The Effect of Jaw Exercise on Trismus in Head and Neck Cancer Patients

Abstract

Objectives:

Trismus is a symptom that impacts daily life activities and adversely affects patient health-related quality of life (HRQL). Radiation-induced fibrosis is probably one of the most important etiological factors to trismus in head and neck cancer (HNC). The aim of this randomized prospective study was to compare 2 different jaw exercise devices, regarding improvement in mouth opening (MIO) and patient-reported symptoms in HNC patients with trismus.

Methods:

The 50 study patients were enrolled in a 10-week structured MIO training program and randomized to training with either TheraBite® device or Engström jaw device. The patients were regularly assessed by an oral surgeon and answered different questionnaires (ie, EORTC HN35 and the Gothenburg Trismus Questionnaire [GTQ])).

Results:

Both groups improved their MIO, 7.2 mm (22.9%) and 5.5 mm (17.6%) for TheraBite® and Engström, respectively. The largest increase in MIO was seen during the first 4 weeks of exercise. After the exercise periods 84% in the TheraBite® group (n = 21) and 60% in the Engström group (n = 15) no longer fulfilled the trismus criteria. A statistically significant improvement regarding trismus related symptoms in both groups with less pain, jaw-related problems, and eating limitations after the exercise period was found (P < .05 and P < .01).

Conclusions:

Structured intervention with a jaw exercise device improved the mouth opening capacity with less trismus-related symptoms in HNC patients. No statistically significant differences between the different devices were found. We suggest a feasible exercise program for radiation-induced trismus in HNC patients.