Physiotherapy in the prevention and management of radiotherapy-induced trismus: a critical review
Abstract
Aims:
The aim of this study is to review current evidence on the use of physiotherapy in the
prevention and treatment of Radiotherapy-induced trismus in Head and Neck cancer patients
(HNC) and report on its efficacy in such condition.
Methods:
We searched the digital databases of Medline, Embase, Cochrane Library and PubMed for
articles published in the period from January 1980 to July 2015 that were related to the topic.
The key word used were trismus, radiotherapy induced trismus, radiotherapy induced trismus,
head and neck cancer and physiotherapy in titles, abstract and Mesh terms. Additional articles
identified by tracing any literature containing preventive methods or managements for
trismus in patients of head and neck cancer.
Results:
11 articles related to the use of physiotherapy as a management and/or preventive tool for
RT-induced trismus were identified of which 3 were randomized controlled trials, 2 were
controlled trails, 5 were cohort studies and 1 were prospective case series. Modalities of
physiotherapy used in these studies included unassisted exercises, tongue blade assisted
exercises, Therabite® Jaw Motion Rehabilitation System, Dynasplint Trismus System,
Engström jaw mobilizing device. Current evidence suggests that passive jaw mobilization
devices can be beneficial in individuals with RT-induced trismus, whereas unassisted
exercises and active range motion techniques seems to provide less clear benefits.
Conclusion:
This review demonstrate the various techniques of physiotherapy in prevention and
management of radiotherapy induced trismus and its efficacy. Physiotherapy is a valid noninvasive method to manage radiotherapy induced trismus that need more investigation to
maximise its benefits. Passive jaw mobilization devices and structured physiotherapy
protocols coupled with positive motivation are effective in increasing mouth opening in HNC
treated or planned to be treated with radiotherapy.
Description
Keywords
Head and Neck cancer, Radiotherapy-induced trismus, physiotherapy
Citation
APA