Purpose: Expiratory muscle strength training (EMST) is a non-invasive, low cost, evidence-based treatment that improves swallowing in head and neck cancer (HNC) survivors. EMST is traditionally delivered in-person with a speech pathologist. This requires significant clinician time and travel burden and costs for clients. This implementation study evaluated the effectiveness, acceptability and feasibility of a new student-led telehealth EMST program for HNC survivors.
Methodology: HNC survivors (n = 13) completed 8 weeks of EMST via telehealth with supervised speech pathology students (n = 13). Pre-and post-treatment measures of swallowing and quality of life (SwalQoL) were recorded as well as participant and student satisfaction. Feasibility (i.e., technical issues and session duration) was monitored weekly. All data was collected using REDCap and analysed using descriptive and non-parametric statistics.
Results: Following the 104 EMST sessions, participants strongly agreed 80.8% (n = 84) they were satisfied, and their expectations had been met 79.8% (n = 83). Following the block of therapy, 77% (n = 10) of participants agreed or strongly agreed that telehealth was more convenient and less disruptive to daily activities than if done in-person.
Technical issues occurred in 20% of sessions and un-planned student support from clinical educators occurred in 15% of sessions. The average duration of initial sessions was 44 minutes with the remaining weekly sessions taking an average of 27 minutes.
Conclusion: This new model of dysphagia telerehabilitation for HNC survivors was acceptable and feasible. These preliminary findings support scalability and monitoring of the program in the healthcare system.

1. Impact of Head and Neck Cancer (HNC) to swallowing function
2. Benefit of expiratory muscle strength training (EMST) for HNC survivors
3. Effectiveness of using student-led telerehabilitation to deliver EMST