title: Patient-reported outcomes, body composition, and nutrition status in patients with head and neck cancer: Results from an exploratory randomized controlled exercise trial.
abstract: BACKGROUND
  Patients with head and neck cancer experience loss of weight and muscle mass, decreased functioning, malnutrition, depression, and declines in quality of life during and after treatment. The purpose of this exploratory randomized study was to determine the optimal timing for the initiation of a lifestyle and progressive resistance exercise training intervention (during or after radiation therapy), as determined by intervention adherence and by comparing between-group outcomes across 24 weeks.
  
  
  METHODS
  Sixty patients with head and neck cancer were randomized to engage in a 12-week lifestyle intervention and progressive resistance-training program either during radiation treatment or immediately after completion. The primary outcome of body composition--specifically, lean body mass, body mass index, and body fat--as well as secondary outcomes of fitness, quality of life, depression, and nutrition status were evaluated.
  
  
  RESULTS
  The progressive resistance-training intervention carried out during treatment did not significantly influence the primary outcome of body composition, despite a significant increase in weekly physical activity reported by the intervention group. A small-to-medium intervention effect was noted for some secondary outcomes, including fitness, quality of life, and nutrition status. Regardless of whether patients received the immediate or delayed progressive resistance-training intervention, the analysis revealed a main effect of time on body composition, fitness, quality of life, depression, and nutritional scores.
  
  
  CONCLUSIONS
  Although the intervention during treatment did not reduce the loss of lean body mass, delaying the exercise program until after treatment completion was associated with improved intervention adherence, a finding with important clinical implications.
authors.affiliation: Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Lauren C
authors.initials: LC
authors.lastname: Capozzi
authors.affiliation: Department of Physical Therapy, University of Alberta and Cross Cancer Institute, Calgary, Alberta, Canada.
authors.forename: Margaret L
authors.initials: ML
authors.lastname: McNeely
authors.affiliation: Department of Oncology, Cumming School of Medicine, University of Calgary and Tom Baker Cancer Center, Calgary, Alberta, Canada.
authors.forename: Harold Y
authors.initials: HY
authors.lastname: Lau
authors.affiliation: Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.|Department of Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Raylene A
authors.initials: RA
authors.lastname: Reimer
authors.affiliation: Department of Oncology, Cumming School of Medicine, University of Calgary and Tom Baker Cancer Center, Calgary, Alberta, Canada.|Department of Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Janine
authors.initials: J
authors.lastname: Giese-Davis
authors.affiliation: Information Technologies, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Tak S
authors.initials: TS
authors.lastname: Fung
authors.affiliation: Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.|Department of Physical Therapy, University of Alberta and Cross Cancer Institute, Calgary, Alberta, Canada.|Department of Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: S Nicole
authors.initials: SN
authors.lastname: Culos-Reed
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001823:Body Composition / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000534:rehabilitation* / Q000628:therapy; D006801:Humans; D008019:Life Style; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D063868:Patient Outcome Assessment; D010809:Physical Fitness / Q000502:physiology; D011379:Prognosis; D011788:Quality of Life; D055070:Resistance Training / Q000379:methods; D057566:Self Report; D012737:Sex Factors; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
keywords: depression; exercise; fatigue; head and neck cancer; physical activity; physical functioning; quality of life