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Felser S, Rogahn J, Glass Ä, Bonke LA, Strüder DF, Stolle J, Schulze S, Blaurock M, Kriesen U, Junghanss C, Grosse-Thie C. Feasibility of individualized home exercise programs for patients with head and neck cancer-study protocol and first results of a multicentre single-arm intervention trial (OSHO #94). PLoS One 2024; 19:e0301304. [PMID: 39173016 PMCID: PMC11341025 DOI: 10.1371/journal.pone.0301304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 07/23/2024] [Indexed: 08/24/2024] Open
Abstract
INTRODUCTION Patients with head and neck cancer (PwHNC) benefit from targeted exercise interventions: symptom relief, compensation for dysfunction, improvement in quality of life (QoL). Data on acceptance physical interventions in PwHNC are rare. The 'OSHO #94' trial investigates the short- and medium-term effects of individualized home exercise in PwHNC on QoL, physical activity and functionality. The study includes a feasibility phase (proof of concept) in order to evaluate the acceptance. Here we present the study protocol as well as the feasibility results. METHODS AND ANALYSIS This prospective, multicentre, single-arm intervention study includes PwHNC ≥18 years of age in aftercare or palliative care with stable remission under immunotherapy. The study opened in January 01, 2021, with estimated completion by December 31, 2024. The PwHNC receive an individualized home exercise program consisting of mobilization, coordination, strengthening and stretching exercises. This should be carried out at least three times a week over 12 weeks for 15 to 30 minutes, supplemented by aerobic training two to three times a week for 30 minutes (intervention). Once weekly telephone calls with a physiotherapist are performed. Subsequently, there is a 12-week follow-up (FU) without exercise specifications/contact. Outcomes are measured before and after the intervention and following the FU. Primary outcome of the feasibility phase (n = 25) was the determination of the dropout rate during the intervention with a termination cut off if more than 30% PwHNC withdrew premature. The primary outcome of the OSHO #94' trial (N = 53) is the change in global QoL score from pre- to post-intervention (EORTC QLQ-C30). Secondary outcomes include clinical and patient-reported measures, training details as well as functional diagnostic data (e.g. level of physical activity, training frequency, flexibility, fall risk and aerobic performance). RESULTS 25 PwHNC were enrolled onto the feasibility cohort. Only16% (4/25 patients) did not complete the study. Therefore, recruitment of PwHNC was continued. The dropout rate was adjusted from 30% (N = 60) to 20% (N = 53, calculated sample size n = 42 PwHNC and 20% (n = 11) to dropout). CONCLUSIONS Individualized home exercise programs in PwHNC in aftercare seem feasible. Consequently, the aim is now to evaluate the short and medium-term effects of individualized home exercise.
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Affiliation(s)
- Sabine Felser
- Department of Internal Medicine, Clinic III–Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Julia Rogahn
- Department of Internal Medicine, Clinic III–Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Änne Glass
- Institute of Biostatistics and Informatics in Medicine, Rostock University Medical Center, Rostock, Germany
| | - Lars Arne Bonke
- Department of Internal Medicine, Clinic III–Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Daniel Fabian Strüder
- Department of Otorhinolaryngology, Head and Neck Surgery "Otto Koerner", Rostock University Medical Center, Rostock, Germany
| | - Jana Stolle
- Krukenberg Cancer Center Halle, University Hospital Halle, Halle (Saale), Germany
| | - Susann Schulze
- Krukenberg Cancer Center Halle, University Hospital Halle, Halle (Saale), Germany
- Department of Internal Medicine, Medical Clinic II, Carl-von-Basedow-Klinikum, Merseburg, Germany
| | - Markus Blaurock
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Ursula Kriesen
- Department of Internal Medicine, Clinic III–Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Christian Junghanss
- Department of Internal Medicine, Clinic III–Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Christina Grosse-Thie
- Department of Internal Medicine, Clinic III–Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
- Hematology and Oncology Practice, Rostock, Germany
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Nayak SG, George A, Sharan K, Nayak BS, Ravishankar N. Effectiveness of Comprehensive Intervention Programme on Quality of life, fatigue, self-efficacy, and psychosocial distress among head and neck cancer patients receiving radiotherapy. Support Care Cancer 2024; 32:216. [PMID: 38448712 PMCID: PMC10917822 DOI: 10.1007/s00520-024-08381-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/12/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE The study aimed at evaluating the Effectiveness of Comprehensive Intervention Programme (CIP) on Quality of life (QOL), fatigue, self-efficacy, and psychosocial distress among Head and Neck Cancer (HNC) patients receiving radiotherapy treatment. METHODS Single-centre non-RCT time series study was conducted among 134 HNC patients (67 observed, followed by 67 subjected to CIP). FACT- H&N, FACT-F, Cancer Behavior Inventory and psychosocial distress scales were used to assess QOL, fatigue, self-efficacy, and psychosocial distress respectively. CIP was provided to the intervention arm twice a week during the course of radiation therapy along with the standard care; the control arm received only standard care. Data were collected before commencing radiotherapy, and post-test assessments were carried out at the end of radiotherapy treatment, and at 3 and 6 months after completion of radiotherapy. RESULTS Repeated measures ANOVA revealed a statistically significant improvement with CIP in QOL (F (1.917) = 454.103, p = 0.001), fatigue (F (2.106) = 183.775, p = 0.001), self-efficacy (F (2.429) = 190.861, p = 0.001), and psychosocial distress (F (2.288) = 290.105, p = 0.001) in the intervention arm. CONCLUSION The CIP implemented to address multitude of issues in HNC patients receiving radiotherapy, proved to be effective in reducing the impact of treatment on QOL, fatigue, self-efficacy and psychosocial distress in HNC patients receiving radiotherapy.
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Affiliation(s)
- Shalini Ganesh Nayak
- Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anice George
- Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Krishna Sharan
- Radiotherapy & Oncology, KS Hegde Medical Academy, Nitte (Deemed to Be University), Mangalore, Karnataka, India
| | - Baby S Nayak
- Department of Child Health Nursing Manipal College of Nursing Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - N Ravishankar
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, India
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Tuomi L, Magnusson-Sandkvist J, Fridolfsson J, Arvidsson D, Börjesson M, Finizia C. A pilot study using pre-treatment physical activity level to predict long-term health-related quality of life in patients with head and neck cancer. Head Neck 2023; 45:1288-1298. [PMID: 36912147 DOI: 10.1002/hed.27345] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 02/23/2023] [Accepted: 03/02/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Pre-treatment levels of physical activity (PA) in head and neck cancer (HNC) are rarely evaluated using accelerometry. This study aimed to investigate whether pre-treatment PA level in HNC predicts aspects of long-term health-related quality of life (HRQL) at 12 months after end of treatment. METHODS This pilot study included 48 patients diagnosed with HNC, 41 participants remaining at 12 months post-treatment. Pre-treatment PA was objectively assessed by an accelerometer. Self-perceived PA and HRQL were assessed pre-treatment and at 6- and 12-months post-treatment. RESULTS Patients with a higher pre-treatment PA level scored higher on physical function and role function and less fatigue and pain at the 12 months follow-up compared to patients with a lower pre-treatment PA. At 6 months the groups differed only on physical functioning. When comparing changes over time, there were statistically significant differences comparing high and low pre-treatment PA in the fatigue and pain domains between 6 and 12 months. Exploratory multiple regression analyses also indicated that higher pre-treatment PA levels were associated with greater favorable change in the four HRQL measures. CONCLUSIONS Higher levels of PA assessed with accelerometer before oncologic treatment associated favorably with aspects of self-perceived HRQL and PA over time in patients with HNC.
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Affiliation(s)
- Lisa Tuomi
- Department of Otorhinolaryngology - Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Otorhinolaryngology - Head and Neck Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Julia Magnusson-Sandkvist
- Department of Otorhinolaryngology - Head and Neck Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jonatan Fridolfsson
- Center for Health and Performance, Department of Food and Nutrition, and Sports Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden
| | - Daniel Arvidsson
- Center for Health and Performance, Department of Food and Nutrition, and Sports Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden
| | - Mats Börjesson
- Center for Health and Performance, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medicine, Geriatric and Acute Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Caterina Finizia
- Department of Otorhinolaryngology - Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Otorhinolaryngology - Head and Neck Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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Ning Y, Wang Q, Ding Y, Zhao W, Jia Z, Wang B. Barriers and facilitators to physical activity participation in patients with head and neck cancer: a scoping review. Support Care Cancer 2022; 30:4591-4601. [PMID: 35032199 DOI: 10.1007/s00520-022-06812-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/03/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Patients with head and neck cancer (HNC) usually experienced disfigurement, dysfunction, and psychosocial distress, leading to a decline in their quality of life. Physical activity (PA) is recommended for such patients. Despite the proven benefits of participating in PA, the compliance of patients with HNC is still poor. Hence, the factors influencing PA participation and adherence in patients with HNC need to be explored. OBJECTIVES This study aimed to (1) identify barriers and enablers of PA in adult patients living with HNC and (2) map barriers and facilitators to the Capability-Opportunity-Motivation-Behavior (COM-B) model. ELIGIBILITY CRITERIA Types of studies: Studies with qualitative, quantitative, and mixed designs were included in this review. TYPES OF PARTICIPANTS The current review takes into account patients with HNC aged 18 years or above. Types of interventions: This review considered all studies focusing on full-body PA. TYPES OF OUTCOMES This scoping review focused on studies examining health behavior, patients' compliance, and facilitators and/or barriers to PA engagement. Five databases (Ovid Medline, Ovid Embase, CINAHL, Cochrane Library, and PsycINFO) were searched following the methodology for scoping reviews from inception to July 2021. DATA EXTRACTION The extracted data included author(s)/year of publication, country, main purpose of the study, sample size/disease site and stage, methodology and methods, type of treatment, and main findings/barriers, or facilitators. RESULTS A total of 22 studies were finally selected. The top three barriers were physical-related issues, time pressures, and low motivation or interest. Most facilitators included perceived psychological, health, and social benefits and preference for the model of PA. The most frequent COM-B model components were physical capability, automatic motivation, and physical opportunity. CONCLUSIONS Patients with HNC have unique facilitators and barriers to participating in PA. Interventions must leverage facilitators and limit barriers to exercise so as to increase compliance with exercise. Future studies should test the effectiveness of behavioral change measures based on the factors influencing the COM-B model.
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Affiliation(s)
- Yan Ning
- Nursing College of Shanxi Medical University, Taiyuan, 030001, China
| | - Qian Wang
- Nursing College of Shanxi Medical University, Taiyuan, 030001, China
| | - Yongxia Ding
- Nursing College of Shanxi Medical University, Taiyuan, 030001, China.,Shanxi Key Laboratory of Otolaryngology, Head and Neck Cancer, First Hospital of Shanxi Medical University, No.85, Jiefang Road South, Shanxi, Taiyuan, 030001, China
| | - Wenting Zhao
- Nursing College of Shanxi Medical University, Taiyuan, 030001, China
| | - Zehuan Jia
- Nursing College of Shanxi Medical University, Taiyuan, 030001, China
| | - Binquan Wang
- Nursing College of Shanxi Medical University, Taiyuan, 030001, China. .,Shanxi Key Laboratory of Otolaryngology, Head and Neck Cancer, First Hospital of Shanxi Medical University, No.85, Jiefang Road South, Shanxi, Taiyuan, 030001, China. .,Department of Otolaryngology, Head and Neck Surgery, The First Hospital of Shanxi Medical University, No.85, Jiefang Road South, Taiyuan, 030001, Shanxi, China. .,Research Center for Precision Medicine of Head and Neck Cancer, First Hospital of Shanxi Medical University, Taiyuan, 030001, China.
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