Exercise program design considerations for head and neck cancer survivors

Abstract

The present study aimed to establish exercise preferences, barriers, and perceived benefits among head and neck cancer survivors, as well as their level of interest in participating in an exercise program. Patients treated for primary squamous cell carcinoma of the head and neck between 2010 and 2014 were identified from the hospital database and sent a postal questionnaire pack to establish exercise preferences, barriers, perceived benefits, current physical activity levels, and quality of life. A postal reminder was sent to non-responders 4 weeks later. The survey comprised 1021 eligible patients of which 437 (43%) responded [74% male, median (interquartile range) age, 66 (60–73) years]. Of the respondents, 30% said ‘Yes’ they would be interested in participating in an exercise program and 34% said ‘Maybe’. The most common exercise preferences were a frequency of three times per week, moderate-intensity, and 15–29 min per bout. The most popular exercise types were walking (68%), flexibility exercises (35%), water activites/swimming (33%), cycling (31%), and weight machines (19%). Home (55%), outdoors (46%) and health club/gym (33%) were the most common preferred choices for where to regularly exercise. Percieved exercise benefits relating to improved physical attributes were commonly cited, whereas potential social and work-related benefits were less well-acknowledged. The most commonly cited exercise barriers were dry mouth or throat (40%), fatigue (37%), shortness of breath (30%), muscle weakness (28%) difficulty swallowing (25%), and shoulder weakness and pain (24%). The present findings inform the design of exercise programs for head and neck cancer survivors.

Physical activity programming and counseling preferences among cancer survivors: a systematic review

“…Craike et al [ 84 ] and Whitehead et al [ 83 ] qualitatively found participants to generally be interested in participating in a PA program, but noted that some participants were disinterested or hesitant for a number of reasons such as concerns about the format of the program (i.e., disinterest in the proposed group activities) and treatment status (i.e., being uninterested in participating in the proposed program during treatment). Although most studies found positive interest in PA program participation, three quantitative studies found higher percentages of participants to indicate disinterest in participating in a physical activity program [ 47 , 80 , 81 ]. Lowe et al [ 47 ] found 65% of patients with brain metastases were not interested in a PA program now.…”

“…However, when asked the same question after treatment, most participants were interested (55.7%) [ 80 ]. Additionally, although Midgley et al [ 81 ] found most head and neck cancer survivors indicated that they were or may be interested in participating in a PA program (64%), a higher percentage of head and neck cancer survivors were disinterested in a PA program (36%) than interested (30%). Forbes et al [ 69 ] found similar numbers of mixed cancer survivors interested in doing a PA program for cancer survivors (i.e., 32% responded “yes” and 32% responded “no”), while more participants (47%) were interested in a program that would increase PA levels [ 69 ].…”

“…Twenty-two quantitative studies asked participants when they would prefer to start a PA program and two qualitative studies reported program start preferences [ 36 , 50 , 52 , 53 , 55 , 61 – 65 , 68 – 74 , 76 – 78 , 81 , 82 , 84 , 85 ]. There was a large range of preferences for when to start a program.…”

“…Thirty-one quantitative studies and three qualitative studies assessed PA program location preferences, asking participants where they would most like to be active (e.g., home, neighborhood, fitness center) [ 36 , 47 – 57 , 59 , 61 – 64 , 66 , 68 , 69 , 71 – 74 , 76 – 85 ]. Most quantitative studies ( n = 20) across cancer types found cancer survivors to prefer exercising at home [ 36 , 47 – 51 , 54 , 56 , 57 , 59 , 62 – 64 , 71 – 74 , 77 , 80 , 81 ]. Among the majority high quality studies, preference for doing PA at home remained stable [ 51 , 63 , 64 , 72 , 74 , 77 ].…”

Importance of activity and recreation for the quality of life of patients treated for cancer of the head and neck

“…1 Common physical issues such as speech and swallowing problems, xerostomia, and shoulder dysfunction can be detrimental to activity and recreation. 2 Emotional disturbances such as anxiety, low mood, self-esteem and body image will compromise social and recreational functioning and could lead to social isolation. 3 Fatigue, pain, and morbidity after free tissue transfer can also be important.…”