A Student-Led Tele-Expiratory Muscle Strength Training (EMST) Program for Head and Neck Cancer (HNC) Survivors-A Pilot Implementation Study.

BACKGROUND

Expiratory muscle strength training (EMST) is a non-invasive, evidence-based treatment that is used to improve swallowing in head and neck cancer (HNC) survivors. This prospective, pilot implementation study evaluated the feasibility, acceptability, and potential clinical effectiveness of a novel student-led tele-EMST program for HNC survivors.

METHODOLOGY: HNC survivors (n = 13) completed an eight-week tele-EMST program. Acceptability was measured using the Theoretical Framework of Acceptability Questionnaire (TFAQ) and the Telehealth Usability Questionnaire (TUQ). Feasibility was tracked weekly. Swallowing performance, airway clearance, and quality of life were evaluated using the Timed Water Swallow Test (TWST), peak expiratory flow rate (PEFR), and SWAL-QoL, respectively. Data were collected with REDCap. Descriptive and non-parametric statistics were performed.

RESULTS

Acceptability of the tele-EMST program was high, as evidenced by high ratings on the TUQ (mean: 88.1/100%, SD: 16.3) and significant improvement on the TFAQ (p < 0.05). Technical issues occurred in 24% of sessions but were all resolved. Swallowing performance (TWST, p < 0.05), self-reported dysphagia symptoms, and mental health scores (SWAL-QoL, p = 0.03; p = 0.02) significantly improved. No significant changes in PEFR were observed (p = 0.59).

CONCLUSION

The findings of this small pilot feasibility suggest that a student-led, tele-EMST program is a promising, scalable approach to reduce treatment inequities and support survivorship care for HNC survivors with dysphagia.