Comparison Between Effects Of Different Suprahyoid Muscles Strengthening Exercises On Irradiated Nasopharyngeal Carcinoma With Dysphagia

Objective To compare effects of suprahyoid muscles strengthening exercises of Shaker exercise and Chin Tuck against Resistance(CTAR)exercise on irradiated nasopharyngeal carcinoma(NPC)patients with dysphagia.Methods Seventy-five NPC patients with radiation-induced dysphagia were selected from the rehabilitation medicine department of the First Affiliated Hospital of Guangxi Medical University from October 2016 to December 2017.According to inclusion criteria,NPC patients were randomly divided into control group,Shaker group and CTAR group,25 patients in each group.The control group received routine swallowing exercise while Shaker group accepted Shaker exercise and CTAR group accepted CTAR exercise in addition routine swallowing exercise.The swallowing function of these patients was assessed with Penetration-Aspiration Scale under video fluoroscopic swallowing study(VFSS)before intervention,two weeks,four weeks and six weeks after intervention.Results There were no significant difference in PAS scores among the three groups before intervention(F=0.293,P>0.05).Compare between before and after 4weeks,6 weeks intervention,there were no significant change in PAS scores of the control group(F=1.486,P>0.05)but there were a significant decrease in Shaker group(F=13.843,P<0.05)and CTAR group(F=12.689,P<0.05).According to multiple comparison analyses of VFSS scores,after 4 and 6 weeks of treatment,the PAS scores were significantly lower in Shaker and CTAR groups than in the control group(P<0.05)but there was no significant difference between Shaker group and CTAR group(P>0.05).The total effective rate was 84% in Shaker group and 88% in CTAR group that was significantly higher than 40% in the control group(x2=-2.478,P<0.05)(x2 =-2.162,P<0.05)and it was not significantly different between Shaker group and CTAR group(x2 =-1.452,P>0.05).Conclusion Compared with only routine swallowing exercise,suprahyoid muscles strengthening exercise of Shaker exercise or CTAR exercise combine with routine swallowing exercise have a more significant effect on the treatment of dysphagia after radiotherapy in NPC patients while Shaker exercise and CTAR exercise have similar swallowing rehabilitation effect.Compared with Shaker exercise,CTAR exercise has no environmental restrictions and has the relative advantage of convenience but during the clinical treatment,the rehabilitation therapist should choose the treatment according to the patient's state of illness.