App-Assisted Swallowing Program After Oral Cancer Surgery (AASP)

This study aims to examine the effects of a swallowing care program combined with an exercise mobile application (App) on swallowing function, anxiety, and quality of life in patients with oral cancer after flap reconstruction surgery. The goal is to determine whether integrating App-based swallowing exercises into postoperative care can improve rehabilitation outcomes compared with conventional care alone.

A purposive sampling method will be used to recruit 72 participants from the surgical wards of a medical center in northern Taiwan. Eligible patients scheduled for oral cancer tumor resection and flap reconstruction will be identified through consultation with plastic surgeons. After screening and informed consent, participants will be assigned to a control group or an experimental group, with approximately 36 patients in each group.

The control group will receive routine ward education and standard postoperative nursing care, while the experimental group will receive the same care plus an additional intervention using a swallowing exercise App. The intervention will begin on postoperative day 7, guided by the researcher. Follow-up assessments will be conducted during outpatient visits at postoperative week 4 and week 12. To minimize potential interference between participants, data collection will be performed sequentially-first for the control group, followed by the experimental group.

Data will be collected through self-administered questionnaires or researcher-assisted interviews, including a demographic survey, the Postoperative Oral Dysfunction-10 (POD-10), the Functional Oral Intake Scale (FOIS), a Visual Analog Scale for Anxiety, and the EORTC QLQ-H&N35 questionnaire for quality of life. Each assessment will take approximately 20-30 minutes. Participants may withdraw from the study at any time without penalty.

Descriptive statistics will be used to summarize participant characteristics. The chi-square test and independent t-test will be used to examine group homogeneity. Paired t-tests will be applied to evaluate within-group changes in swallowing function, anxiety, and quality of life before and after the intervention. The results of this study are expected to provide empirical evidence on the effectiveness of App-assisted swallowing rehabilitation for patients with oral cancer following reconstructive surgery, supporting the development of innovative, technology-based postoperative care models.

Study Overview

• Status: Not yet recruiting
• Conditions: Oral Cancer; Postoperative; Reconstructive Surgery
• Intervention / Treatment: Behavioral: Swallowing Care + Exercise App; Behavioral: Routine Postoperative Care

Detailed Description

This study adopts a purposive sampling method and will be conducted in surgical wards of a medical center in northern Taiwan. A total of 72 participants will be recruited, with approximately 36 patients in the experimental group and 36 in the control group, based on the sample size estimation.

Participants will be identified by the researcher through consultation with plastic surgeons regarding patients scheduled for oral cancer tumor resection and flap reconstruction surgery. Eligible patients will be screened according to inclusion and exclusion criteria. One day before surgery, the researcher will explain the study purpose and procedures to each patient. Those who agree to participate will sign an informed consent form and complete the baseline questionnaires either by self-administration or interview.

After surgery, when patients return to the ward, the intervention will begin on postoperative day 7. Participants will be divided into two groups:

Control group: receives routine ward education and standard postoperative care. Experimental group: receives the same routine care plus an additional intervention using a swallowing exercise mobile application (App). The researcher will assist participants in downloading and using the App.

Follow-up assessments will be conducted at 4 weeks and 12 weeks after surgery during outpatient clinic visits. To prevent contamination between participants, data will be collected sequentially-first from the control group and then from the experimental group.

Data collection instruments include a demographic questionnaire, the Postoperative Oral Dysfunction-10 (POD-10), Functional Oral Intake Scale (FOIS), Visual Analog Scale for Anxiety, and EORTC QLQ-H&N35 for quality of life. Each interview or questionnaire session will take approximately 20-30 minutes. Participants may withdraw at any time during the data collection process without penalty.

Data analysis will be performed using descriptive statistics to summarize participant characteristics. Homogeneity between groups will be tested using chi-square and independent t-tests. Paired t-tests will be used to compare pre- and post-intervention differences within groups. The study aims to evaluate the effects of an App-based swallowing exercise intervention on swallowing function, anxiety, and quality of life among patients with oral cancer after flap reconstruction surgery.

• Study Type: Interventional
• Enrollment (Estimated): 72
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: CHUAN WEN HSU, Master; Phone Number: 886+033281200* 886+0975367585; Email: f22877@cgmh.org.tw

Study Locations

• Taiwan
  • Taoyuan City
    • Taoyuan District, Taoyuan City, Taiwan, 333
      • Chang Gung Memorial Hospital, Linkou Branch

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Willing to sign a written informed consent form
• Diagnosed with oral cancer
• Hospitalized for first-time oral cancer tumor resection and flap reconstruction surgery
• Aged 18 years or older
• Conscious and mentally clear
• Able to communicate in Mandarin or Taiwanese

Exclusion Criteria:

• Diagnosed by a physician with poor postoperative wound healing that prevents participation in oral rehabilitation exercises
• Unable to perform oral rehabilitation exercises within one week after surgery, as determined by a physician

Withdrawal Criteria:

-Participants who withdraw consent at any time during the study will be excluded from further participation

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Sequential Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Swallowing Care + Exercise App Intervention; Participants receive a swallowing care program combined with a mobile exercise App, starting on postoperative day 7. The App provides guided swallowing exercises, reminders, and progress tracking. Follow-up assessments at weeks 4 and 12.	Behavioral: Swallowing Care + Exercise App; Participants receive a swallowing care program combined with a mobile exercise App, starting on postoperative day 7. The App provides guided swallowing exercises, reminders, and progress tracking. Follow-up assessments at weeks 4 and 12.
Active Comparator: Routine Postoperative Care; Participants receive standard postoperative care and routine ward education without the App-based swallowing intervention. Assessments at the same time points as the experimental group.	Behavioral: Routine Postoperative Care; Participants receive standard postoperative care and routine ward education without the App-based swallowing intervention. Assessments at the same time points as the experimental group.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Oral Dysfunction-10 (POD-10) questionnaire	Swallowing-related oral dysfunction was assessed using the Postoperative Oral Dysfunction-10 (POD-10) questionnaire. The POD-10 is a patient-reported outcome measure consisting of 10 items, with total scores ranging from 0 to 40, where higher scores indicate more severe oral dysfunction.	Beginning on postoperative day 7, and during outpatient visits at postoperative week 4 and week 12.
The Functional Oral Intake Scale (FOIS)	Functional swallowing ability was evaluated using the Functional Oral Intake Scale (FOIS), a 7-point ordinal scale ranging from Level 1 (nothing by mouth) to Level 7 (total oral diet with no restrictions), where higher scores represent better oral intake function.	Beginning on postoperative day 7, and during outpatient visits at postoperative week 4 and week 12.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
anxiety	Anxiety levels were assessed using the Visual Analog Scale for Anxiety (VAS-A). The scale ranges from 0 to 10, where 0 indicates no anxiety and 10 indicates the highest level of anxiety, with higher scores reflecting greater anxiety severity.	begin on postoperative day 7, during outpatient visits at postoperative week 4 and week 12.

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Quality of Life Scores Measured by EORTC QLQ-H&N35 at 4 and 12 Weeks After Surgery	Quality of life was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck 35 (EORTC QLQ-H&N35). The questionnaire comprises multiple head and neck cancer-specific symptom items, with scores linearly transformed to a 0-100 scale. Higher scores indicate greater symptom burden and poorer quality of life.	postoperative day 7, during outpatient visits at postoperative week 4 and week 12.

Collaborators and Investigators

• Sponsor: Chang Gung Memorial Hospital
• Investigators: Study Director: Yean Hsiao Chiu, PHD, Taipei Medical University

Publications and helpful links

Helpful Links

• Chang Gung Memorial Hospital Official Website

Study record dates

Study Major Dates

• Study Start (Estimated): January 1, 2026
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: December 9, 2025
• First Submitted That Met QC Criteria: December 23, 2025
• First Posted (Actual): December 24, 2025

Study Record Updates

• Last Update Posted (Actual): December 24, 2025
• Last Update Submitted That Met QC Criteria: December 23, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Postoperative; Oral Cancer; Reconstructive Surgery
• Additional Relevant MeSH Terms: Mouth Diseases; Stomatognathic Diseases; Neoplasms by Site; Neoplasms; Head and Neck Neoplasms; Mouth Neoplasms
• Other Study ID Numbers: 202501330B0

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Not applicable. Individual participant data will not be shared. Only aggregated study results may be published in scientific journals.

Study Data/Documents

1. No individual participant data (IPD) or supporting documents will be shared. Only aggregated study results may be published in journals or presented at conferences.
   Information identifier: No individual participant data
   Information comments: No individual participant data (IPD) or supporting documents will be shared. Only aggregated study results may be published in journals or presented at conferences.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No