Effectiveness of exercise-based rehabilitation on functional capacity and quality of life in head and neck cancer patients receiving chemo-radiotherapy

Abstract

Background & objectives:Patients with head and neck cancer (HNC) undergoing chemoradiotherapy (CRT) suffer from fatigue causing a decrease in functional capacity and quality of life (QoL). Limited research in the field of exercise training among these patients demanded the need for this study to assess the effects of exercise training on functional capacity and quality of life.Methods:A randomized controlled trial was conducted on 48 patients with HNC undergoing CRT. The exercise group received an individually tailored, supervised, exercise programme for six weeks, while the control group did not receive any form of exercise. Functional capacity and QoL were assessed at baseline and at the end of the intervention using the six minute walk distance (6MWD) and medical outcomes survey short form 36 (SF 36).Results:The mean age of patients was 52 yr with 42 males. After six weeks, the 6MWD improved by 42 metres (P<0.05) in the exercise group while the control group showed a decrease by 96 metres (P<0.001). There was an improvement on the mental component score (MCS) of SF36 for the exercise group (4.8; P<0.05) and the physical component score (PCS) remained almost the same, while a decrease in PCS and MCS was seen in the control group (-5.9; P=0.064 and -17.3; P<0.05). When 6MWD and SF36 were compared between the groups, there was a statistically significant difference (P<0.001) seen after six weeks.Interpretation & conclusions:Our results showed that the functional capacity and QoL decreased among those not receiving a supervised exercise program, while exercise training improved functional capacity and QoL in HNC patients undergoing CRT.

Physical rehabilitation in patients with head and neck cancer: Impact on health‐related quality of life and suitability of a post‐treatment program

“…The future RCT should probably include a combination of physical exercise and nutritional support initiated before start of tumor directed treatment with continuation during treatment and into the post‐treatment recovery phase compared to a usual care group. To our knowledge, the largest RCT that has investigated the effectiveness of a physical exercise program in patients with HNC undergoing chemoradiotherapy was recently published by Samuel et al, and conclude that physical exercise during treatment has the potential to enhance HRQoL . They studied the effect of an 11‐week program with aerobic and resistance training exercises on quality of life (using the generic Short Form‐36), functional capacity, and worsening of fatigue.…”

Progressive resistance training in head and neck cancer patients undergoing concomitant chemoradiotherapy

“…We hypothesized that moving PRT forward, concurrent with treatment, may attenuate the deterioration experienced during treatment and facilitate quicker recovery. A few studies have investigated exercise training in HNSCC patients concurrent with treatment . However, these trials are heterogeneous with regard to several variables such as patient group (radiotherapy treated only, CCRT, or mixed), intervention (type, frequency, and intensity), and outcome measures (e.g., feasibility, QoL, functional performance, fatigue) making them nearly impossible to compare, let alone extend the results and conclude on the feasibility of a different program in another clinical setting.…”

“…A few studies have investigated exercise training in HNSCC patients concurrent with treatment. [18][19][20][21] However, these trials are heterogeneous with regard to several variables such as patient group (radiotherapy treated only, CCRT, or mixed), intervention (type, frequency, and intensity), and outcome measures (e.g., feasibility, QoL, functional performance, fatigue) making them nearly impossible to compare, let alone extend the results and conclude on the feasibility of a different program in another clinical setting. Thus, before launching a larger clinical trial, we decided to conduct a pilot study testing the feasibility of the program.…”

“…In head and neck cancer patients, exercise trials studying training intervention during radiotherapy or CCRT are sparse but have been gaining ground and some studies have been published whilst this study was conducted . The trials all differ in type of intervention, intensity, frequency, as well as outcome measures.…”

“…17 In head and neck cancer patients, exercise trials studying training intervention during radiotherapy or CCRT are sparse but have been gaining ground and some studies have been published whilst this study was conducted. [18][19][20][21] The trials all differ in type of intervention, intensity, frequency, as well as outcome measures. But across these studies, changes in muscle strength, mobility, physical activity, fatigue, diet, and QoL endpoints in favor of the training intervention group are reported.…”