Disclosures: Sara Parke: Nothing to disclose

Objective: A scoping review of the literature from January 1990 to April 2017 identified 33 controlled studies of rehabilitation interventions for patients with head and neck cancer (HNC). The scoping review of HNC rehabilitation also identified 2 practice guidelines. We compared the interventional studies to the practice guidelines in order to determine if further guideline development is indicated.

Design: Narrative review

Setting: Multi-institutional

Participants: Members of the cancer rehabilitation physician consortium research subcommittee reviewed the interventional studies and practice guidelines.

Interventions: not applicable

Main Outcome Measures: not applicable

Results: Both guidelines were published in 2016, while the majority of the interventional studies were published earlier (31/33 between 1992-2015; two in 2016). Most interventional studies examined interventions in speech and swallow (22; 67%) including jaw exercises (9), swallowing exercises (5), voice training (5), and neuromuscular electrical stimulation for dysphagia and xerostomia (3). In these studies, maximum inter-incisor opening was the most common primary outcome (8), followed by voice quality (3) and time to oral intake (2). Eight studies (24%) evaluated exercise interventions, including upper extremity exercise (4), full body resistive training (3), and tai chi (1). Three studies (9%) combined dietary and exercise interventions. The most common primary outcome in these studies was lean body mass (3), the Shoulder Pain and Disability Index (2), and functional mobility measures including the 5x sit-to-stand and 10-meter walk test. Of the two practice guidelines, one focused entirely on speech and swallow; the other highlighted a wide range of survivorship issues including exercise. The guidelines were primarily based on observational evidence and expert opinion, and rarely included evidence from the identified interventional studies (0/31; 3/31).

Conclusions: Although there are relatively few controlled interventional studies, there are themes in both interventions and outcome measures that could inform the development of future evidence-based practice guidelines in HNC rehabilitation.

Level of Evidence: Level I

« Back to AAPM&R Annual Assembly 2019

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/a-paucity-of-practice-guidelines-for-rehabilitation-of-survivors-of-head-and-neck-cancer-a-scoping-review-sub-analysis/