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Grant Details

Grant Number: 5R01CA095576-05 Interpret this number
Primary Investigator: Logemann, Jerilyn
Organization: Northwestern University
Project Title: Effects of Swallowing Therapy in Head and Neck Cancer
Fiscal Year: 2006


Abstract

DESCRIPTION (provided by applicant): Treatment for head and neck cancer often results in significant swallowing problems because of reduced range of motion of the larynx, tongue base and pharyngeal walls. Therapy procedures to improve range of motion including swallowing maneuvers have been shown in pilot data to be efficacious in patients with reduced range of motion. In this project, we propose to compare two rehabilitation programs introduced for one month beginning at 1 month post-treatment in a randomized longitudinal design involving 198 patients who have been treated for head and neck cancer with chemoradiation, supraglottic laryngectomy, anterior resection with primary or skin graft closure, anterior resection with distal or free flap closure, posterior resection with primary or skin graft closure, or posterior resection with distal or free flap closure: 1) aggressive range of motion with postural sensory therapy and 2) postural sensory therapy. After the one-month of therapy, patients in both therapy arms will receive a one-month rest period followed by a one-month therapy refresher at month 3 post-treatment. We hypothesize that the patients randomized to range of motion with postural sensory therapy will exhibit significantly more oral intake at 2 months post cancer treatment, will maintain their gains better after 1 month rest and will have a more normal diet at 4 months post-treatment and significantly better pharyngeal flexibility at 4, 6 and 12 months after tumor treatment completion as measured by the duration and width of cricopharyngeal opening during swallows of various volumes than patients receiving postural sensory therapy. We also hypothesize that patients in the range of motion program will maintain tongue base, hyoid, laryngeal and cricopharyngeal range of motion at 4, 6 and 12 months after completion of their tumor treatment and that it will be significantly better than that of patients who were on the postural sensory programs. Cost-effectiveness is a critical factor in today's health care system. We believe that patients in the range of motion/postural sensory group will exhibit less cost for medically needed services at 4, 6 and 12 months after completion of tumor treatment (immediately after, 2 and 8 months after completion of swallowing therapy) than patients in the postural sensory therapy group.



Publications

Critical Factors In The Oral Control Needed For Chewing And Swallowing
Authors: Logemann J.A. .
Source: Journal Of Texture Studies, 2014-06-01 00:00:00.0; 45(3), p. 173-179.
PMID: 25386030
Related Citations

Effects Of Enhanced Bolus Flavors On Oropharyngeal Swallow In Patients Treated For Head And Neck Cancer
Authors: Pauloski B.R. , Logemann J.A. , Rademaker A.W. , Lundy D. , Sullivan P.A. , Newman L.A. , Lazarus C. , Bacon M. .
Source: Head & Neck, 2013 Aug; 35(8), p. 1124-31.
PMID: 22907789
Related Citations

Relation Of Mucous Membrane Alterations To Oral Intake During The First Year After Treatment For Head And Neck Cancer
Authors: Pauloski,B.R. , Rademaker,A.W. , Logemann,J.A. , Lundy,D. , Bernstein,M. , McBreen,C. , Santa,D. , Campanelli,A. , Kelchner,L. , Klaben,B. , et al. .
Source: Head & Neck, 2011 Jun; 33(6), p. 774-9.
PMID: 20737496
Related Citations

The Feasibility Of Establishing Agreement Between Laboratories For Measures Of Oropharyngeal Structural Movements
Authors: Pauloski B.R. , Rademaker A.W. , Kern M. , Shaker R. , Logemann J.A. .
Source: Journal Of Medical Speech-language Pathology, 2009 Mar; 17(1), p. 9-19.
PMID: 21512610
Related Citations

Rehabilitation Of Dysphagia Following Head And Neck Cancer
Authors: Pauloski,B.R. .
Source: Physical Medicine And Rehabilitation Clinics Of North America, 2008 Nov; 19(4), p. 889-928, x.
PMID: 18940647
Related Citations



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