Effects of exercise on swallowing and tongue strength in patients with oral and oropharyngeal cancer treated with primary radiotherapy with or without chemotherapy

Int J Oral Maxillofac Surg. 2014 May;43(5):523-30. doi: 10.1016/j.ijom.2013.10.023. Epub 2013 Dec 11.


Tongue strength is reduced in patients treated with chemoradiotherapy for oral/oropharyngeal cancer. Tongue strengthening protocols have resulted in improved lingual strength and swallowing in healthy individuals, as well as in patients following a neurological event. However, no studies have examined the efficacy of tongue strengthening exercises on tongue strength, swallowing, and quality of life (QOL; Head and Neck Cancer Inventory) in patients treated with chemoradiotherapy. A randomized clinical trial examined the effects of a tongue strengthening programme paired with traditional exercises vs. traditional exercises alone. Dependent variables included tongue strength, swallowing, and QOL in a group of patients with oral and oropharyngeal cancer treated with primary radiotherapy with or without chemotherapy. Differences with regard to tongue strength and oropharyngeal swallow efficiency (OPSE) were not observed within or between groups. QOL in the eating and speech domains improved following treatment in both groups. However, the experimental group demonstrated greater impairment in QOL in the social disruption domain following treatment, whereas the control group demonstrated a slight improvement in functioning. Tongue strengthening did not yield a statistically significant improvement in either tongue strength or swallowing measures in this patient cohort. Patient compliance and treatment timing may be factors underlying these outcomes.

Keywords: chemoradiation; exercise; quality of life; swallowing; tongue strength.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Combined Modality Therapy
  • Deglutition Disorders / etiology*
  • Deglutition Disorders / physiopathology
  • Deglutition Disorders / rehabilitation*
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Oropharyngeal Neoplasms / drug therapy
  • Oropharyngeal Neoplasms / radiotherapy*
  • Quality of Life
  • Surveys and Questionnaires
  • Tongue / physiopathology*
  • Tongue / radiation effects
  • Treatment Outcome