TY - JOUR
T1 - Exercise therapy for cancer treatment-induced trismus in patients with head and neck cancer
T2 - A systematic review and meta-analysis of randomized controlled trials
AU - Shao, Chia Hui
AU - Chiang, Chia Chun
AU - Huang, Tsai Wei
N1 - Copyright © 2020 Elsevier B.V. All rights reserved.
PY - 2020/10
Y1 - 2020/10
N2 - Background: Trismus is a common complication of cancer treatment, particularly radiotherapy, for head and neck cancer. We investigated whether exercise therapy could prevent or manage limited mouth opening in patients before or after the cancer treatment. Methods: We performed a systematic review and meta-analysis to evaluate the effectiveness of exercise therapy combined with a jaw-mobilizing device in the prevention and treatment of cancer treatment-induced trismus. The electronic databases PubMed, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials were searched for articles on trismus published before July 2020 with no language restrictions. The primary outcome for prevention was trismus incidence. The treatment outcome for trismus was the improvement of maximal interincisal opening (MIO). Results: Thirteen randomized controlled trials (RCTs) involving 733 patients were identified. Six studies assessed MIO and found that exercise therapy adjuvant to the use of a jaw-mobilizing device significantly improved the MIO from 4.48 (95% confidence interval [CI] = 0.20, 8.75) to 14.20 (95% CI = 10.73, 17.67) mm. Seven studies evaluating the preventive outcome of incidence of trismus found no significant difference between standard usual care and exercise therapy adjuvant to the use of a jaw-mobilizing device (risk ratio = 1.20; 95% CI = 0.61, 2.34). Conclusions: The current evidence from RCTs revealed that exercise therapy can lead to MIO improvement following the development of cancer treatment-induced trismus, but does not prevent trismus in patients being treated for head and neck cancer. The clinical exercise programs used in the studies were heterogeneous; therefore, additional high-quality RCTs are required.
AB - Background: Trismus is a common complication of cancer treatment, particularly radiotherapy, for head and neck cancer. We investigated whether exercise therapy could prevent or manage limited mouth opening in patients before or after the cancer treatment. Methods: We performed a systematic review and meta-analysis to evaluate the effectiveness of exercise therapy combined with a jaw-mobilizing device in the prevention and treatment of cancer treatment-induced trismus. The electronic databases PubMed, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials were searched for articles on trismus published before July 2020 with no language restrictions. The primary outcome for prevention was trismus incidence. The treatment outcome for trismus was the improvement of maximal interincisal opening (MIO). Results: Thirteen randomized controlled trials (RCTs) involving 733 patients were identified. Six studies assessed MIO and found that exercise therapy adjuvant to the use of a jaw-mobilizing device significantly improved the MIO from 4.48 (95% confidence interval [CI] = 0.20, 8.75) to 14.20 (95% CI = 10.73, 17.67) mm. Seven studies evaluating the preventive outcome of incidence of trismus found no significant difference between standard usual care and exercise therapy adjuvant to the use of a jaw-mobilizing device (risk ratio = 1.20; 95% CI = 0.61, 2.34). Conclusions: The current evidence from RCTs revealed that exercise therapy can lead to MIO improvement following the development of cancer treatment-induced trismus, but does not prevent trismus in patients being treated for head and neck cancer. The clinical exercise programs used in the studies were heterogeneous; therefore, additional high-quality RCTs are required.
KW - Exercise therapy
KW - Head and neck cancer
KW - Jaw-mobilizing device
KW - Meta-analysis
KW - Radiotherapy
KW - Trismus
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U2 - 10.1016/j.radonc.2020.08.024
DO - 10.1016/j.radonc.2020.08.024
M3 - Review article
C2 - 32890607
AN - SCOPUS:85090866749
SN - 0167-8140
VL - 151
SP - 249
EP - 255
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
ER -