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Open Access 19-09-2022 | Radiotherapy | Original Article

Increasing Adherence to Prophylactic Swallowing Exercises During Head and Neck Radiotherapy: The Multicenter, Randomized Controlled PRESTO-Trial

Authors: Margot Baudelet, Fréderic Duprez, Leen Van den Steen, Sandra Nuyts, Daan Nevens, Ann Goeleven, Caroline Vandenbruaene, Hanne Massonet, Alice Vergauwen, Heleen Bollen, Sarah Deschuymer, Kristien Wouters, Marc Peeters, Carl Van Laer, Steven Mariën, Michiel Van den Brekel, Lisette van der Molen, Tom Vauterin, Joost van Dinther, Hilde Verstraete, Isabel Hutsebaut, Sabine Meersschout, Olivier Vanderveken, Marc De Bodt, Gwen Van Nuffelen, members of the Belgian PRESTO-group

Published in: Dysphagia | Issue 3/2023

Abstract

Background

Prophylactic swallowing exercises (PSE) during radiotherapy can significantly reduce dysphagia after radiotherapy in head and neck cancer (HNC). However, its positive effects are hampered by low adherence rates during the burdensome therapy period. Hence, the main goal of this multicenter randomized controlled trial (RCT) was to investigate the effect of 3 different service-delivery modes on actual patients’ adherence.

Methods

A total of 148 oropharyngeal cancer patients treated with primary (chemo)radiotherapy were randomly assigned to a 4 weeks PSE program, either diary-supported (paper group; n = 49), app-supported (app group; n = 49) or therapist-supported (therapist group; n = 50). Participants practiced 5 days/week, daily alternating tongue strengthening exercises with chin tuck against resistance exercises. Adherence was measured as the percentage of completed exercise repetitions per week (%reps). Statistical analysis was performed by means of SPSSv27, using Linear Mixed-effects Models with post hoc pairwise testing and Bonferroni-Holm correction.

Results

Adherence and evolution of adherence over time was significantly different between the three groups (p < .001). Adherence rates decreased in all three groups during the 4 training weeks (p < .001). During all 4 weeks, the therapist group achieved the highest adherence rates, whilst the app group showed the lowest adherence rates.

Conclusions

PSE adherence decreased during the first 4 radiotherapy weeks regardless of group, but with a significant difference between groups. The therapist group achieved the highest adherence rates with a rather limited decline, therefore, increasing the face-to-face contact with a speech-language therapist can overcome the well-known problem of low adherence to PSE in this population.

Trial Registration

Trial registration: ISRCTN, ISRCTN98243550. Registered December 21, 2018 – retrospectively registered, https://www.isrctn.com/ISRCTN98243550?q=gwen%20van%20nuffelen&filters=&sort=&offset=1&totalResults=2&page=1&pageSize=10&searchType=basic-search.

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Title: Increasing Adherence to Prophylactic Swallowing Exercises During Head and Neck Radiotherapy: The Multicenter, Randomized Controlled PRESTO-Trial
Authors: Margot Baudelet
Fréderic Duprez
Leen Van den Steen
Sandra Nuyts
Daan Nevens
Ann Goeleven
Caroline Vandenbruaene
Hanne Massonet
Alice Vergauwen
Heleen Bollen
Sarah Deschuymer
Kristien Wouters
Marc Peeters
Carl Van Laer
Steven Mariën
Michiel Van den Brekel
Lisette van der Molen
Tom Vauterin
Joost van Dinther
Hilde Verstraete
Isabel Hutsebaut
Sabine Meersschout
Olivier Vanderveken
Marc De Bodt
Gwen Van Nuffelen
members of the Belgian PRESTO-group
Publication date: 19-09-2022
Publisher: Springer US
Keywords: Radiotherapy
Cytostatic Therapy
Dysphagia
Dysphagia
Dysphagia
Published in: Dysphagia / Issue 3/2023
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI: https://doi.org/10.1007/s00455-022-10513-6

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Increasing Adherence to Prophylactic Swallowing Exercises During Head and Neck Radiotherapy: The Multicenter, Randomized Controlled PRESTO-Trial

Abstract

Background

Methods

Results

Conclusions

Trial Registration

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial Registration

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