Abstract
PurposeThis study aims to examine effects of jaw exercise on trismus 3 years following completion of a post-radiotherapy jaw exercise intervention.MethodsProspective study including 50 patients with head-and-neck cancer receiving radiotherapy and/or chemotherapy, plus a matched control group. The intervention group underwent 10 weeks of jaw exercise training. Patients were followed pre-and postintervention and 3 years postintervention completion. Outcome measures were maximal interincisal opening (MIO), trismus-related symptoms, and health-related quality-of-life as measured by Gothenburg Trismus Questionnaire, EORTC QLQ-C30, and EORTC QLQ-H&N35.ResultsThe intervention group had a statistically significantly higher mean MIO compared with the control group (40.1 mm and 33.9 mm, respectively, p < 0.001), reported less trismus-related problems and had an improved health-related quality-of-life when compared with the control group at the 3-year follow-up. These differences were all statistically significant.ConclusionJaw exercise therapy resulted in increased MIO, less trismus-related symptoms, and improved health-related quality-of-life. Jaw exercise therapy should be initiated early, in a structured manner and continued long-term.
Highlights
Trismus is defined as reduced mouth opening, Maximum Interincisal Opening (MIO) ≤ 35 mm [1], and can be caused by benign disorders, infections in the oral cavity, trauma, and malignant disorders [2]
In patients with head and neck cancer (HNC), trismus is a common symptom with a reported incidence after oncologic treatment of up to 40% [3]
Both the intervention group and the control group developed trismus within 9 months from radiotherapy termination of which the majority presented with trismus within 3–6 months
Summary
Trismus is defined as reduced mouth opening, Maximum Interincisal Opening (MIO) ≤ 35 mm [1], and can be caused by benign disorders, infections in the oral cavity, trauma, and malignant disorders [2]. In patients with head and neck cancer (HNC), trismus is a common symptom with a reported incidence after oncologic treatment of up to 40% [3]. The majority of the HNC patients are treated surgically or with radiotherapy and sometimes with additional chemotherapy for advanced stage tumors according to Swedish Cancer Guidelines [4]. Symptom trajectory reveals a typical worsening of the condition immediately after treatment, peaking 6–9 months posttreatment [5]. There is no standardized treatment for radiotherapy-induced trismus, and several studies have assessed exercise intervention, these studies included small study populations [6,7,8]. A recently published study by this research group reported that structured exercise intervention with jaw mobilizing devices improved mouth
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