We carried out a randomized control trial to test a bimodal exercise program carried out during curatively intended (chemo)radiotherapy for patients with newly diagnosed cancer in the oral cavity, larynx, hypopharynx, oropharynx and cancers from unknown primary tumours with lymph node metastases to the neck. Swallowing exercises were tailored to each patient during occupational therapist-led sessions three times weekly and to be performed three times daily at home. Progressive resistance training was physiotherapy-led and carried out twice weekly throughout treatment. We tested the effect on degree of airway penetration and aspiration, functional swallowing, mouth opening, general physical functioning, quality of life, depression and anxiety during four follow-ups in the first year after treatment. 

We found some effects of the intervention at end-of-treatment, but the differences between intervention group and control group were inconsistent and we did not observe any long-term effects. Most likely, maintaining exercise programs into survivorship is a prerequisite for the effects of preventive swallowing exercises to prevail.

Nevertheless, this thesis contributes t important knowledge regarding including and retaining head and neck cancer patients into exercise trials. We found that adherence to the swallowing exercises was high, the intervention did no harm and feed-back from participants were positive. 

Christoffer Johansen

Susanne Oksbjerg Dalton

Irenel Wessel