Exercise After Radiation for Head & Neck Cancer
Klíčová slova
Abstraktní
Popis
Background and Rationale
Patients who receive radiation therapy for head and neck cancer treatment are susceptible to side-effects such as a significant loss in body mass and a loss of muscle mass (cancer cachexia) compared to pre-treatment. In addition, radiation therapy treatment may cause cancer-related fatigue and a reduction in overall physical function and health-related quality of life. Some research has shown success in the use of generic (dynamic exercise) resistance training interventions when applied for head and neck cancer survivors. Typically, when the correct training principals are adhered to in healthy populations (i.e. progressive overload, specificity, variation, rest/recovery), muscle strength and muscle mass are effectively enhanced. However, these training variables may be less effective in eliciting positive outcomes in clinical populations in that they are less effective in increasing muscle mass and muscle strength. Exercise is beneficial for people affected by all cancer types, but resistance training may be particularly beneficial for people who have completed radiation therapy treatment for head and neck cancer. Alternative modalities may provide superior improvements in muscle strength and muscle mass. Therefore, further research is warranted to investigate optimized resistance training prescription in head and neck cancer patients.
Research Question & Objectives
The primary aim of this research is to investigate the effect of conventional resistance training vs. an experimental intervention (electromyostimulation combined with accentuated eccentric loading) on muscle strength and muscle mass after radiation for HNC.
Methods
Head and neck cancer survivors who have completed radiation therapy ≥ 1 month and ≤ 1 year from enrollment will be randomly allocated to one of two treatment arms: conventional (active control) and accentuated eccentric loading + electromyostimulation. Participants will be assessed before and after the intervention for patient-reported outcomes, neuromuscular function and fatigability in response to whole-body exercise.
Termíny
| Poslední ověření: | 06/30/2019 |
| První předloženo: | 07/04/2019 |
| Odhadovaná registrace vložena: | 07/04/2019 |
| První zveřejnění: | 07/08/2019 |
| Poslední aktualizace byla odeslána: | 07/08/2019 |
| Poslední aktualizace zveřejněna: | 07/10/2019 |
| Aktuální datum zahájení studie: | 03/30/2017 |
| Odhadované datum dokončení primární: | 06/25/2019 |
| Odhadované datum dokončení studie: | 06/25/2020 |
Stav nebo nemoc
Intervence / léčba
Behavioral: Accentuated eccentric loading + electromyostimulation
Behavioral: Traditional resistance training
Fáze
Skupiny zbraní
| Paže | Intervence / léčba |
|---|---|
| Experimental: Accentuated eccentric loading + electromyostimulation This group will undertake a supervised 12-week intervention involving accentuated eccentric loading and electromyostimulation of the knee extensors, dynamic resistance training of lower limb antagonist and synergist muscles and upper limb dynamic resistance training. | Behavioral: Accentuated eccentric loading + electromyostimulation An innovative training intervention to optimize muscle strength and muscle mass |
| Active Comparator: Traditional resistance training This group with undertake a supervised 12-week intervention involving volume matched dynamic resistance training of the knee extensors, and dynamic resistance training of lower limb antagonist and synergist muscles and upper limb dynamic resistance training. | Behavioral: Traditional resistance training A conventional approach to resistance training |
Kritéria způsobilosti
| Věky způsobilé ke studiu | 18 Years Na 18 Years |
| Pohlaví způsobilá ke studiu | All |
| Přijímá zdravé dobrovolníky | Ano |
| Kritéria | Inclusion Criteria: - a verified clinical diagnosis of head and neck cancer (stage I-IV) with the primary tumor in the oral cavity, pharynx, larynx, paranasal sinuses, or salivary glands. - received radiation therapy ± concomitant chemotherapy - able to walk without assistance - received Canadian Society for Exercise Physiology-Certified Exercise Physiologist (CSEP-CEP) approval via The Physical Activity Readiness Questionnaire for Everyone (PAR-Q+) and/or physician approval - willing/able to travel to the University of Calgary (Calgary, AB). Exclusion Criteria: - comorbidities that could confound the ability to participate in laboratory tests (e.g. other malignancies, neuromuscular, musculoskeletal or vascular conditions affecting the lower extremities, such as radiculopathy or myopathy, (where the research team were consulted for individual cases) - presence of a percutaneous endoscopic gastrostomy - unable to follow verbal instructions in English |
Výsledek
Primární výsledná opatření
1. Maximal Isometric Force in the Knee Extensors [Baseline and after the 12-week intervention]
2. Assessment of change in Muscle Cross-Sectional Area [Baseline and after the 12-week intervention]
Měření sekundárních výsledků
1. Assessment of change in the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) Scale [Baseline to after the 12-week intervention, at 6 month and 12 month follow up]
2. Assessment of change in the Functional Assessment of Chronic Therapy - Head and Neck (FACT-H&N) Scale [Baseline to after the 12-week intervention, at 6 month and 12 month follow up]
3. Voluntary Activation [Baseline and after the 12-week intervention]
4. Potentiated Twitch Force [Baseline and after the 12-week intervention]
5. Muscle Compound Action Potential (M-Wave) Peak-to Peak Amplitude [Baseline and after the 12-week intervention]
6. Voluntary Electromyography (EMG) [Baseline and after the 12-week intervention]
7. Time to volitional exhaustion [Baseline and after the 12-week intervention]
8. Body mass (kg) [Baseline and after the 12-week intervention]
9. Estimated body fat % [Baseline and after the 12-week intervention]
10. Body mass index [Baseline and after the 12-week intervention]
