Increasing Swallowing Rehabilitation Participation during Radiation Therapy: Protocol Development

Objective: The purpose of the current study was to develop a swallowing rehabilitation protocol using the PETTLEP model to support participation of individuals with head and neck cancer while undergoing radiation treatment. Methods: A swallowing rehabilitation protocol combining motor execution and motor imagery was used by twenty participants with head and neck cancer undergoing radiation treatment. The motor imagery components were constructed utilizing the PETTLEP model and its seven elements. Participants self-reported daily completion of the swallowing rehabilitation program and tracked pain in the mouth and throat region weekly. Results: Results noted average weekly participation above 50% and 45% of participants demonstrating strong participation throughout radiation treatment. Statistical significance was documented during participation between the first week and last week of treatment. Average weekly pain ratings throughout the duration of radiation treatment ranged from 1.21 - 5.17. Statistically significant differences were noted between weekly pain ratings. No difference between motor execution and motor imagery was observed for participation, but a significant difference was noted between the two modalities for pain. Conclusions: Our protocol presented a potential framework for incorporating motor imagery into rehabilitation protocols for individuals with dysphagia who are unable to execute movements. Results suggest motor imagery is a promising method to improve participation in swallowing rehabilitation for head and neck cancer patients undergoing radiation therapy.