Expiratory Muscle Strength Training in Improving Bulbar Function and Quality of Life in Patients With Head and Neck Cancer

NCT ID: NCT03175289

Last Updated: 2019-05-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

49 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-09-29

Study Completion Date

2019-01-03

Brief Summary

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This randomized clinical trial studies how well expiratory muscle strength training works in improving bulbar function and quality of life in patients with head and neck cancer. Expiratory muscle strength training may help to strengthen the muscles involved in breathing and swallowing and may allow improved breathing, airway safety, swallow function, and quality of life in patients with head and neck cancer.

Detailed Description

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PRIMARY OBJECTIVES:

I. Investigate the impact of a prophylactic targeted exercise program, expiratory muscle strength training (EMST), on swallowing function and well-being of individuals on head and neck cancer (HNC).

II. Determine the impact of EMST on objective respiratory measures of individuals with HNC.

III. Determine the relationship between mean dose across the swallowing muscles (oral tongue and supra-hyoids, base of tongue, superior, middle and inferior pharyngeal constrictors, proximal esophagus)/dose on each muscle and the swallowing functional outcomes from aim 1.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients receive standard of care comprising of written patient education materials focusing on oral care, signs/symptoms of dysphagia/aspiration, and trismus. Patients participate in a therapy session conducted by a speech pathologist over 30 minutes once per week for 6 weeks during chemoradiation therapy. Patients also perform prescribed exercises at home daily for 3 sets of 10 repetitions.

ARM II: Patients receive standard of care comprising of written patient education materials focusing on oral care, signs/symptoms of dysphagia/aspiration, and trismus. Patients participate in a therapy session conducted by a speech pathologist over 30 minutes once per week for 6 weeks during chemoradiation therapy. Patients perform prescribed exercises at home daily for 3 sets of 10 repetitions. Patients also participate in an EMST session over 30 minutes comprising of 5 sets of 5 repetitions daily for 5 days per week for 6 weeks during chemoradiation therapy.

After completion of study, patients are followed up at 1, 3, 6, and 12 months.

Conditions

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Malignant Head and Neck Neoplasm

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Arm I (standard of care, home exercises)

Patients receive standard of care comprising of written patient education materials focusing on oral care, signs/symptoms of dysphagia/aspiration, and trismus. Patients participate in a therapy session conducted by a speech pathologist over 30 minutes once per week for 6 weeks during chemoradiation therapy. Patients also perform prescribed exercises at home daily for 3 sets of 10 repetitions.

Group Type ACTIVE_COMPARATOR

Best Practice

Intervention Type OTHER

Undergo therapy session conducted by a speech pathologist

Educational Intervention

Intervention Type OTHER

Receive standard of care patient education materials focusing on oral care, signs/symptoms of dysphagia/aspiration, and trismus

Exercise Intervention

Intervention Type OTHER

Perform prescribed home exercises

Quality-of-Life Assessment

Intervention Type OTHER

Ancillary studies

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Arm II (standard of care, home exercises, EMST)

Patients receive standard of care comprising of written patient education materials focusing on oral care, signs/symptoms of dysphagia/aspiration, and trismus. Patients participate in a therapy session conducted by a speech pathologist over 30 minutes once per week for 6 weeks during chemoradiation therapy. Patients perform prescribed exercises at home daily for 3 sets of 10 repetitions. Patients also participate in an EMST session over 30 minutes comprising of 5 sets of 5 repetitions daily for 5 days per week for 6 weeks during chemoradiation therapy

Group Type EXPERIMENTAL

Best Practice

Intervention Type OTHER

Undergo therapy session conducted by a speech pathologist

Educational Intervention

Intervention Type OTHER

Receive standard of care patient education materials focusing on oral care, signs/symptoms of dysphagia/aspiration, and trismus

Exercise Intervention

Intervention Type OTHER

Perform prescribed home exercises

Expiratory Muscle Strength Training

Intervention Type OTHER

Participate in EMST

Quality-of-Life Assessment

Intervention Type OTHER

Ancillary studies

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Interventions

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Best Practice

Undergo therapy session conducted by a speech pathologist

Intervention Type OTHER

Educational Intervention

Receive standard of care patient education materials focusing on oral care, signs/symptoms of dysphagia/aspiration, and trismus

Intervention Type OTHER

Exercise Intervention

Perform prescribed home exercises

Intervention Type OTHER

Expiratory Muscle Strength Training

Participate in EMST

Intervention Type OTHER

Quality-of-Life Assessment

Ancillary studies

Intervention Type OTHER

Questionnaire Administration

Ancillary studies

Intervention Type OTHER

Other Intervention Names

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standard of care standard therapy Education for Intervention Intervention by Education Intervention through Education Intervention, Educational EMST Quality of Life Assessment

Eligibility Criteria

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Inclusion Criteria

* Patients with a definitive, curative treatment plan consisting of chemoradiation for head \& neck cancer

* Surgery, if required, must be limited to: diagnostic biopsy

Exclusion Criteria

* Participants enrolled in a radiation de-intensification protocol
* Current or previous neurological disease, which may adversely affect swallowing
* History of oropharyngeal swallowing disorder prior to cancer diagnosis
* Previous neurosurgery on the brain
* Severe chronic obstructive pulmonary disease (COPD) requiring oxygen dependence, as this is a contraindication of EMST
Minimum Eligible Age

19 Years

Maximum Eligible Age

78 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ohio State University Comprehensive Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Loni Arrese, PhD, SLP

Role: PRINCIPAL_INVESTIGATOR

Ohio State University Comprehensive Cancer Center

Locations

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Ohio State University Comprehensive Cancer Center

Columbus, Ohio, United States

Site Status

Countries

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United States

Related Links

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Other Identifiers

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NCI-2017-00848

Identifier Type: REGISTRY

Identifier Source: secondary_id

OSU-16023

Identifier Type: -

Identifier Source: org_study_id

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