Effects of exercise prehabilitation on functional capacity and health-related quality of life in head and neck cancer patients: Preliminary results of the FIT4TREAT trial
DOI:
https://doi.org/10.6063/motricidade.31672Keywords:
Head and neck cancer, exercise, prehabilitationAbstract
Head and neck cancer (HNC) patients submitted to radical chemoradiotherapy (CRT) have to deal with various physical and psychosocial problems related to cancer and its treatment, which negatively affect functional capacity and health-related quality of life (HRQoL). Thus, the aim of this work was to analyse the impact of an exercise prehabilitation (EP) program on the functional capacity and HRQoL in HNC patients. In this randomised-controlled trial (NCT05418842), 30 HNC patients proposed for radical CRT were randomly allocated to EP or usual care (UC) group. The EP group participated in an exercise program composed of a combined aerobic and resistance training program (60 minutes), three sessions/week, from randomisation to the beginning of radiotherapy (RT). Aerobic capacity (6-minute walk test, 6MWT), isometric handgrip muscle strength (dynamometer), lower limb functional capacity (30 seconds chair sit-to-stand test, STS) and HRQoL (EORTC QLQ-C30 and EORTC QLQ-HN43) were assessed at diagnosis (baseline, M0), and 1-3 days before starting RT (M1). Twenty-six patients completed both pre-treatment assessments, 12 in the EP (61.8±8.4 years, 91.7% men) and 14 in the UC (66.1±9.9 years, 92.9% men) group. The median length of the pre-treatment phase was 28 days (IQR, 24-28 days) and 29 days (IQR, 22-32 days) in EP and UC groups (p=0.786), respectively. Patients adhered on average to 66.3±34.9% of exercise sessions. No differences between groups were observed in any variable at baseline (M0). The 30 seconds STS performance improved with the EP program and remained unchanged in the UC group (EP: Δ4.4±4.6 vs UC: Δ0.1±2.5 repetitions, p=0.007). No differences between groups were observed for the change in the 6MWT (p=0.162); handgrip muscle strength (dominant hand: p=0.819; non-dominant hand, p=0.964); or any domain of HRQoL, except for body image (p=0.020) and dry mouth and sticky saliva (p=0.020) favouring the EP group. In the per-protocol analysis (i.e., adherence ≥80% of planned exercise sessions), changes in 30 seconds STS test remained significant (EP: Δ7.2±2.9 vs UC: Δ0.1±2.5 repetitions, p=0.009) while the 6MWT improved as compared in EP as compared to the UC group (EP: Δ44.7±31.5 vs UC: Δ-5.9±36.0 meters, p<0.001). No serious adverse events related to exercise were reported in the EP group. These preliminary results suggest that EP is safe and improves lower limb functionality, body image, and dry mouth and sticky saliva domains of HRQoL in HNC patients. The benefits of the 6MWT performance appear limited to those with good adherence to the planned exercise sessions.
Downloads
Published
How to Cite
Issue
Section
License
Authors retain copyright of their work.
Upon acceptance for publication, authors grant Sílabas Didáticas, LDA a non-exclusive licence to publish, reproduce, distribute, communicate the article to the public, and identify itself as the original publisher of the article in print and electronic formats, including its indexing and dissemination through databases, repositories, and other scholarly platforms.
All published articles are made available under the terms of the Creative Commons Attribution–NonCommercial 4.0 International Licence (CC BY-NC 4.0).
This licence permits non-commercial use, sharing, distribution, and reproduction in any medium or format, provided that appropriate credit is given to the original author(s) and to Journal Motricidade, and that any changes made are indicated.
Authors may deposit the final published version of the article (Version of Record) in institutional repositories, subject repositories, academic networks, or personal websites, provided that the original publication is properly cited.
