Evaluating Outcomes From a Combined Supervised Therapeutic and Physical Exercise Program for Post-surgical Head and Neck Cancer Survivors: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Functional Assessment of Cancer Therapy: Fatigue Scale Questionnaire
研究概览
简要总结
The investigators will conduct a randomized controlled trial examining 12-week, 24-week and one year outcomes from a combined therapeutic and physical exercise program that aims to bridge head-and-neck cancer survivors from acute care rehabilitation services to community-based exercise programming.
详细描述
Participants will be stratified by early (within 18 months of surgery) and late (> 18 months of surgery) and randomized on a one-on-one basis to (1) a supervised therapeutic exercise program for the neck and shoulder (serving as standard care) or (2) a combined therapeutic and lower body resistance exercise program. The randomization sequence will be generated by staff in the Rehabilitation Research Centre at Corbett Hall and placed in sealed opaque envelopes.
The exercise program will be offered in a group setting. Participants will exercise 2 times per week for a 10-week session and will have the option to continue for an additional 10-week maintenance session. The primary outcome for the study will be quality of life as measured by the Functional Assessment of Cancer Therapy (FACT)-Fatigue Scale at 12-weeks.
At each measurement point following the baseline assessment, including the 12-week and 24-week and one year follow-ups, an Independent Assessor will perform the objective fitness measurements. The Independent Assessor will also administer the Neck Dissection Impairment Questionnaire and the FACT-Fatigue quality of life questionnaires. The Physical Activity Adherence Diary will be collected by a Research Coordinator at each follow-up visit.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Squamous cell carcinoma/ thyroid cancer/ melanoma or lymphoma involving: oral cavity, oropharynx, larynx or hypopharynx, or lymph nodes in the neck region
- •Surgical treatment includes radical neck dissection, modified radical neck dissection and other variants of functional/selective neck dissection OR radiation therapy to lymph node regions
- •Presenting with shoulder and/ or neck dysfunction related to cancer treatment
- •Karnofsky Performance Status greater than or equal to 60%
- •No evidence of residual cancer in the neck and no distant (M0) metastasis. Potential participants with symptoms suggestive of distant metastasis (M1) must have appropriate investigations (e.g. bone scan) to rule these out.
- •Participants must have completed their head and neck/ thyroid/ melanoma/ lymphoma cancer treatment (minimum 4 weeks post treatment)
- •Pre-participation Screening: Prior to participation in the exercise program, potential participants will complete general and cancer-specific Physical Activity Readiness Questionnaires (PAR-Q+) to determine appropriateness for the exercise program. Physician consent and approval for supervised exercise will be required prior to enrollment.
排除标准
- •A participant will be ineligible if they present with medical illness or psychiatric illness, which, in the opinion of the investigators, would impact his/her ability to participate in exercise or interfere with follow-up.
研究组 & 干预措施
Therapeutic Exercise
Therapeutic Exercise Program (standard care) will include:
- Neck range of motion and strengthening, and posture retraining.
- Shoulder specific progressive resistance exercise program that focuses on spinal accessory nerve dysfunction and rehabilitation of trapezius muscle function.
干预措施: Therapeutic Exercise (Behavioral)
Therapeutic + Lower Body Exercise
The Therapeutic Exercise Program (standard care) will include:
- Neck range of motion and strengthening, and posture retraining.
- Shoulder specific progressive resistance exercise program that focuses on spinal accessory nerve dysfunction and rehabilitation of trapezius muscle function.
The Resistance Exercise component will target 6-8 muscle groups of the lower extremities and core including gluteal, quadriceps, hamstrings, abdominals, and gastrocnemius muscles. A progressive introduction of exercises will occur over the first 3 weeks.
- a personalized program of lower extremity resistance exercises
- core strengthening exercises
干预措施: Therapeutic Exercise (Behavioral)
Therapeutic + Lower Body Exercise
The Therapeutic Exercise Program (standard care) will include:
- Neck range of motion and strengthening, and posture retraining.
- Shoulder specific progressive resistance exercise program that focuses on spinal accessory nerve dysfunction and rehabilitation of trapezius muscle function.
The Resistance Exercise component will target 6-8 muscle groups of the lower extremities and core including gluteal, quadriceps, hamstrings, abdominals, and gastrocnemius muscles. A progressive introduction of exercises will occur over the first 3 weeks.
- a personalized program of lower extremity resistance exercises
- core strengthening exercises
干预措施: Therapeutic + Lower Body Exercise (Behavioral)
结局指标
主要结局
Functional Assessment of Cancer Therapy: Fatigue Scale Questionnaire
时间窗: change from baseline to 12 weeks.
Cancer related fatigue
次要结局
- Functional capacity(Change from baseline to 24 weeks.)
- Upper extremity muscular endurance: number of repetitions performed.(baseline, 12-weeks, 24-weeks, one year)
- Lower extremity flexibility in centimetres.(Change from baseline to 12-weeks.)
- Neck Dissection Impairment Index(Change from baseline to one year.)
- 1 repetition maximum leg press in pounds(Change from baseline to 12 weeks.)
- Body mass index(Change from baseline to 24 weeks.)
- 1 repetition maximum chest press in pounds.(Change from baseline to 12 weeks.)
- Functional Assessment of Cancer Therapy Questionnaire Trial Outcome Index(Baseline to 12-weeks.)
- Shoulder range of motion in degrees.(Change from baseline to one year)
- Neck Range of Motion in degrees.(Change from baseline to 12 weeks.)
- Grip strength in pounds.(Change from baseline to 12-weeks.)
- 1 repetition maximum (1RM) strength for seated row in pounds.(Change from baseline to 12 weeks.)
- 30 second sit to stand (optional: in lieu of leg press)(Change from baseline to 12 weeks.)
研究者
Margie McNeely
Associate Professor
University of Alberta