Feasibility of eccentric overloading and neuromuscular electrical stimulation to improve muscle strength and muscle mass after treatment for head and neck cancer

Role of Prehabilitation and Rehabilitation on Functional Recovery and Quality of Life in Thyroid Cancer Patients: A Comprehensive Review

BACKGROUND

This narrative review aims to provide a comprehensive overview of the current prehabilitation and rehabilitation strategies for thyroid cancer survivors to optimize functional outcomes and enhance their quality of life.

METHODS

The review follows the SANRA quality criteria and includes an extensive literature search conducted in PubMed/Medline, Web of Science, and Scopus.

RESULTS

The review emphasizes the role of a comprehensive rehabilitation approach in targeting the different domains that generate disability in thyroid cancer patients. In this context, physical activity, range of motion exercises, myofascial release, joint mobilization, and postural exercises are crucial for improving functional outcomes and reducing treatment-related discomfort and disability. Moreover, tailored rehabilitative management addressing dysphonia and dysphagia might have a positive impact on the quality of life of these patients. Despite these considerations, several barriers still affect the implementation of a multimodal rehabilitative approach in common clinical practice. Thus, sustainable and effective strategies like digital innovation and patient-centered approaches are strongly needed in order to implement the rehabilitative treatment framework of these subjects.

CONCLUSIONS

This narrative review provides valuable insights into the current prehabilitation and rehabilitation strategies to treat thyroid cancer survivors, addressing physical, psychological, and vocational needs to optimize functional outcomes and enhance their quality of life.

An Overview on the Evidence of Physical Activity Interventions in the Health of Individuals with Head and Neck Cancer: Literature Systematic Review

Introduction: Head and neck cancer is considered a global public health problem, which arises in aesthetically and functionally critical areas. The practice of physical exercise has been considered one of the significant and effective non-pharmacological strategies to minimize the physical and psychological consequences. Objective: To analyze the evidence of physical activity interventions in the physical and psychological health of individuals with head and neck cancer. Method: A systematic review was conducted blindly and independently, from March to May 2021, according to the PRISMA guidelines. The search was performed in the following databases: PubMed Central®; Cochrane Library; Web of Science, Scopus, ScienceDirect. Results: Of the 515 selected studies, 15 were included in this systematic review with a total of 670 participants aged between 18 and 76 years old. The studies included aerobic exercises, endurance, mobility, stretching, strengthening, and yoga. Conclusion: Evidence proves that physical activity interventions performed with individuals with head and neck cancer may be beneficial in the treatment and physical/psychological health of this population. This study may help new researches considering the detailed information described previously regarding the interventions applied, in addition to discussing the most used instruments with this public and indicating the modalities that are being safely performed. It is suggested that more randomized trials be conducted to obtain more concise results.

Fatigue, physical activity and quality of life in people self-reporting symptoms of chronic venous disease

OBJECTIVE

The aim of this study was to quantify fatigue and quality of life (QoL) in people self-reporting chronic venous disease (CVD) symptoms or at risk of CVD within a large cohort representative of the French population. The relationship between self-reported physical activity and both fatigue and QoL was also investigated. We hypothesised that a greater fatigue and impaired QoL would exist in participants self-reporting CVD symptoms, with the impairments being attenuated in those with greater level of physical activity.

METHODS

Using a web-based, custom and adaptive survey, 3,008 participants were asked to self-report the presence of common symptoms and risk factors of CVD. Fatigue, QoL and physical activity were assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale, the Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ-14) and the Godin-Shepard Leisure-Time Physical Activity Questionnaire (GSLTPAQ), respectively.

RESULTS

32% of the participants were categorized as having CVD symptoms whereas 50% were categorized as at risk of CVD. Fatigue was greater in participants with CVD symptoms than non-CVD participants (p < 0.001), with the score of participants at risk of CVD being intermediate (p ≤ 0.001). QoL was more impaired in participants with CVD symptoms compared to participants at risk of CVD (p < 0.001). In participants with CVD symptoms, there were relationships between fatigue and QoL (p < 0.001) and between physical activity and fatigue (p < 0.001). Despite the relationship between physical activity and QoL not reaching significance (p = 0.067), a lower QoL was found in insufficiently active as compared to active (p < 0.001) and moderately active (p < 0.001) participants with CVD symptoms.

CONCLUSIONS

Participants self-reporting CVD symptoms suffer from greater fatigue and impaired QoL. In this population, a higher level of physical activity is associated with reduced fatigue and a tendency toward improved QoL.

State of Rehabilitation Research in the Head and Neck Cancer Population: Functional Impact vs. Impairment-Focused Outcomes

PURPOSE OF REVIEW

Management of head and neck cancer (HNC) typically involves a morbid combination of surgery, radiation, and systemic therapy. As the number of HNC survivors grows, there is growing interest in rehabilitation strategies to manage HNC-related comorbidity. In this review, we summarize the current state of HNC rehabilitation research.

RECENT FINDINGS

We have organized our review using the World Health Organization's International Classification of Function (ICF) model of impairment, activity, and participation. Specifically, we describe the current research on rehabilitation strategies to prevent and treat impairments including dysphagia, xerostomia, dysgeusia, dysosmia, odynophagia, trismus, first bite syndrome, dysarthria, dysphonia, lymphedema, shoulder syndrome, cervicalgia, cervical dystonia and dropped head syndrome, deconditioning, and fatigue. We also discuss the broader impact of HNC-related impairment by exploring the state of rehabilitation literature on activity, participation, psychosocial distress, and suicidality in HNC survivors. We demonstrate that research in HNC rehabilitation continues to focus primarily on impairment-driven interventions. There remains a dearth of HNC rehabilitation studies directly examining the impact of rehabilitation interventions on outcomes related to activity and participation. More high-quality interventional studies and reviews are needed to guide prevention and treatment of functional loss in HNC survivors.

Output of Electronic Muscle Stimulators: Physical Therapy and Police Models Compared

INTRODUCTION

Both physical therapists and police officers use electrical muscle stimulation. The typical physical therapist unit is attached with adhesive patches while the police models use needle-based electrodes to penetrate clothing. There have been very few papers describing the outputs of these physical therapy EMS (electrical muscle stimulator) units.

METHODS

We purchased 6 TENS/EMS units at retail and tested them with loads of 500 Ω, 2 kΩ, and 10 kΩ.

RESULTS

For the typical impedance of 500 Ω, the EMS units delivered the most current followed by the electrical weapons; TENS units delivered the least current. At higher im-pedances (> 2 kΩ) the electrical weapons delivered more current than the EMS units, which is explained by the higher voltage-compliance of their circuits. Some multi channel EMS units deliver more calculated muscle stimula tion than the multi-channel weapons.

CONCLUSION

Present therapeutic electrical muscle stimula-tors can deliver more current than present law-enforcement muscle stimulators.

Effect of Physical Therapy Modalities on Quality of Life of Head and Neck Cancer Survivors: A Systematic Review with Meta-Analysis

The objective was to describe the effectiveness of different physical therapy modalities to improve Quality of Life (QoL) in Head and Neck Cancer (HNC) survivors. PubMed, Scopus, Web of Science, CINAHL and Cochrane Library were searched for randomized clinical controlled trials published until 30 April 2020. Risk of bias assessment and meta-analysis were conducted using the Cochrane tools. A total of 251 records were retrieved, and 10 met the inclusion criteria. Interventions whose parameters focus on a 12-week exercise programs of aerobic activity (walking) or Progressive Resistance Training (PRT) for the whole body are effective and safe modalities improving QoL in HNC survivors. Electrophysical agents did not show significant results between groups. As for the assessment of methodological quality, 4 of the 10 articles included had a high risk of overall bias. Only five articles provided sufficient information to conduct a meta-analysis for exercise program intervention on QoL, showing a tendency in favor of intervention group, even when the global results did not show statistically significant improvements (pooled Cohen's d 0.15; 95% CI: -0.25 to 0.54; I² 45.87%; p heterogeneity = 0.10). The present review and meta-analysis identified meaningful benefits of exercise on QoL of HNC survivors; this has been confirmed in a meta-analysis. This review adds evidence supporting exercise interventions on Head and Neck Cancer population whose opportunities for successful recovery after medical treatment are more limited.