# Clinical Impact of Respiratory-Swallow Training on Refractory Dysphagia in OP HNC

> **NIH VA I01** · EDWARD HINES JR VA HOSPITAL · 2021 · —

## Abstract

Despite important advancements in medical and surgical cancer treatments that prolong survival, veterans with
oropharyngeal head and neck cancer (OP HNC) are faced with chronic, intractable dysphagia resulting in
persistent drastic alterations in diet, the need for feeding tubes, and increased risk for aspiration pneumonia –
a life threatening infection. We must devote research and clinical efforts to mitigate these devastating
impairments because currently our rehabilitative intervention options are severely limited. As such, and in
keeping with the VHA’s Blueprint for Excellence Transformative Actions, the need for the development of
effective swallowing interventions that show potential for rapid translation to clinical practice is imperative.
Respiratory-swallow coordination is an essential element of airway protection during swallowing and facilitates
many key aspects of swallowing physiology. This key coordinative event is significantly disrupted in patients
who are dysphagic following medical and surgical treatments for OP HNC. [Our preliminary trial tested an
innovative swallowing treatment approach developed in our clinical laboratory, respiratory-swallow training
(RST), that targets respiratory-swallow coordination directly and resulted in compelling improvements in
physiologic swallowing outcomes in veterans suffering from dysphagia that persisted long after traditional
behavioral swallowing intervention(s). The goal of this proposed trial is to extend our preliminary study using a
rigorous, randomized cross over design and determine the impact and durability of RST on clinical outcomes
essential for eating, drinking, health, and quality-of-life in veterans with OP HNC. As such, positive results from
the proposed trial have high significance and clinical relevance for veterans’ health and well-being.]
A total of 88 subjects will be recruited and randomly assigned 1:1 to either RST (intervention arm) or no active
treatment (control arm), which is considered standard of care in this patient population. Data obtained will be
used to evaluate clinical efficacy and durability. Data obtained from [an additional 11] subjects randomized to
RST + home practice (HP) will be used to assess the feasibility of adjuvant HP program and to obtain
preliminary data on its added impact on efficacy and response durability. The primary efficacy endpoint is
Functional Oral Intake Scale level, and the secondary endpoint will be respiratory-swallow phase patterning.
We will also elaborate on the impact of RST by detailing the physiological, airway protective, and morphometric
changes that occur. We will use reproducible, reliable, and validated metrics that include the Modified Barium
Swallow Impairment Profile, Penetration-Aspiration Scale, and Computational Analysis of Swallowing
Mechanics to distinguish the mechanistic effects of RST. Further, adherence to a novel HP component using
self-guided practice will be introduced and tested for feasibility and con...

## Key facts

- **NIH application ID:** 10084171
- **Project number:** 5I01RX002352-04
- **Recipient organization:** EDWARD HINES JR VA HOSPITAL
- **Principal Investigator:** BONNIE J MARTIN-HARRIS
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-01-01 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10084171

## Citation

> US National Institutes of Health, RePORTER application 10084171, Clinical Impact of Respiratory-Swallow Training on Refractory Dysphagia in OP HNC (5I01RX002352-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10084171. Licensed CC0.

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