Research Gwen Van Nuffelen

Abstract

Radiation associated dysphagia (RAD) is one of the most serious and disabling complications in head and neck cancer survivors. Due to the specific nature of RAD, including the never-ending cascade of tissue fibrosis and muscle atrophy, treatment of RAD is very challenging and RAD often becomes chronic (C-RAD). Although the need for evidence-based and patient-supported therapy methods for C-RAD is loud and clear and internationally acknowledged, research addressing this issue is very scarce, heterogeneous and levels of evidence are low, retarding clinical implementation.. This multicentric project aims to fill in this need by conducting a 3-arms randomized controlled trial. The study design allows to investigate the effect of state-of-the-art and innovative rehabilitation methods in patients with C-RAD, comparing the efficacy and possible detraining effects of mere strengthening exercises (group 1) with a combination of strengthening exercises and functional swallowing therapy (group 2) and non-invasive brain stimulation added to that combination (group 3). In order to limit the additional burden for the patients, therapy sessions take place at home under supervision of a qualified speech language pathologist. Functional oral intake (i.e. what the patient really can eat) following 8 weeks of therapy is the primary outcome measure. Secondary outcome measures are related to changes in quality of life, muscle strength and swallowing function. Since clinical implementation of a therapy method requires that it is patient-supported, a dummy run will be conducted prior to actual data collection and patient-centred outcome parameters like adherence and patient attitudes and experiences are investigated. It is expected that the study results will facilitate and promote clinical implementation of evidence-based patient-centered care in this challenging population.

Researcher(s)

• Promoter: Van Nuffelen Gwen

Research team(s)

• Translational Neurosciences (TNW)

Project type(s)

• Research Project

Abstract

Speech rehabilitation in persons with a (chronic) speech disorders like dysarthria is very demanding and requires a lot of time and financial means. Speech technology based solutions offer an interesting supplementary opportunity. In this project which started within a European H2020 project, a Virtual Articulation Therapist (VAT) is build and further clinically operationalised. Different neural networks were trained in collaboration with partners from the TAPAS consortium (https://www.tapas-etn-eu.org/) to allow a precise phoneme identification and detailed phoneme error detection. The developed algorithms were integrated in a friendly user interface to allow patients to train themselves in their own environment. The VAT will be further evaluated with samples of healthy speakers and speakers with dysarthria on feasibility, acceptability and effectiveness. Next to the development of the VAT, acoustic features of accent production are explored to support perceptual evaluation of dysarthric speech. Both articulation and prosodic features like word accent play an important role in speech intelligibility.

Researcher(s)

• Promoter: Van Nuffelen Gwen
• Fellow: Mendoza Ramos Viviana

Research team(s)

• Translational Neurosciences (TNW)

Project type(s)

• Research Project

Abstract

Swallowing disorders are considered to be the most important long term adverse event after radiotherapy for head and neck cancer (HNC), impacting on health related quality of life (QoL). An increasing number of studies showed a significant positive effect of prophylactic swallowing exercises (PSE) on swallowing function in HNC-patients treated with (chemo)radiotherapy. Low adherence rates are however a major issue, preventing clinical implementation of PSE. This multicenter randomized trial investigates the effect service-delivery model (home practice versus app-supported versus therapist supported) on actual patient compliance, swallowing function and QoL. Secondly, the effects of multiple covariates patients and disease characteristics and patients attitudes towards exercising are investigated. The final part involves a cost-effectiveness study.

Researcher(s)

• Promoter: Van Nuffelen Gwen

Research team(s)

• Translational Neurosciences (TNW)

Project type(s)

• Research Project