Tongue pressure, respiratory muscle and limb strength and functional exercise capacity in oesophageal cancer

Objectives: Preoperative management of oesophageal cancer requires effective prehabilitation. This study investigates the relationship between tongue pressure, respiratory muscle, handgrip and lower limb muscle strengths, and functional exercise capacity in patients with oesophageal cancer to develop a novel prehabilitation strategy.

Methods: This prospective, single-centre, observational study analysed data from 29 pretreatment patients with oesophageal cancer. We evaluated tongue pressure, maximal inspiratory and expiratory pressures, handgrip and lower limb muscle strengths, functional exercise capacity and dysphagia scores before treatment. The relationship between parameters was identified using Spearman's correlation analysis.

Results: Maximal inspiratory and expiratory pressures were significantly associated with handgrip and lower extremity muscle strengths and functional exercise capacity. However, tongue pressure was not associated with maximal inspiratory and expiratory pressures, handgrip and lower extremity muscle strengths and functional exercise capacity. Rather, tongue pressure was significantly associated with clinical T, dysphagia and nutritional status scores.

Conclusions: Respiratory muscle strength was associated with conventional sarcopenia and functional exercise capacity. Tongue pressure was not associated with respiratory muscle strength, conventional sarcopenia and functional exercise capacity. Rather, tongue pressure was associated with clinical T, dysphagia and nutritional status scores. Preoperative management of oesophageal cancer requires prehabilitation consisting of exercise and nutritional therapy and an additional swallowing programme, such as tongue resistance training, for patients without progress in oral intake, based on tongue pressure evaluation.