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Rehabilitation Practice and Science

Abstract

Objective: To investigate therapeutic effects of a compound swallowing training program(CSTP) that includes neuromuscular electrical stimulation, swallowing muscle strengthening, posture training, food texture modification, and the use of adaptive feeding devices on chronic dysphagia after surgical treatment of tongue cancer(TC), and review the long-term swallowing outcomes and possible adverse effects.

Materials and methods: In this retrospective longitudinal study, we included patients with chronic dysphagia after surgical treatment of TC, who received a total of 10 CSTPs three times weekly, for one hour each time. Penetration-Aspiration Scale (PAS), Functional Dysphagia Scale (FDS), and Swallowing Performance Rating Scale (SPS) scores were compared before and after curative treatment and at the 6-month follow-up.

Results: Twelve patients were included in this study (11 men and one woman; mean age: 56 years; range: 42-74 years). The initial assessment was performed an average of 11.9 months after surgery (range: 6-34 months). There was a significant improvement in the SPS scores one month and six months after completing CSTP (p = 0.015, p = 0.024). Six months after completing CSTP, the total FDS scores of 5 mL of thin liquids and 5 mL of thick liquids significantly improved compared with those before training (p = 0.007, p = 0.011). Three of seven patients requiring chronic tube feeding had the nasogastric tube successfully removed after training.

Conclusion: This study suggested that CSTP has positive effect on improving the swallowing function, based on the SPS and FDS score on the liquid swallowing test in TC patients with chronic dysphagia. CSPT may increase the likelihood of feeding tube removal in TC patient with chronic dysphagia.

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