None listed
Conditions
Brief summary
This study is assessing the feasibility of group dysphagia therapy for people with swallowing difficulties following treatment for head and neck cancer. Who is it for? You may be eligible to join this study if you are aged over 18 years, have a been diagnosed with head and neck cancer which has been treated with surgery or radiotherapy plus or minus chemotherapy with curative intent and have had persistent dysphagia for 6 months after treatment completion. You must have been cleared for intensive swallow rehabilitation by your treating medical or surgical team. Study details All participants will receive swallowing therapy conducted in a group setting alongside others with swallowing difficulties following head and neck cancer treatment. Therapy will consist of 1 hour weekly group therapy sessions, and individual home practice, focusing on swallowing progressively challenging foods and fluids. Therapy will be closely guided by the speech pathologists. The therapy sessions will occur for 9 consecutive week, with the 10th week being a focus group exploring participants views on the benefits and challenges of the group approach. Swallowing will be comprehensively assessed before and after the program, either with videofluroscopy (x-ray based) or FEES (endoscopy), this ensures safety and guides the best individualised rehabilitation. Additionally, participants will be asked to complete questionnaires exploring the impact of their swallowing difficulties on their day to day life. This research will explore whether swallowing therapy is feasible to be conducted in a group setting, it is anticipated this approach provide peer support a motivating environment to enhance engagement with therapy. This feasibility study will evaluate the feasibility of delivering an intensive group-based swallow therapy program for patients with dysphagia persisting beyond 6 months after treatment for head and neck cancer.
Interventions
An intensive group-based swallow therapy program supervised by a speech pathologist. The There will be 6 participants to each group and the session will be carried out face-to-face at Chris O'Brien Lifehouse, The groups will be held weekly for 1 hour for a total of 9 weeks. In the 10th week, a focus group session will be held.
To monitor adherence to the intervention, attendance will be noted at each session.
Group dysphagia therapy outline:
- 10 minutes: group discussion, speech pathologist
An intensive group-based swallow therapy program supervised by a speech pathologist. The There will be 6 participants to each group and the session will be carried out face-to-face at Chris O'Brien Lifehouse, The groups will be held weekly for 1 hour for a total of 9 weeks. In the 10th week, a focus group session will be held. To monitor adherence to the intervention, attendance will be noted at each session. Group dysphagia therapy outline: - 10 minutes: group discussion, speech pathologists will prompt participants to reflect on what has gone well with swallowing over past week, what has been more challenging. - 40 minutes: swallowing therapy based around intensive, bolus driven rehabilitation program derived from the principles of exercise physiology and neuroplasticity. Each participant will have an individualised therapy program according to their goals and swallowing capability, they will be supported to complete this by Speech Pathologists leading the group. Intensity will be increased and decreased according to the McNeil Dysphagia Therapy hierarchy, this is based on the viscosity of food and drink. Participants will complete as many functional swallows as they are able to within 40 minutes, using their recommended textures. The textures will be selected according to the most challenging and safe texture (no laryngeal penetration or aspiration) identified on instrumental assessment and will be modified according to progress. The individually tailored program will be designed by the speech pathologist in the month prior to the intervention starting using the data collected at the enrolment visit- including the instrumental swallow study (Swallowing will be comprehensively assessed before and after the program, either with videofluroscopy (x-ray based) or FEES (endoscopy)), goal setting and patient questionnaires. Participants will be recommended 30 minutes of daily home practice according to their individualised therapy programme provided in the group therapy sessions and updated according to progress. Should participants experience any signs of aspiration during home practice e.g. shortness of breath, voice changes, coughing, throat clearing, they will be advised to revert to easier consistencies, if this does not resolve aspiration signs they will be advised to cease swallow therapy until review at the next session and contact the Speech Pathologist
Sponsors
Chris O'Brien Lifehouse
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
19 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• greater than or equal to 6 months post completion of treatment for head and neck cancer • Diagnosis of head and neck cancer which has been treated with surgery or radiotherapy +/- chemotherapy with curative intent. • Presenting with persistent dysphagia, as assessed by treating speech pathologist to require modification of diet and/or fluids due to swallow function, or with EAT-10 score of less than or equal to 3. • Clearance for intensive swallow rehabilitation by treating oncology/surgical team. • >18 years of age. • Willingness to provide informed consent and attend intensive swallow rehabilitation program.
Exclusion criteria
• Patients who were unable to follow instructions in English or commit to a 9-week therapy programme. • Patients who are deemed unsafe to consume any form of liquid/diet intake. • Active head and neck cancer.
Outcome results
None listed