Neoplasms

All Conditions

Head and Neck Neoplasms

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.

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.

An innovative training intervention to optimize muscle strength and muscle mass

Accentuated eccentric loading + electromyostimulation

A conventional approach to resistance training

Conventional resistance training

Gui Millet, PhD

People who receive radiation therapy for head and neck cancer (HNC) can experience side-effects which include a significant loss in body mass and a loss of muscle mass (cancer cachexia). Some research has shown success in the use of generic (dynamic) resistance training interventions for patients affected by head and neck cancer. However, this approach could be optimized with the use of novel training methods.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.

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.

Participants are assigned to one of two groups in parallel for the duration of the study

Exercise After Radiation for Head & Neck Cancer

Eccentric Exercise and Electromyostimulation to Improve Muscle Strength and Muscle Mass After Radiation Therapy for Head and Neck Cancer

A change in maximal isometric force in the knee extensors measured before, during and after an intermittent cycling test.

ultrasound measurement of the vastus lateralis and rectus femoris

Self-report questionnaire for the assessment of cancer-related fatigue. This scale is between a possible raw score of 0 - 52, where the higher the number, the better the outcome.

Self-report questionnaire for the assessment of quality of life. This scale is between a possible 0 - 144 points, where the higher the number the better the outcome. There are 5 individual sub scales that measure physical-, social-, emotional-, and functional well-being as well as head and neck specific concerns.

A reduction voluntary activation (using femoral nerve stimulation) measured before, during and after an intermittent cycling test

A reduction in potentiated quadriceps twitch force measured before, before, during and after an intermittent cycling test.

evoked from supra-maximal stimulation of the femoral nerve and measured before, during and after an intermittent cycling test

Root mean square of the EMG signal during an MVC, measured before, during and after an intermittent cycling test.

Time to task failure during an intermittent cycling test

University of Calgary

Professor

Conventional resistance training program (CRT)

Whole body vibration resistance training (WBV) on the FITVIBE-platform

Whole body vibration resistance training

Jan Van Meerbeeck, MD, PhD

Eric Derom, MD, PhD

The first part of the study is an observational part. In eligible patients with early stage respiratory cancer, the primary and secondary endpoints will be evaluated before and after their scheduled radical cancer therapy. The measured variables, include a blood sample, pulmonary function tests, level of dyspnea, exercise tests, measurement of body composition, respiratory and peripheral muscle force, health related quality of life and psychological status. Only registered participants having completed a radical treatment and having either less than 70% of the predicted normal value of the quadriceps force (QF) or a decrease of more than 10% predicted value of the QF between pre-and post radical treatment, will be allowed to participate to the second part of the study. These patients will then be randomized in three groups. Group A, the control group, will have the usual care and follow up according to clinical symptoms. Group B will be offered a conventional resistance training program (CRT), and group C, will be offered a whole body vibration resistance training (WBV) on the FITVIBE-platform. All previous variables will be measured after 6 and 12 weeks of training.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Exercise After Radiation for Head & Neck Cancer	NCT04013178	Head and Neck N...	Accentuated ecc... Conventional re...	18 Years - 75 Years	University of Calgary
Resistance Exercise Training For Radically Treated Respiratory Cancer	NCT00752700	Respiratory Can...	Conventional re... Whole body vibr...	18 Years - 80 Years	University Hospital, Ghent

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