Prehabilitation and Recovery After Head and Neck Cancer Surgery

Official Title

Multiphasic Prehabilitation in Patients Undergoing Surgery for Head and Neck Cancer

Summary:

Implementing a multiphasic, multimodal prehabilitation intervention for people undergoing surgery with free flap reconstruction for the treatment of head and neck cancer.

Trial Description

Primary Outcome:

• Quality of life: Functional Assessment of Cancer Therapy-Head and Neck Version 4 (FACT-H&N)

Secondary Outcome:

• Weekly step counts
• Weekly "intensity minutes"
• Weekly step counts
• Weekly "intensity minutes"
• Self-reported moderate and strenuous physical activity score: Godin Leisure-Time Exercise Questionnaire (GLTEQ)
• Self-reported physical activity (leisure score index): Godin Leisure-Time Exercise Questionnaire (GLTEQ)
• Fatigue severity: Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F). Total score.
• Anxiety score: Hospital Anxiety and Depression Scale (HADS)
• Depression score: Hospital Anxiety and Depression Scale (HADS)
• Symptom burden: Edmonton Symptom Assessment System (ERAS-r).
• Self-reported health status: EQ VAS (visual analogue) score
• Single-leg balance (s)
• Lower-limb muscular endurance (number of sit-to-stands)
• Functional exercise capacity (total steps)
• Hospital length of stay (total number of days)
• Number of complications
• Mobilization after surgery (i)
• Mobilization after surgery (ii)

BACKGROUND: Head and neck cancer (HNC) is the 7th most common cancer worldwide, and treatment often involves surgery. HNC surgery is intensive, complications are common, and quality of life (QOL) is negatively impacted. Support must be expanded to not only help patients survive HNC but to recover faster and live well following surgery. Prehabilitation, or optimizing a patient's condition before surgery, is a key opportunity to integrate supportive care early in the clinical care pathway for this underserved patient group. RESEARCH DESIGN AND METHODS: Using a mixed-methods approach, the aims of this hybrid implementation-effectiveness study are to (i) implement a multiphasic exercise prehabilitation program for HNC patients in a real-world setting and describe factors influencing implementation across the phases; (ii) determine the safety and tolerability of a multiphasic exercise prehabilitation program for HNC patients; (iii) explore the potential benefits of a multiphasic exercise prehabilitation program for HNC patients, and (iv) build a systematic screening and referral pathway into exercise oncology resources post-operatively. Outcomes are detailed below and include patient-reported outcomes, physical function, mobility (step count) and hospital length of stay.

View this trial on ClinicalTrials.gov