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Photobiomodulation and Sonophoresis Improving Jaw Mobility and Quality of Life Among Head and Neck Cancer Survivors

Not Applicable
Conditions
Head and Neck Cancer
Trismus
Interventions
Combination Product: Photobiomodulation therapy with mandibular exercises
Combination Product: Sonophoresis with mandibular exercises
Registration Number
NCT04082793
Lead Sponsor
Asir John Samuel
Brief Summary

Head and neck cancer originate from the several different anatomical subsites especially the squamous cell carcinoma. This involves mainly Oropharynx, Hypopharynx, and Larynx. The common treatment approaches for HNC is radiation therapy, alone or combined with chemotherapy and surgery. In the present scenario, very little literature is available improving the QOL by physiotherapeutic measures in patients with HNC. To improve QOL, a well-designed study is needed. The study will be a two-group pretest-posttest design. The study will include patients with HNC receiving radiation or chemotherapy. One group will receive photobiomodulation therapy and another group will receive Sonophoresis. Both the group will receive Mandibular mobilization and stabilization exercises after electrotherapy. The Algometer, Digital Vernier caliper and core measure Questionnaire-C30 (QLQ-C30) will be used as an outcome measure to measure the effect of interventions between baseline and post-interventions.

Detailed Description

The trial will include two experimental groups. The study design will be two groups pretest-posttest design. The study will recruit patients with HNC receiving radiation or chemotherapy. The study will be conducted in Tertiary care teaching hospital, in the departments of Radiotherapy and physiotherapy of Maharishi Markandeshwar Hospital, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala. Total of 48 patients will be recruited in the study. Patients will be randomized by block randomization method into two groups. One group will receive Photobiomodulation therapy whereas another group will receive Sonophoresis. Mandibular mobilization and stabilization exercises will be given to both groups. The intervention will be given for 4 weeks. Three sessions of photobiomodulation therapy will be given per week on alternating days for 12 minutes, whereas three sessions of sonophoresis will also be given per week on alternating days for 8 minutes. Mandibular mobilization, as well as stabilization exercises, will be advised to perform regularly continuously for 4 weeks. There will be blinding of patients who will receive the therapy, therapist who will administer the therapy, and therapist who will assess the patients, therefore, the study will follow triple blinding.Algometer for pain measurement, Digital vernier caliper for measuring mandibular mobility and Core measure Questionnaire-C30 (QLQ-C30) for measuring the quality of life in patients with head and neck cancer will be taken as outcome measures. The outcomes will be taken before giving intervention, then again after 2 weeks of interventions and again on another 2 weeks of intervention.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
48
Inclusion Criteria
  • Patients with Clinical diagnosis of HNC undergoing chemo and radiation therapy
  • Patient having joint pain and stiffness following chemo and radiation therapy
  • Patients with the age group of 18 - 70 years
Exclusion Criteria
  • Patients with Mandibular reconstruction surgery
  • Patients with platelet count <80,000/µl of blood and haemoglobin count <8g/dl
  • Patients with cervical spine dysfunction and nerve damage
  • Patients who is not willing to participate in the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Photobiomodulation groupSonophoresis with mandibular exercisesLow-level laser therapy will be given to the PTMB group along with mandibular mobilization and stabilization exercises
Sonophoresis groupPhotobiomodulation therapy with mandibular exercisesUltrasonic massage with diclofenac gel will be given to the sonophoresis group along with mandibular mobilization and stabilization exercises
Sonophoresis groupSonophoresis with mandibular exercisesUltrasonic massage with diclofenac gel will be given to the sonophoresis group along with mandibular mobilization and stabilization exercises
Photobiomodulation groupPhotobiomodulation therapy with mandibular exercisesLow-level laser therapy will be given to the PTMB group along with mandibular mobilization and stabilization exercises
Primary Outcome Measures
NameTimeMethod
AlgometerChange from baseline, 2 weeks after intervention and at the end of 4th week will be measured.

Algometer is a digital calibrated outcome measure, measures the pain pressure threshold.

Core measure Questionnaire-C30 (QLQ-C30)Change from baseline, 2 weeks after intervention and at the end of 4th week will be measured.

The questionnaire are designed to measure physical, social and psychological functions of patients with cancer. The questionnaire contains physical, social, emotional and cognitive functioning multi item scales and 9 single items. These items are pain, fatigue, financial impact, appetite loss, nausea and vomiting, diarrhea, constipation, sleep disturbance and quality of life. All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level. Time required for administration is 10 to 15 minutes.

Secondary Outcome Measures
NameTimeMethod
Digital Vernier calliperChange from baseline, 2 weeks after intervention and at the end of 4th week will be measured.

Digital Vernier calliper measures the range of motion of mandibular mobility

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