Expiratory Muscle Strength Training in Head and Neck Cancer Survivors with Dysphagia: A Pilot Study

Description: The Expiratory Muscle Strength Training device (EMST150) is a one-way, adjustable spring-loaded valve that creates resistance against expiration. Its objective is to train the muscles required for exhalation, improving their capacity for coughing and swallowing. Dose and Duration: To use the hand-held device, patients take a deep breath and blow forcefully into the mouthpiece 5 times, 5 times a day, 5 days a week, for 5 weeks. Using the rotating knob, the device is calibrated to the optimum resistance for training, which is 75% of the patient’s maximum expiratory pressure. No other speech pathology interventions will be provided during the 5-week period. Mode of Delivery: EMST is a speech pathology led intervention. The therapy program begins with a 1-hour in-person outpatient appointment with the speech pathologist, whereby baseline swallow and voice function measures are collected. Then, the EMST150 device is calibrated to the optimum training resistance by the speech pathologist and the participant is taught how to use the device. After initial consultation, the participant completes the training in their home, and the speech pathologist provides weekly 15-minute telehealth appointments to recalibrate the device as necessary and ensure adherence to the training program. At the completion of the 5-week therapy program, participants attend a 1-hour in-person outpatient speech pathology appointment to repeat swallow and voice function measures and establish a maintenance program. Materials: Prior to commencing the therapy program, patients will be provided with - Patient information sheet outlining the aims of the proposed project and any risks or contraindications for use of the EMST150 device. - The EMST150 device and instructions manual - Adherence diary