title: Early self-care rehabilitation of head and neck cancer patients.
abstract: CONCLUSIONS
  No positive effects of early preventive rehabilitation could be identified. The results do not contradict the proposition that rehabilitation based on self-care can be effective but it is important to establish evidence-based training programs and identify proper instruments for selection of patients and evaluation of intervention.
  
  
  OBJECTIVE
  Patients with head and neck cancer suffer from functional impairments due to intense treatment. In this study, we investigated the effectiveness of an experimental early preventive rehabilitation using hard, objective end points in a nonselective, longitudinal, prospective cohort study.
  
  
  METHODS
  In all, 190 patients were included in the program and received instructions for training before the start of treatment with the aim of reducing swallowing problems and reducing mouth opening and stiffness in the neck. A control group of 184 patients was recruited.
  
  
  RESULTS
  There was no difference in weight loss and 2-year survival between the two groups. No positive effects concerning functional impairments were found in patient-reported outcome measures.
authors.affiliation: Department of Otolaryngology, Karolinska University Hospital, Stockholm, Sweden. alexander.ahlberg@karolinska.se
authors.forename: Alexander
authors.initials: A
authors.lastname: Ahlberg
authors.forename: Therese
authors.initials: T
authors.lastname: Engström
authors.forename: Polymnia
authors.initials: P
authors.lastname: Nikolaidis
authors.forename: Karin
authors.initials: K
authors.lastname: Gunnarsson
authors.forename: Hemming
authors.initials: H
authors.lastname: Johansson
authors.forename: Lena
authors.initials: L
authors.lastname: Sharp
authors.forename: Göran
authors.initials: G
authors.lastname: Laurell
mesh_terms: D000368:Aged; D003679:Deglutition; D003680:Deglutition Disorders / Q000209:etiology / Q000517:prevention & control*; D005081:Exercise Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000534:rehabilitation*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D011878:Radiotherapy / Q000009:adverse effects; D012648:Self Care / Q000379:methods*; D013064:Speech Disorders; D014313:Trismus / Q000209:etiology / Q000517:prevention & control*; D015431:Weight Loss