Purpose: Treatment of head and neck cancer (HNC) results in severe weight loss, mainly due to loss of lean body mass. Consequently, decreases in muscular strength and health-related quality of life (HRQL) occur. This study investigated the feasibility of a 12-week experimental (EXP) and conventional (CON) strength training intervention delivered after HNC treatment.Methods: Participants were randomized to an EXP group (n=11) involving eccentric strength training and neuromuscular electrical stimulation (NMES), or a CON group (n=11) involving dynamic strength training matched for training volume. Feasibility outcomes included recruitment, completion, adherence and evidence of progression. A neuromuscular assessment involving maximal isometric voluntary contractions (MIVCs) in the knee extensors was evaluated prior to and during incremental cycling to volitional exhaustion at baseline and after the interventions. Anthropometrics and patient-reported outcomes (PROs) were also assessed.Results: Although recruitment was challenging, completion was 82% in CON and 100% in EXP. Adherence was 81% in CON and 92% in EXP. Overall, MIVC increased by 19 ± 23%, muscle mass improved 18 ± 22%, cycling exercise time improved by 18 ± 13%, and improvements in HRQL and fatigue were clinically relevant.Conclusions: Both interventions were found to be feasible for HNC patients after treatment. Strength training significantly improved maximal muscle strength, muscle mass, and PROs after HNC treatment. Future research should include fully powered trials and consider the use of eccentric overloading and NMES during HNC treatment.Implications for Cancer Survivors: Eccentric overloading and NMES may be useful alternatives to conventional strength training after HNC treatment.
Neuromuscular electrical stimulation (NMES) in head and neck cancer patients treated by radiation therapy with dysphagia
