EMST in Patients Undergoing CRT for HNCA

NCT ID: NCT03916809

Last Updated: 2024-12-04

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

RECRUITING

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-07-12

Study Completion Date

2025-08-01

Brief Summary

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This study is a randomized trial examining the impact of expiratory muscle strength training (EMST) on maintenance of safe and efficient oropharyngeal swallow function in persons with cancer of the head and neck (HNCA) undergoing treatment with radiation therapy or chemoradiotherapy (RT/CRT).

Detailed Description

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Thirty (30) persons with newly-diagnosed HNCA who will be treated with RT/CRT will be randomized to an 8-week program of either Active Expiratory Muscle Strength Training (EMST) + Standard Care or Sham EMST + Standard Care in order to examine the impact of EMST on swallowing function. The training program will consist of 5 sets of 5 breaths, 5 days per week for 8 weeks, coincident with RT/CRT. Patients randomized to the Active EMST group will use the EMST150 (product name) expiratory muscle strength trainer according to package instructions. Those randomized to the Sham EMST group will use an EMST150 device that has been modified to eliminate resistance to airflow.

All subjects will be evaluated prior to initiation of cancer treatment (baseline assessment), 4 weeks into cancer treatment and again at the completion of cancer treatment (8 weeks after initiation of treatment). Assessment will include measurement of maximum expiratory pressure (MEP), a videofluoroscopic swallow study (VFSS) to objectively document swallow function, and administration of swallow-related quality of life (QOL) questionnaires.

Conditions

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Head and Neck Neoplasms Deglutition Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Subjects will be randomized to an 8-week program of either Active Expiratory Muscle Strength Training (EMST) + Standard Care or Sham EMST + Standard Care in order to examine the impact of EMST on swallowing function.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Participants Outcome Assessors
Subjects will not know whether the device that they are given has a functioning valve spring or whether the valve spring has been removed.

Researchers assessing the outcomes will not know the arm to which the subject was randomized.

Study Groups

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Active EMST + Standard Care

Patients randomized to the Active EMST + Standard Care arm (ACTIVE) will use the EMST150 device as packaged, i.e. following package instructions with a device that has its valve spring maintained.

Group Type EXPERIMENTAL

EMST

Intervention Type OTHER

Expiratory muscle strength training (EMST) is an exercise program designed to strengthen the muscles of expiration by increasing expiratory load during breathing exercises using either resistive or pressure threshold devices. The EMST150 is a commercially-available device considered non-significant risk (NSR). The EMST150 device will be used for this study.

Sham EMST + Standard Care

Those randomized to the Sham EMST + Standard Care arm (SHAM) will use an EMST150 device that has been modified by removing the internal spring, which allows the valve to open in response to airflow through the device regardless of the amount of pressure generated.

Group Type SHAM_COMPARATOR

EMST

Intervention Type OTHER

Expiratory muscle strength training (EMST) is an exercise program designed to strengthen the muscles of expiration by increasing expiratory load during breathing exercises using either resistive or pressure threshold devices. The EMST150 is a commercially-available device considered non-significant risk (NSR). The EMST150 device will be used for this study.

Interventions

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EMST

Expiratory muscle strength training (EMST) is an exercise program designed to strengthen the muscles of expiration by increasing expiratory load during breathing exercises using either resistive or pressure threshold devices. The EMST150 is a commercially-available device considered non-significant risk (NSR). The EMST150 device will be used for this study.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* New diagnosis of cancer in the oral cavity, oropharynx, hypopharynx, or larynx;
* Planned treatment with primary radiotherapy with or without chemotherapy;
* Age 18 or older and able to provide consent;
* Ability to use the EMST150 device (hold in mouth and maintain lip seal)

Exclusion Criteria

* Primary surgery to the head and neck (neck dissection is permitted);
* Unknown primary tumor;
* Primary cancers of the nasopharynx, paranasal sinuses, salivary glands and skin.
* Progressive neurologic condition affecting muscle strength (e.g. amyotrophic lateral sclerosis (ALS), Parkinson's disease)
* Dysphagia not related to HNCA (e.g. unresolved swallowing difficulty post-stroke or post--traumatic brain injury (TBI))
* Prior history of head and neck radiotherapy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Froedtert Hospital

OTHER

Sponsor Role collaborator

Medical College of Wisconsin

OTHER

Sponsor Role collaborator

University of Wisconsin, Milwaukee

OTHER

Sponsor Role lead

Responsible Party

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Barbara Pauloski

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Barbara Pauloski

Role: PRINCIPAL_INVESTIGATOR

University of Wisconsin, Milwaukee

Locations

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University of Wisconsin Milwaukee

Milwaukee, Wisconsin, United States

Site Status ACTIVE_NOT_RECRUITING

Froedtert Hospital

Milwaukee, Wisconsin, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Barbara Pauloski, Ph.D.

Role: CONTACT

4142296719

Stephanie Stevens, M.S.

Role: CONTACT

Facility Contacts

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Stephanie Stevens, MS

Role: primary

Other Identifiers

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PRO29168

Identifier Type: -

Identifier Source: org_study_id