{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T15:27:41Z","timestamp":1774020461983,"version":"3.50.1"},"reference-count":55,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T00:00:00Z","timestamp":1697241600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Exercise\u2010based swallowing training (EBST) and transcutaneous neuromuscular electrical stimulation (TNMES) are common modalities used to treat late dysphagia after radiotherapy for nasopharyngeal carcinoma (NPC). We aimed to investigate and compare the efficacies of EBST and TNMES as proactive treatments administered early after radiotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with early post\u2010radiotherapy NPC (<jats:italic>n<\/jats:italic>\u2009=\u2009120) underwent either TNMES or EBST. Flexible endoscopic evaluation of swallowing (FEES), quality of life (QOL), and swallowing function questionnaires were completed before the intervention as well as immediately, 6, and 12\u2009months after the intervention. Outcome measures included the scores for the swallowing function score (SFS), penetration and aspiration scale (PAS), dynamic imaging grade of swallowing toxicity (DIGEST), functional oral intake scale (FOIS), swallowing performance status scale (SPSS), pharyngeal motor impairment (PMI), pharyngeal function impairment (PFI), and functional assessment after cancer therapy\u2013nasopharyngeal (FACT\u2010NP) questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three months after radiotherapy, 31 and 34 patients underwent TNMES and EBST, respectively, and completed swallowing assessments at all four assessment timepoints. All patients showed post\u2010radiotherapy impairments in the SFS, PAS, DIGEST, PMI, and PFI. Compared with the EBST group, the TNMES group showed significant improvements in the PFI and PMI scores, with small\u2010to\u2010medium effect sizes. Additionally, compared with the EBST group, the TNMES group demonstrated a trend toward slightly better improvements in the PAS, DIGEST, FOIS, and SPSS scores immediately and 6\u2009months after the intervention. The SFS scores improved from baseline in both groups; however, the TNMES group showed an earlier improvement. Finally, the TNMES group showed better QOL according to the FACT\u2010NP than the EBST group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Proactive TMNES and EBST are safe and feasible modalities for improving swallowing in patients with NPC when administered early after radiotherapy. Although TNMES showed better results than EBST, these results should be interpreted with caution given the study limitations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>1B.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.1162","type":"journal-article","created":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T10:39:45Z","timestamp":1697279985000},"page":"1532-1546","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Quality of life and swallowing outcomes after early proactive swallowing rehabilitation by either transcutaneous neuromuscular electrical stimulation or exercise\u2010based swallowing training in patients with nasopharyngeal carcinoma after radiotherapy"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2669-9126","authenticated-orcid":false,"given":"Peter K. 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M.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2010 Head and Neck Surgery The Chinese University of Hong Kong, Prince of Wales Hospital  Shatin New Territories Hong Kong"},{"name":"The Institute of Human Communicative Research The Chinese University of Hong Kong  Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas S. 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T.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2010 Head and Neck Surgery The Chinese University of Hong Kong, Prince of Wales Hospital  Shatin New Territories Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology Prince of Wales Hospital  Shatin New Territories Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florence S. T.","family":"Mok","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology Prince of Wales Hospital  Shatin New Territories Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. 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