{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:18:31Z","timestamp":1780499911970,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Expiratory muscle strength training (EMST) is a non\u2010invasive, evidence\u2010based treatment that is used to improve swallowing in head and neck cancer (HNC) survivors. This prospective, pilot implementation study evaluated the feasibility, acceptability, and potential clinical effectiveness of a novel student\u2010led tele\u2010EMST program for HNC survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>\n                      HNC survivors (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913) completed an eight\u2010week tele\u2010EMST program. Acceptability was measured using the Theoretical Framework of Acceptability Questionnaire (TFAQ) and the Telehealth Usability Questionnaire (TUQ). Feasibility was tracked weekly. Swallowing performance, airway clearance, and quality of life were evaluated using the Timed Water Swallow Test (TWST), peak expiratory flow rate (PEFR), and SWAL\u2010QoL, respectively. Data were collected with REDCap. Descriptive and non\u2010parametric statistics were performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Acceptability of the tele\u2010EMST program was high, as evidenced by high ratings on the TUQ (mean: 88.1\/100%, SD: 16.3) and significant improvement on the TFAQ (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Technical issues occurred in 24% of sessions but were all resolved. Swallowing performance (TWST,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), self\u2010reported dysphagia symptoms, and mental health scores (SWAL\u2010QoL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) significantly improved. No significant changes in PEFR were observed (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.59).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings of this small pilot feasibility suggest that a student\u2010led, tele\u2010EMST program is a promising, scalable approach to reduce treatment inequities and support survivorship care for HNC survivors with dysphagia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70206","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T10:01:45Z","timestamp":1771581705000},"page":"1822-1829","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Student\u2010Led Tele\u2010Expiratory Muscle Strength Training (\n                    <scp>EMST<\/scp>\n                    ) Program for Head and Neck Cancer (\n                    <scp>HNC<\/scp>\n                    ) Survivors\u2014A Pilot Implementation Study"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4053-0092","authenticated-orcid":false,"given":"Katrina","family":"Blyth","sequence":"first","affiliation":[{"name":"Discipline of Speech Pathology, School of Health Sciences, Faculty of Medicine and Health The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9925-6263","authenticated-orcid":false,"given":"Jessica","family":"Tam","sequence":"additional","affiliation":[{"name":"Discipline of Speech Pathology, School of Health Sciences, Faculty of Medicine and Health The University of Sydney  Sydney Australia"},{"name":"Speech Pathology Department The Royal North Shore Hospital, Northern Sydney Local Health District, New South Wales Health  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachelle","family":"Robinson","sequence":"additional","affiliation":[{"name":"Speech Pathology Department Prince of Wales Hospital, South\u2010Eastern Sydney Local Health District, New South Wales Health  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0563-8225","authenticated-orcid":false,"given":"Danielle","family":"Stone","sequence":"additional","affiliation":[{"name":"Discipline of Speech Pathology, School of Health Sciences, Faculty of Medicine and Health The University of Sydney  Sydney Australia"},{"name":"Speech Pathology Department The Royal North Shore Hospital, Northern Sydney Local Health District, New South Wales Health  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5329-1222","authenticated-orcid":false,"given":"Emma S.","family":"Wallace","sequence":"additional","affiliation":[{"name":"Discipline of Speech Pathology, School of Health Sciences, Faculty of Medicine and Health The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41415-022-5166-x"},{"key":"e_1_2_10_4_1","unstructured":"Australian Institute of Health and Welfare \u201cHead and Neck Cancer in Australia \u201d2014 [cited 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Muscle Strength Training: Results of a Pilot Prospective Trial","volume":"34","author":"Hutcheson K.","year":"2019","journal-title":"Dysphagia"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1044\/2020_AJSLP-20-00252"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1044\/2022_AJSLP-22-00063"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-011-9390-9"},{"issue":"5","key":"e_1_2_10_20_1","first-page":"1088","article-title":"Dysphagia Management via Telerehabilitation: A Review of the Current Evidence","volume":"3","author":"Ward E. C.","year":"2017","journal-title":"Journal of Gastroenterology and Hepatology Research"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-017-9850-y"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1044\/2021_AJSLP-21-00026"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.2196\/47324"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12961-015-0005-z"},{"key":"e_1_2_10_25_1","unstructured":"Aspire Products LLC \u201cPrecautions and Contraindications \u201d[cited 2025 27th June] https:\/\/emst150.com\/wp\u2010content\/uploads\/2021\/03\/Contraindications\u201011\u20102019.pdf."},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181fef115"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-07577-3"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.5195\/IJT.2016.6196"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24706"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/1357633X17733020"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26060"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/17549507.2022.2096925"}],"container-title":["Head &amp; Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.70206","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hed.70206","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.70206","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T14:21:52Z","timestamp":1780496512000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.70206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,20]]},"references-count":31,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/hed.70206"],"URL":"https:\/\/doi.org\/10.1002\/hed.70206","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"value":"1043-3074","type":"print"},{"value":"1097-0347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,20]]},"assertion":[{"value":"2025-10-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}