Exercise for Trismus Prevention in Patients With Head and Neck Cancer: A Network Meta-Analysis of Randomized Controlled Trials

Healthcare

Wang, Y. -H., Huang, Y. -A., et al. (2022).

Healthcare, 10(3), 442.

This systematic review and meta-analysis investigates the effect of prophylactic exercise programs on trismus in patients with head and neck cancer.

Taipei Medical University (Taiwan); Taipei Medical University Hospital (Taiwan); Wan Fang Hospital (Taiwan)

Not specified

Randomized controlled trials

19

<div>Prophylactic trismus exercises (i.e., exercises delivered prior to cancer treatments) had a positive effect on reducing trismus and increasing oral opening in individuals with head and neck cancer. Specific findings include:&nbsp;</div> <ul> <li><span style="color: #333333;"><strong>Trismus:</strong> Prophylactic exercises with phone call follow-up (relative risk [RR] = 0.42) and prophylactic exercises in isolation (RR = 0.33) had a significantly lower risk of long-term trismus compared to usual care. However, there were no significant effects on short term trismus outcomes.&nbsp;</span></li> <li><span style="color: #333333;"><strong>Oral Opening: </strong>Prophylactic exercises in isolation (effect size [ES]= 3.42), exercises plus the use of a trismus instrument (ES = 4.06), exercises with phone call follow-up, and interventions incorporating all three elements (ES = 5.10)&nbsp; had large significant effects on increasing short-term oral opening.&nbsp; Large significant treatment effects were maintained for long-term mouth opening.&nbsp;</span></li> </ul> <div><span style="color: #333333;">Two studies revealed that prophylactic exercises with and without use of a trismus instrument was associated with improved quality of life.</span></div> <div>&nbsp;</div> <div><span style="color: #333333;">Limitations to this review include heterogeneity in patient populations (e.g., course of cancer treatment and cancer type, stage, and location),&nbsp; limited research for each individual treatment, risk of bias, and generally small sample sizes. Further research is warranted.</span></div>