Manual therapy for patients with radiation-associated trismus after head and neck cancer

Trismus is highly prevalent in head and neck cancer survivors. A study at MD Anderson Cancer Center (Houston, TX) found that in survivors of head and neck cancer with radiation-associated trismus manual therapy improved the maximum interincisal opening with a medium to large effect size. The largest increase in oral opening was achieved after the initial treatment and although gains were modest, oral opening continued to improve with serial treatment. Covariates werd not associated with response, suggesting that patients with clinical features often considered treatment refractory (eg, advanced disease, multiple lines of oncology treatment, ≥ 5 years posttreatment) may benefit from manual therapy. Manual therapy may be a beneficial frontline or adjuvant treatment when combined with traditional stretching therapy.