Online Supplement 2.The Allied Health Disciplines’modules as applied in the HNR program in this study.

Abbreviations: Nt- Nutritionist; OT- Occupational Therapist; PT – Physical Therapist; SLP – Speech Language Pathologist; SW – Social Worker; ADL – Activities of Daily living; NAIM – Nasal Airflow- Inducing Maneuver; SMART – Specific, Measurable, Assignable, Realistic, Time-related, ICF – International Classification of Functioning Disability and Health

Nt Modules / Target problem /symptom / ICF code1 / Intervention / Intended global outcome2
Feeding tube / Functions related to ingestion. Severe functional swallowing problems due to alterations in the structure of the mouth, pharynx, larynx. / B510 Ingestion functions
B5105 Swallowing functions
S320 Structure of the mouth
S330 Structure of the pharynx
S340 Structure of the larynx
D550 Eating
D560 Drinking / Nutritional advice on using tube feeding. Determining type and quantity of tube feeding. / Obtaining and maintaining adequate nutritional status.
Weight monitoring / Functions related to ingestion functions. Self-care related to eating and drinking. / B510 Ingestion functions
B5105 Swallowing functions
S320 Structure of the mouth
S330 Structure of the pharynx
S340 Structure of the larynx
D550 Eating
D560 Drinking / Structured weight monitoring. General advice and nutritional advice based on patient symptoms and nutritional history. / Obtaining and maintaining adequate nutritional status.
Prevention of weight loss.
Additional Nutrition / Functions related to ingestion. Swallowing problems due to alterations in the structure of the mouth, pharynx, larynx. Self-care related to eating and drinking. / B510 Ingestion functions
B5105 Swallowing functions
S320 Structure of the mouth
S330 Structure of the pharynx
S340 Structure of the larynx
D550 Eating
D560 Drinking / Specific nutritional advice on complementary nutritional drinks. Determining type and quantity of additional nutritional drinks. / Obtaining and maintaining adequate nutritional status.
Prevention of weight loss.
Nutritional advice / Functions related to ingestion functions. Self-care related to eating and drinking. / B510 Ingestion functions
B5105 Swallowing functions
S320 Structure of the mouth
S330 Structure of the pharynx
S340 Structure of the larynx
D550 Eating
D560 Drinking / General advice and nutritional advice based on patient symptoms and nutritional history. / Obtaining and maintaining adequate nutritional status.
OT Modules / Target problem/symptom / ICF code1 / Intervention / Intended global outcome2
Daily functioning / Limitations in ADL due to mental functions, or due to pain and functions related to movement in the head and neck region. Restrictions in activities and participation in community, social, domestic and civic life. / B1 Mental functions
B280 Sensation of pain
D4 Mobility
D5 Self-care
D6 Domestic life / Health-counseling, adjustments in daily activities, providing self-management strategies. Body protecting principles and ergonomics in activities of daily living. / Optimal daily functioning. Increased activity level. Effective coping with physical and cognitive impairments. Improved self-management.
Return to work / Problems with or support needed with work and employment. / D850-855 Employment
D9 Community, social and civic life
E3 Support and relationships / Health-counseling, return-to-work schedule, providing self-management strategies, work-related advice on ergonomics. / Obtaining and/ or maintaining employment. Adjusting work-related activities to alterations in body structure and functioning.
Energy conservation / Limitations in activities and participation in community, social, domestic and civic life. / B2552 Fatigue ability
D6 Domestic life
D9 Community, social and civic life / Health-counseling, motivational interviewing, advice on alternative action strategies. / Obtaining optimal daily functioning. Increased energy level. Effective coping with fatigue related impairments.
PT Modules / Target problem /symptom / ICF code1 / Intervention / Intended global outcome2
Preventive shoulder rehabilitation / High risk profile for shoulder pain and disability after neck dissection, as indicated by e.g. scapular instability / S710 Structure of the head and neck region
S720 Structure of the shoulder region
B2801 Pain in bodypart
B710 Mobility of joint functions
B715 Stability of joint functions / Progressive Resistance training, education on risk reducing behavior and advice on movement strategies that protect the shoulder in ADL. / Low risk profile for shoulder pain and disability, optimal functioning of the shoulder in ADL
Curative shoulder rehabilitation / Present shoulder pain and/ or -disability after neck dissection, interfering with activities of daily living / S710 Structure of the head and neck region
S720 Structure of the shoulder region
B2801 Pain in bodypart
B710 Mobility of joint functions
B715 Stability of joint functions
D5 Self-care
D6 Domestic life
D9 Community, social and civic life
D850-855 Employment / Progressive resistance exercise therapy, mobilizing exercises, education, and practicing movement strategies that protect the shoulder in ADL / Improved shoulder function, reduced pain and disability in specific areas of ADL
Exercise tolerance / Limited exercise tolerance (aerobic capacity/ muscle power/ flexibility/ coordination), resulting in disability in ADL / B455 Exercise tolerance functions
B4550 General physical endurance
B4551 Aerobic capacity
B730 Muscle power functions D400 Mobility
D5 Self-care
D6 Domestic life
D920 Recreation and Leisure / Circuit training aimed at improving aerobic capacity, muscle power, coordination, agility and flexibility, related to target activities. Practicing functional movements related to ADL.
Behavioral components to reinforce exercise behavior. / Reduction in specific ADL limitations, gaining (more) active lifestyle, improve overall exercise tolerance, improve exercise-self efficacy.
Lymphedema / Impairments in structure of the skin and function of the lymphatic system / S810 Structure areas of the skin B4352-4353 Functions of lymphatic system
D400 Mobility
D5 Self-care
D6 Domestic life / Manual lymph drainage, exercise, compression, lymph taping, self-management skills, education. / Reduction of swelling, improvement of tissue compliance, reduction of symptom burden, improvement of self-management skills and knowledge.
SLP Modules / Target problem /symptom / ICF code1 / Intervention / Intended global outcome2
Voice and speech rehabilitation / Impaired voice and speech functions. Structure of the mouth, nose, pharynx and larynx. Communication problems. / B310 Voice functions
B320 Articulation functions
S320 Structure of the mouth
S330 Structure of the pharynx
S340 Structure of the larynx
D330 Speaking / Breathing exercises. Vocal training. Articulation exercises. Tongue exercises. Communication options. Speech rehabilitation after a total laryngectomy. / Improved voice and/or speech quality. Improved tongue mobility and function. Improved communication.
Swallowing rehabilitation / Structure of the mouth, pharynx and larynx Eating and drinking. / B5105 Swallowing
S320 Structure of the mouth
S330 Structure of the pharynx
S340 Structure of the larynx
D550 Eating
D560 Drinking / Swallowing exercises. Compensatory techniques. Advice on a safe oral intake. Advice on nutritional consistencies. / Improved swallowing function. Reduced aspiration risk.
Obtaining and maintaining an optimal and safe oral intake.
Smell rehabilitation / Structure of the Larynx, loss of smell after a total laryngectomy. / S340 Structure of the larynx
B1562 Olfactory perception / Olfaction rehabilitation by using the NAIM technique. Manometer for visual feedback. Transfer to daily life. / Restoring and maintaining olfactory function.
Trismus treatment / Limited mouth opening due to
impairments in structure of the mouth and/or jaw, or related to muscle tone or power functions. / S320 Structure of the mouth
B280 Sensation of pain
D330 Speaking
D5201 Caring for teeth
D550 Eating / Mouth opening exercises. Advice on pain and oral hygiene. / Increased mouth opening. Reduction of pain. Increased oral hygiene/oral intake. Improved communication
Hearing training/advice / Hearing function. / B230 Hearing function
D115 Listening
D310 Communicating with - receiving - spoken messages / Hearing test. Advice on communication in daily life. Hearing aid. / Improved communication in daily life.
SW Modules / Target problem /symptom / ICF code / Intervention / Intended global outcome*
Guidance coping& adjustment / High levels of distress, ineffective coping, and/ or limitations related to e.g. handling stress and other psychological demands, anxiety, communication, or non-helping illness beliefs. / B250 Emotional functions.
B1602 Content of thought
B162 Temperament and personality functions
D240 Handling stress and other psychological demands / Psycho-education and coaching / Diminished distress and/or anxiety, effective coping, improved self-management and/ or communication.

1 Patient specific outcome goals are formulated in SMART terms, relating to personal rehabilitation needs and objectives.