ArticleThe Laryngoscope2018
Expiratory muscle strength training for radiation-associated aspiration after head and neck cancer: A case series.
Article in The Laryngoscope, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04468191 (Quantifying Fatigue of the Respiratory and Swallowing Musculature in Patients With Amyotrophic Lateral Sclerosis), which is not on this map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Quantifying Fatigue of the Respiratory and Swallowing Musculature in Patients With Amyotrophic Lateral Sclerosis
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- Effectiveness of Home-Based Telerehabilitation Interventions for Dysphagia in Patients With Head and Neck Cancer: Systematic Review.Journal of medical Internet research · 2023Pooled it
- Pooled it
- Treatment of Radiation-Associated Dysphagia with Statins (TRADstat): protocol for a prospective, single-site, single-arm pilot trial.BMJ open · 2026Article
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- Management of dysphagia in head and neck cancer: current and future perspectives.Frontiers in oncology · 2026Review
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- Respiratory muscle training reduces painful swallowing and opioid use during radiation therapy for head and neck cancer: a matched pair analysis.BMC cancer · 2025Article
- Expiratory Musculature Targeted Resistance Training Modulates Neural Connections During Swallowing Tasks: Preliminary fMRI Evidence.Neural plasticity · 2025Review
- Improvement in Swallowing Function in Patients with Previous Irradiation for Nasopharyngeal Carcinoma by Expiratory Muscle Strength Training.Dysphagia · 2024Article
- Linking the impact of aspiration to host variables using the BOLUS framework: support from a rapid review.Frontiers in rehabilitation sciences · 2024Review
- Hypotussic cough in persons with dysphagia: biobehavioral interventions and pathways to clinical implementation.Frontiers in rehabilitation sciences · 2024Review
- Dysphagia Advances in Head and Neck Cancer.Current otorhinolaryngology reports · 2023Review
- Statistical Power and Swallowing Rehabilitation Research: Current Landscape and Next Steps.Dysphagia · 2022Review
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- Impact of Dysphagia Rehabilitation in Adults on Swallowing Physiology Measured With Videofluoroscopy: A Mapping Review.American journal of speech-language pathology · 2022Review
- Using Ultrasound to Document the Effects of Expiratory Muscle Strength Training (EMST) on the Geniohyoid Muscle.Dysphagia · 2022Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
objective/hypothesisExpiratory muscle strength training (EMST) is a simple, inexpensive, device-driven exercise therapy. Therapeutic potential of EMST was examined among head and neck cancer survivors with chronic radiation-associated aspiration. STUDY
designRetrospective case series.
methodsMaximum expiratory pressures (MEPs) were examined among n = 64 radiation-associated aspirators (per penetration-aspiration scale score ≥ 6 on modified barium swallow). Pre-post EMST outcomes were examined in a nested subgroup of patients (n = 26) who enrolled in 8 weeks of EMST (25 repetitions, 5 days/week, 75% load). Nonparametric analyses examined effects of EMST on the primary endpoint MEPs. Secondary measures included swallowing safety (Dynamic Imaging Grade of Swallowing Toxicity [DIGEST]), perceived dysphagia (M.D. Anderson Dysphagia Inventory [MDADI]), and diet (performance status scale for head and neck cancer patients [PSSHN]).
resultsCompared to sex-matched published normative data, MEPs were reduced in 91% (58 of 64) of aspirators (mean ± standard deviation: 89 ± 37). Twenty-six patients enrolled in EMST and three patients withdrew. MEPs improved on average 57% (87 ± 29 to 137 ± 44 cm H
conclusionMEPs were reduced in chronic radiation-associated aspirators relative to normative data, suggesting that expiratory strengthening could be a novel therapeutic target to improve airway protection in this population. Similar to findings in neurogenic populations, these data also suggest improved expiratory pressure-generating capabilities after EMST and translation to functional improvements in swallowing safety in chronic radiation-associated aspirators. LEVEL OF EVIDENCE: 4. Laryngoscope, 128:1044-1051, 2018.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.