Title : A Randomized Controlled Trial of Wooden Tongue Depressor Exercise Therapy versus Usual Care to Improve Mouth Opening Ability Among Head and Neck Cancer Patients
Cancer treatment among head and neck cancer (HNC) patients affect the maximum interincisal mouth opening (MIO). Exercise therapy could improve the MIO of HNC who received cancer treatment. This study is randomized controlled trial (RCT) aimed to study the effectiveness of wooden tongue depressor exercise (WTDE) to improve mouth opening ability among HNC patients. The 80 HNC patients in 2 tertiary hospitals in Khon Kaen Province, Thailand, were recruited into intervention (n=40) and control (n=40) by used simple random sampling. The intervention had received WTDE plus usual care (UC) compared with the control group had received UC alone. The MIO was measured by using ruler in millimetres (mm) at a baseline before the intervention, and after cancer treatment at 1 month, 3 months, and 6 months from May 2016 until June 2019. Statistical used were descriptive statistics and repeated measure ANOVA to test the effectiveness of intervention. This study had an ethical approved. Results show that the baseline characteristics of most HNC patients were female in both intervention (60.0%), and control group (50%) (p>0.05). The average age of the intervention was 54.6 years old (S.D=11.0), and the controls were 56.8 years old (S.D.=13.0) (p>0.05). Most HNC had received surgery plus radiotherapy (interventions 30.0% vs controls 45.0%). The median radiation dose in interventions was 66.0 Gy (IQR=6.0, n=34), and controls was 66.7 Gy (IQR=10.0, n=31) (p>0.05). The interventions most found cancer site at nasopharynx (42.5%), and floor of mouth in the control group (17.5%). The stage of HNC was at T3 (interventions 70.0% vs controls 75.0%), N1 (interventions 30.0% vs controls 25.0%), M0 (100% both). The median of MIO was 38.0 mm interventions (IQR=3.0), and controls was 37.0 mm (IQR=4.0) (p>0.05). The average of MIO after interventions were 32.6 mm in the intervention vs 29.2 in the controls at 1 month (p>0.05), 35.0 mm vs 29.3 mm at 3 months (p<0.05), and 37.4 mm vs 29.8 mm at 6 months respectively (p<0.05). There was a significant different among intervention and control group and the following tine at 1 month, 3 months, and 6 months (p<0.05). WTDE plus UC is better than a UC alone to improve mouth opening ability among HNC patients. It may promote to using WTDE plus UC among HNC patients to reduce MIO loss after cancer treatment.