Publications by authors named "Leen Van Den Steen"

Dysphagia is a prevalent complication before, during and after treatment for head and neck cancer (HNC). Besides the medical and societal consequences, dysphagia has a negative impact on functioning, activity, participation and quality of life. These aspects are all affected by the environmental factors (EF).

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The use of texture modified food (TMF) is widely spread in the daily care of patients with oropharyngeal dysphagia (OD). However, TMF have been shown to have a negative impact on the patients' quality of life. Adherence rates are low, increasing the risk of malnutrition and aspiration in an already vulnerable patient population.

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Prophylactic swallowing exercises (PSE) during head-and-neck cancer (HNC) (chemo)radiotherapy (CRT) have a positive effect on swallowing function and muscle strength. Adherence rates to PSE are, however, moderate to low, undermining these effects. PRESTO already showed that the service-delivery mode (SDM), the way the exercises are offered, can influence adherence.

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Background: Acute and late toxicities in patients treated with (chemo)radiotherapy for head and neck cancer (HNC) is common and can negatively impact quality of life and performance. Performance status instruments measure the functional ability to perform daily life activities and are important tools in the oncologic population.

Aims: Since Dutch performance status scales for the HNC population are lacking, we conducted this study to translate the Performance Status Scale for Head and Neck Cancer Patients (PSS-HN) into Dutch (D-PSS-HN) and to validate this version.

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Article Synopsis
  • Chronic radiation-associated dysphagia (C-RAD) significantly affects head and neck cancer survivors' quality of life after radiation therapy, highlighting the need for effective management strategies.* -
  • A multicenter trial will compare three groups: those doing only strengthening exercises, those combining strengthening with functional swallowing therapy, and those with added non-invasive brain stimulation, involving 105 C-RAD patients.* -
  • The study aims to enhance understanding of rehabilitation techniques for C-RAD and improve swallowing function after treatment, with evaluations conducted before, during, and after the therapy.*
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Background: Prophylactic swallowing exercises (PSE) during radiotherapy can significantly reduce dysphagia after radiotherapy in head and neck cancer (HNC). However, its positive effects are hampered by low adherence rates during the burdensome therapy period. Hence, the main goal of this multicenter randomized controlled trial (RCT) was to investigate the effect of 3 different service-delivery modes on actual patients' adherence.

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Article Synopsis
  • The study aims to translate and validate the Communicative Participation Item Bank (CPIB) short form into Dutch for adults with speech issues stemming from neurological disorders or head and neck cancer.
  • The translation adhered to guidelines from the European Organisation for Research and Treatment for Cancer, and the psychometric properties of the Dutch CPIB were assessed using various questionnaires, including SHI and USER-P.
  • Results indicated high internal consistency and reliability of the Dutch CPIB, with strong validity confirmed through correlations with established speech assessment measures.
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Dysprosody is a hallmark of dysarthria, which can affect the intelligibility and naturalness of speech. This includes sentence accent, which helps to draw listeners' attention to important information in the message. Although some studies have investigated this feature, we currently lack properly validated automated procedures that can distinguish between subtle performance differences observed across speakers with dysarthria.

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Background: Imprecise articulation has a negative impact on speech intelligibility. Therefore, treatment of articulation is clinically relevant in patients with dysarthria. In order to be effective and according to the principles of motor learning, articulation therapy needs to be intensive, well organized, with adequate feedback and requires frequent practice.

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Background: The articulatory accuracy of patients with dysarthria is one of the most affected speech dimensions with a high impact on speech intelligibility. Behavioural treatments of articulation can either involve direct or indirect approaches. The latter have been thoroughly investigated and are generally appreciated for their almost immediate effects on articulation and intelligibility.

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Background: Radiation-associated dysphagia (RAD) is highly prevalent in head and neck cancer (HNC) patients, with insufficient tongue strength (TS) as a characteristic of this disabling complication. The effects of tongue-strengthening exercises (TSE) on TS, swallowing, and quality of life (QoL) have not been studied in this population.

Methods: A prospective phase 2 study using an 8 weeks during TSE protocol was carried out in 15 patients with chronic RAD.

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Article Synopsis
  • - Dysphagia is a serious problem for head-and-neck cancer patients after treatment, and prophylactic swallowing exercises (PSE) can improve their swallowing function, but many patients don't stick to them.
  • - A randomized trial is comparing three different ways to deliver PSE—home exercises, home exercises with app counseling, and face-to-face therapy—with 150 patients involved to see which method improves adherence and swallowing outcomes the most.
  • - The study will measure patients' progress through questionnaires and strength assessments, aiming to create a more effective PSE protocol that boosts adherence and improves quality of life.
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Introduction: Positive effects from tongue-strengthening exercises (TSE) are widely described, but dose-dependent studies concerning exercise frequency have not yet been reported. This study aimed to determine the training and detraining effects of TSE with exercise frequencies of respectively 3 and 5 times per week on maximum isometric anterior and posterior tongue pressures (MIPA and MIPP) and on anterior and posterior tongue strength during an effortful saliva swallow (PswalA and PswalP).

Method: Twenty healthy adults were randomly assigned to two exercise groups, training 3 (EX3, n = 10) or 5 (EX5, n = 10) times per week with the Iowa Oral Performance Instrument.

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Background: Acute and late toxicity after intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC) impacts on patient quality of life; yet, very late toxicity data remain scarce. This study assessed dysphagia, xerostomia, and neck fibrosis 3-8 years after IMRT.

Methods: A retrospective analysis using generalized estimated equations was performed on 60 patients with HNC treated with fractionated IMRT between 2000 and 2015 who had a follow-up ≥8 years.

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Background: Radiation-associated-dysphagia is a serious side effect of radiotherapy (RT) for head and neck cancer (HNC).

Methods: Seventy-six patients had a weekly prospective follow-up from baseline until one week post-RT. Combined mixed model analysis (n = 43) determined the evolution of self-perceived swallowing function, isometric tongue strength (MIP), tongue strength (TS) during swallowing (Pswal), and quality of life (QoL) in these patients during RT.

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Tongue-strengthening exercises (TSE) are based on the principles of exercise and motor learning, including intensity. Intensity is manipulated by gradually adjusting the resistive load. This randomized controlled trial (RCT) investigates the effect of three different values resistive load during TSE in healthy older adults.

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Clinical tongue-strengthening therapy programs are generally based on the principles of exercise and motor learning, including the specificity paradigm. The aim of this study was to investigate the specific effect of anterior and posterior tongue-strengthening exercises (TSE) on tongue strength (TS) in healthy older adults and to measure possible detraining effects. Sixteen healthy elderly completed 8 weeks of TSE by means of the Iowa Oral Performance Instrument (IOPI).

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Purpose: The aim of this study was to investigate the feasibility of tongue strength measures (TSMs) and the influence of bulb location, sex, and self-perceived pain and mucositis in head and neck cancer (HNC) patients during chemoradiotherapy (CRT).

Methods: Twenty-six newly diagnosed HNC patients treated with CRT performed anterior and posterior maximal isometric tongue pressures by means of the Iowa Oral Performance Instrument (IOPI). The Oral Mucositis Weekly Questionnaire (OMWQ) and a Visual Analogue Scale (VAS) for pain during swallowing were completed weekly from baseline to 1 week post CRT.

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Objective: The aim of this study was to define patient characteristics of a dysphonic population in terms of voice disorder, gender, age, and subjective and objective vocal parameters and to explore the relevant characteristics of the most frequent groups of voice disorders.

Patients And Methods: Patient records from 4,447 subjects referred for voice assessment and/or voice therapy were analyzed.

Results: Significantly more cases of dysphonia were structural as compared to nonstructural.

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Article Synopsis
  • Reduced tongue strength is linked to dysphagia in head and neck cancer patients who have undergone chemoradiotherapy, and tongue strengthening exercises may help improve swallowing function.
  • An ongoing randomized controlled trial is testing three different exercise protocols with varying loads to see how they impact tongue strength and swallowing in 51 patients.
  • This study seeks to provide insights on the optimal exercise load for effective tongue strengthening, potentially leading to better treatment protocols for dysphagia.
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