngologie - otologie - rhinologie.2007
- Nguyen N. Dysphagia following chemoradiation for locally advanced head and neck cancer. Annals of Oncology. 2004; 15(3):383-388.
- Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia After Stroke: Incidence, Diagnosis, and Pulmonary Complications. Stroke. 2005; 36(12):2756-2763.
- Nguyen N, Sallah S, Karlsson U, Antoine J. Combined chemotherapy and radiation therapy for head and neck malignancies. Cancer. 2002; 94(4):1131-1141.
- I Rudberg, H Bergquist, M Anderson, H Dotevall, S Horvath, C Finizia. Shaker Exercise Rehabilitation in Head and Neck Cancer and Stroke Patients with Dysphagia - A Pilot Study.Journal of Cancer Science and Clinical Oncology.2015; 2(3).
- Hashibe M, Brennan P, Benhamou S, Castellsague X, Chen C, Curado M et al. Alcohol Drinking in Never Users of Tobacco, Cigarette Smoking in Never Drinkers, and the Risk of Head and Neck Cancer: Pooled Analysis in the International Head and Neck Cancer Epidemiology Consortium. JNCI Journal of the National Cancer Institute. 2007; 99(10):777-789
- Norkin CC, White DJ. Measurement of joint motion: a guide to goniometry. FA Davis; 2016
- Sankaranarayanan R, Masuyer E, Swaminathan R, Ferlay J, Whelan S. Head and neck cancer: a global perspective on epidemiology and prognosis. Anticancer research. 1997 Dec;18(6B):4779-86.
- Schlecht NF, Franco EL, Pintos J, Kowalski LP. Effect of smoking cessation and tobacco type on the risk of cancers of the upper aero-digestive tract in Brazil.Epidemiology. 1999 Jul 1;10(4):412-8.
- Sturgis EM, Wei Q, Spitz MR. Descriptive epidemiology and risk factors for head and neck cancer. InSeminars in oncology 2004 Dec 31 (Vol. 31, No. 6, pp. 726-733). WB Saunders.
- Rothman K, Keller A. The effect of joint exposure to alcohol and tobacco on risk of cancer of the mouth and pharynx.Journal of chronic diseases. 1972 Dec 1;25(12):711-6.
- Brennan P, Lewis S, Hashibe M, Bell DA, Boffetta P, Bouchardy C, Caporaso N, Chen C, Coutelle C, Diehl SR, Hayes RB. Pooled analysis of alcohol dehydrogenase genotypes and head and neck cancer: a HuGE review. American journal of epidemiology. 2004 Jan 1;159(1):1-6.
- Brennan P, Lewis S, Hashibe M, Bell DA, Boffetta P, Bouchardy C, Caporaso N, Chen C, Coutelle C, Diehl SR, Hayes RB. Pooled analysis of alcohol dehydrogenase genotypes and head and neck cancer: a HuGE review. American journal of epidemiology. 2004 Jan 1;159(1):1-6.
- Arnold W, Nager F. Dysphagia: definition. TherapeutischeUmschau. Revue therapeutique. 1991 Mar;48(3):135-8.
- Manikantan K, Khode S, Sayed SI, Roe J, Nutting CM, Rhys-Evans P, Harrington KJ, Kazi R. Dysphagia in head and neck cancer. Cancer treatment reviews. 2009 Dec 31;35(8):724-32.
- Browman GP, Wong G, Hodson I, Sathya J, Russell R, McAlpine L, Skingley P, Levine MN. Influence of cigarette smoking on the efficacy of radiation therapy in head and neck cancer. New England Journal of Medicine. 1993 Jan 21;328(3):159-63.
- Epstein JB, Emerton S, Kolbinson DA, Le ND, Phillips N, Stevenson‐Moore P, Osoba D. Quality of life and oral function following radiotherapy for head and neck cancer.Head & neck. 1999 Jan 1;21(1):1-1.
- I Rudberg, H Bergquist, M Anderson, H Dotevall, S Horvath, C Finizia. Shaker Exercise Rehabilitation in Head and Neck Cancer and Stroke Patients with Dysphagia - A Pilot Study.Journal of Cancer Science and Clinical Oncology.2015; 2(3).
- Padwal T, Gurudut P, Hajare S. Effect of shakers exercise with kinesio taping in subjects with gastroesophageal reflux disease: A randomized controlled trial. Health Sciences. 2016;5(10):170-8.
- Crary MA, Carnaby GD, Groher ME, Helseth E. Functional benefits of dysphagia therapy using adjunctive sEMG biofeedback. Dysphagia. 2004 Aug 1;19(3):160-4.
- Crary MA, Carnaby-Mann GD, Faunce A. Electrical stimulation therapy for dysphagia: descriptive results of two surveys. Dysphagia. 2007 Jul 1;22(3):165-73.
- Chen AY, Frankowski R, Bishop-Leone J, Hebert T, Leyk S, Lewin J, Goepfert H. The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the MD Anderson dysphagia inventory. Archives of Otolaryngology–Head & Neck Surgery. 2001 Jul 1;127(7):870-6.
- Bjordal K, Hammerlid E, Ahlner-Elmqvist M, de Graeff A, Boysen M, Evensen JF, Biorklund A, de Leeuw JR, Fayers PM, Jannert M, Westin T. Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35. Journal of Clinical Oncology. 1999 Mar;17(3):1008-.
- Hassan SJ, Weymuller EA. Assessment of quality of life in head and neck cancer patients.Head & neck. 1993 Nov 1;15(6):485-96.
- Ringash J, Bezjak A, O'sullivan B, Redelmeier DA.Interpreting differences in quality of life: the FACT-H&N in laryngeal cancer patients.Quality of Life Research. 2004 May 1;13(4):725-33.
- Murphy BA, Gilbert J. Dysphagia in head and neck cancer patients treated with radiation: assessment, sequelae, and rehabilitation. 2009 Jan 31 (Vol. 19, No. 1, pp. 35-42). WB Saunders.
Corresponding Author
Dr Renu Pattanshetty MPT, Ph.D
Associate Professor and Head, Department of Oncology Physiotherapy,
KLEU Institute of Physiotherapy, Belagavi, 590010
Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Contact No.: +919448482564
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.189
