Rehabilitation interventions for the management of treatment-induced trismus in people with head and neck cancer: A scoping review

Abstract

Objective

Trismus is a common and debilitating complication following head and neck cancer treatment, with significant consequences for quality of life, nutrition and oral function. Although several rehabilitation strategies have been proposed, their design and effectiveness remain poorly systematized. This review aimed to summarize evidence from randomized controlled trials on rehabilitation interventions for treatment-induced trismus in HNC.

Data sources

A scoping review was performed using PubMed, PEDro, Web of Science, Scopus and EMBASE, covering publications up to May 2025.

Review methods

We included randomized controlled trials in English or Spanish evaluating any rehabilitation intervention in adults with trismus following HNC treatment. One author conducted the search, and two authors independently screened articles for inclusion.

Results

From 2215 records identified, 25 randomized controlled trials met the inclusion criteria. Twelve investigated preventions during or shortly after cancer treatment, while 13 addressed established trismus. Most interventions were based on exercise therapy, delivered in hospitals, private clinics or at home. Only a minority incorporated manual therapy or physical agents. Devices such as TheraBite or JawTrainer were evaluated in several studies. While most trials reported improvements in maximal mouth opening, few assessed condition-specific patient-reported outcomes. Rehabilitation interventions were predominantly implemented by physiotherapists.

Conclusion

Exercise therapy, often combined with devices, is the most frequently studied approach for treatment-induced trismus. Evidence for manual therapy and physical modalities remains limited. Considerable heterogeneity across studies hinders comparison and replication, underlining the need for standardized protocols and outcomes in future trials.