Effectiveness of Home-Based Telerehabilitation Interventions for Dysphagia in Patients With Head and Neck Cancer: Systematic Review

Journal of Medical Internet Research · 7 authors, 1 centre

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TL;DR

This systematic review of 13 studies found that home-based telerehabilitation may improve swallowing safety, nutritional status, and quality of life for head and neck cancer patients with dysphagia. The evidence indicates potential benefits, but the current literature is heterogeneous and in its early stages.

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This systematic review analyzed 13 studies of moderate to good quality to evaluate home-based telerehabilitation for dysphagia in head and neck cancer survivors. The interventions included remote swallowing exercises, education, and monitoring. The review found that telerehabilitation showed potential for improving swallowing safety, oral feeding, nutritional status, quality of life, and adherence, while reducing negative emotions. The authors note that the evidence is preliminary and that definitive conclusions about positive impacts cannot yet be drawn. They recommend future research to explore tailored interventions, increase sample sizes, and conduct long-term studies.

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systematic_review

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surgery

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AI pipeline

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ORIGINAL PAPER

PMC10517384

Effectiveness of Home-Based Telerehabilitation Interventions for Dysphagia in Patients With Head and Neck Cancer: Systematic Review

Journal of Medical Internet Research

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ABSTRACT

Abstract Background Multimodal treatment–induced dysphagia has serious negative effects on survivors of head and neck cancer. Owing to advances in communication technologies, several studies have applied telecommunication-based interventions that incorporate swallowing exercises, education, monitoring, feedback, self-management, and communication. It is especially urgent to implement home-based remote rehabilitation in the context of the COVID-19 pandemic. However, the optimal strategy and effectiveness of remote interventions are unclear. Objective This systematic review aimed to examine the evidence regarding the efficacy of telerehabilitation for reducing physiological and functional impairments related to swallowing and for improving adherence and related influencing factors among head and neck cancer survivors. Methods The PubMed, MEDLINE, CINAHL, Embase, and Cochrane Library databases were systematically searched up to July 2023 to identify relevant articles. In total, 2 investigators independently extracted the data and assessed the methodological quality of the included studies using the quality assessment tool of the Joanna Briggs Institute. Results A total of 1465 articles were initially identified; ultimately, 13 (0.89%) were included in the systematic review. The quality assessment indicated that the included studies were of moderate to good quality. The results showed that home-based telerehabilitation improved the safety of swallowing and oral feeding, nutritional status, and swallowing-related quality of life; reduced negative emotions; improved swallowing rehabilitation adherence; was rated by participants as highly satisfactory and supportive; and was cost-effective. In addition, this review investigated factors that influenced the efficacy of telerehabilitation, which included striking a balance among swallowing training strategy, intensity, frequency, duration, and individual motor ability; treating side effects of radiotherapy; providing access to medical, motivational, and educational information; providing feedback on training; providing communication and support from speech pathologists, families, and other survivors; and addressing technical problems. Conclusions Home-based telerehabilitation has shown great potential in reducing the safety risks of swallowing and oral feeding, improving quality of life and adherence, and meeting information needs for dysphagia among survivors of head and neck cancer. However, this review highlights limitations in the current literature, and the current research is in its infancy. In addition, owing to the diversity of patient sociodemographic, medical, physiological and functional swallowing, and behavioral factors, we recommend the development of tailored telemedicine interventions to achieve the best rehabilitation effects with the fewest and most precise interventions. Keywords: head and neck cancer, home-based rehabilitation, remote intervention, swallowing exercise, systematic review

CITATION EXPORT

Wenwen Yang, Yifei Du, Mengran Chen et al.. Effectiveness of Home-Based Telerehabilitation Interventions for Dysphagia in Patients With Head and Neck Cancer: Systematic Review. Journal of Medical Internet Research. (2023). https://doi.org/10.2196/47324

AUTHORS

7 · 1 CENTRES

Wenwen Yang, Yifei Du, Mengran Chen, Sufang Li, Fan Zhang, Peiyang Yu, Xiaoxia Xu

1The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou City, Henan Province, China