Prophylactic exercises among head and neck cancer patients during and after swallowing sparing intensity modulated radiation: adherence and exercise performance levels of a 12-week guided home-based program.
The background and purpose of this paper is to investigate adherence, exercise performance levels and associated factors in head and neck cancer (HNC) patients participating in a guided home-based prophylactic exercise program during and after treatment [swallowing sparing intensity modulated radiation therapy (SW-IMRT)]. Fifty patients were included in the study. Adherence was defined as the percentage of patients who kept up exercising; exercise performance level was categorized as low: ≤1, moderate: 1-2, and high: ≥2 time(s) per day, on average. Associations between 6- and 12-week exercise performance levels and age, gender, tumour site and stage, treatment, intervention format (online or booklet), number of coaching sessions, and baseline HNC symptoms (EORTC-QLQ-H&N35) were investigated. Adherence rate at 6 weeks was 70% and decreased to 38% at 12 weeks. In addition, exercise performance levels decreased over time (during 6 weeks: 34% moderate and 26% high; during 12 weeks: 28% moderate and 18% high). The addition of chemotherapy to SW-IMRT [(C)SW-IMRT] significantly deteriorated exercise performance level. Adherence to a guided home-based prophylactic exercise program was high during (C)SW-IMRT, but dropped afterwards. Exercise performance level was negatively affected by chemotherapy in combination with SW-IMRT.
Department of Otolaryngology, Head and Neck Surgery, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
Ingrid C
IC
Cnossen
Department of Otolaryngology, Head and Neck Surgery, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.|Department of Clinical Psychology, VU University, Amsterdam, The Netherlands.
Cornelia F
CF
van Uden-Kraan
Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
Birgit I
BI
Witte
Department of Otolaryngology, Head and Neck Surgery, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
Yke J
YJ
Aalders
Department of Rehabilitation Medicine and Physical Therapy, VU University Medical Center, Amsterdam, The Netherlands.
Cees J T
CJ
de Goede
Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.
Remco
R
de Bree
Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands.
Patricia
P
Doornaert
Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands.
Derek H F
DH
Rietveld
Department of Medical Oncology, VU University Medical Center, Amsterdam, The Netherlands.
Jan
J
Buter
Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Johannes A
JA
Langendijk
Department of Otolaryngology, Head and Neck Surgery, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
C René
CR
Leemans
Department of Otolaryngology, Head and Neck Surgery, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. IM.Verdonck@vumc.nl.|Department of Clinical Psychology, VU University, Amsterdam, The Netherlands. IM.Verdonck@vumc.nl.
Irma M
IM
Verdonck-de Leeuw
D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology / Q000517:prevention & control*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome
(Chemo)radiation; Head and neck cancer; Prophylactic exercises; Speech problems; Swallowing problems