- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03916809
EMST in Patients Undergoing CRT for HNCA
Impact of Expiratory Muscle Strength Training (EMST) on Swallowing Function in Persons Undergoing Radiotherapy With or Without Chemotherapy (CRT) for Cancers of the Head and Neck (HNCA)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Thirty (30) persons with newly-diagnosed HNCA who will be treated with RT/CRT will be randomized to an 8-week program of either Active Expiratory Muscle Strength Training (EMST) + Standard Care or Sham EMST + Standard Care in order to examine the impact of EMST on swallowing function. The training program will consist of 5 sets of 5 breaths, 5 days per week for 8 weeks, coincident with RT/CRT. Patients randomized to the Active EMST group will use the EMST150 (product name) expiratory muscle strength trainer according to package instructions. Those randomized to the Sham EMST group will use an EMST150 device that has been modified to eliminate resistance to airflow.
All subjects will be evaluated prior to initiation of cancer treatment (baseline assessment), 4 weeks into cancer treatment and again at the completion of cancer treatment (8 weeks after initiation of treatment). Assessment will include measurement of maximum expiratory pressure (MEP), a videofluoroscopic swallow study (VFSS) to objectively document swallow function, and administration of swallow-related quality of life (QOL) questionnaires.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Barbara Pauloski, Ph.D.
- Phone Number: 4142296719
- Email: pauloski@uwm.edu
Study Contact Backup
- Name: Stephanie Stevens, M.S.
Study Locations
-
-
Wisconsin
-
Milwaukee, Wisconsin, United States, 53211
- Active, not recruiting
- University of Wisconsin Milwaukee
-
Milwaukee, Wisconsin, United States, 53226
- Recruiting
- Froedtert Hospital
-
Contact:
- Stephanie Stevens, MS
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- New diagnosis of cancer in the oral cavity, oropharynx, hypopharynx, or larynx;
- Planned treatment with primary radiotherapy with or without chemotherapy;
- Age 18 or older and able to provide consent;
- Ability to use the EMST150 device (hold in mouth and maintain lip seal)
Exclusion Criteria:
- Primary surgery to the head and neck (neck dissection is permitted);
- Unknown primary tumor;
- Primary cancers of the nasopharynx, paranasal sinuses, salivary glands and skin.
- Progressive neurologic condition affecting muscle strength (e.g. amyotrophic lateral sclerosis (ALS), Parkinson's disease)
- Dysphagia not related to HNCA (e.g. unresolved swallowing difficulty post-stroke or post--traumatic brain injury (TBI))
- Prior history of head and neck radiotherapy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Active EMST + Standard Care
Patients randomized to the Active EMST + Standard Care arm (ACTIVE) will use the EMST150 device as packaged, i.e. following package instructions with a device that has its valve spring maintained.
|
Expiratory muscle strength training (EMST) is an exercise program designed to strengthen the muscles of expiration by increasing expiratory load during breathing exercises using either resistive or pressure threshold devices.
The EMST150 is a commercially-available device considered non-significant risk (NSR).
The EMST150 device will be used for this study.
|
Sham Comparator: Sham EMST + Standard Care
Those randomized to the Sham EMST + Standard Care arm (SHAM) will use an EMST150 device that has been modified by removing the internal spring, which allows the valve to open in response to airflow through the device regardless of the amount of pressure generated.
|
Expiratory muscle strength training (EMST) is an exercise program designed to strengthen the muscles of expiration by increasing expiratory load during breathing exercises using either resistive or pressure threshold devices.
The EMST150 is a commercially-available device considered non-significant risk (NSR).
The EMST150 device will be used for this study.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Feeding-tube-free food intake (days)
Time Frame: 8 weeks
|
the number of days from the beginning of the study until change in feeding status from 100% oral intake to combined oral intake and tube intake and/or 100% tube feeding will be calculated
|
8 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Penetration-Aspiration Scale rating (number)
Time Frame: 8 weeks
|
From Videofluoroscopic Swallow Studies (VFSS), change in Penetration-Aspiration scale score will be determined from baseline to mid-treatment to post-treatment.
Penetration-Aspiration Scale is an 8-point ordinal rating scale.
|
8 weeks
|
Timing of Aspiration (category)
Time Frame: 8 weeks
|
From Videofluoroscopic Swallow Studies (VFSS), timing of aspiration will be determined from baseline to mid-treatment to post-treatment.
Timing is identified as a category, either before, during, or after.
|
8 weeks
|
Presence of pharyngeal residue (dichotomous)
Time Frame: 8 weeks
|
From Videofluoroscopic Swallow Studies (VFSS), the presence of residue in the pharynx (yes or no) will be determined from baseline to mid-treatment to post-treatment.
|
8 weeks
|
Extent of hyoid movement (mm)
Time Frame: 8 weeks
|
From Videofluoroscopic Swallow Studies (VFSS), the change in extent of hyoid movement in mm will be determined from baseline to mid-treatment to post-treatment.
|
8 weeks
|
Upper esophageal sphincter (UES) opening width (mm)
Time Frame: 8 weeks
|
From Videofluoroscopic Swallow Studies (VFSS), the change in width of UES opening width in mm will be determined from baseline to mid-treatment to post-treatment.
|
8 weeks
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Eating Assessment Tool (EAT-10) (number)
Time Frame: 8 weeks
|
Change in score on the EAT-10 will be calculated from baseline to mid-treatment to post-treatment.
EAT-10 is an ordinal rating scale with values that range from 0 to 40, with lower score reflecting better function.
|
8 weeks
|
M.D. Anderson Dysphagia Inventory (MDADI) (number)
Time Frame: 8 weeks
|
Change in scores on the M.D. Anderson Dysphagia Inventory (MDADI) will be calculated from baseline to mid-treatment to post-treatment.
MDADI consists of four ordinal rating scales with scores ranging from 0 to 100 with higher score reflecting better function.
|
8 weeks
|
Collaborators and Investigators
Investigators
- Principal Investigator: Barbara Pauloski, University of Wisconsin, Milwaukee
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- PRO29168
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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