Susan E Langmore1,2, Timothy M McCulloch3, Gintas P Krisciunas4, Cathy L Lazarus5,6, Douglas J Van Daele7, Barbara Roa Pauloski8, Denis Rybin9, Gheorghe Doros10. 1. Department of Otolaryngology, Boston University School of Medicine, Boston, Massachusetts. 2. Department of Speech Language Hearing, Boston University, Boston, Massachusetts. 3. Division of Otolaryngology Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin. 4. Department of Otolaryngology, Boston University Medical Center, Boston, Massachusetts. 5. Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York. 6. THANC Foundation, Department of Otolaryngology Head and Neck Surgery, Mount Sinai Beth Israel, New York, New York. 7. Department of Otolaryngology-Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa. 8. Communication Sciences and Disorders, Northwestern University, Evanston, Illinois. 9. Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts. 10. Department of Biostatistics, Boston University, Boston, Massachusetts.
Abstract
BACKGROUND:Neuromuscular electrical stimulation (NMES) is a highly sought after but poorly studied treatment for dysphagia among patients with head and neck cancer with dysphagia. This study investigated the efficacy of NMES in this patient population. METHODS: In this double-blinded, randomized controlled trial, 170 patients with head and neck cancer experiencing posttreatment dysphagia were randomized into active NMES + swallow exercise versus sham NMES + swallow exercise groups. Outcomes after a 12-week program included changes in fluoroscopy measures, diet, and quality of life. RESULTS: After the 12-week program, the active NMES group had significantly worse Penetration Aspiration Scale scores than the sham group. Both groups reported significantly better diet and quality of life. No other measures were significant. CONCLUSION:NMES did not add benefit to traditional swallow exercises. Unfortunately, swallow exercises were not effective by themselves either. For patients with head and neck cancer with moderate to severe dysphagia caused by radiation therapy, current behavioral therapies are of limited help in reversing long-term dysphagia.
RCT Entities:
BACKGROUND: Neuromuscular electrical stimulation (NMES) is a highly sought after but poorly studied treatment for dysphagia among patients with head and neck cancer with dysphagia. This study investigated the efficacy of NMES in this patient population. METHODS: In this double-blinded, randomized controlled trial, 170 patients with head and neck cancer experiencing posttreatment dysphagia were randomized into active NMES + swallow exercise versus sham NMES + swallow exercise groups. Outcomes after a 12-week program included changes in fluoroscopy measures, diet, and quality of life. RESULTS: After the 12-week program, the active NMES group had significantly worse Penetration Aspiration Scale scores than the sham group. Both groups reported significantly better diet and quality of life. No other measures were significant. CONCLUSION:NMES did not add benefit to traditional swallow exercises. Unfortunately, swallow exercises were not effective by themselves either. For patients with head and neck cancer with moderate to severe dysphagia caused by radiation therapy, current behavioral therapies are of limited help in reversing long-term dysphagia.
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