Faculty of Kinesiology, University of Calgary, Calgary, Canada.
Ohlson Research Initiative, Arnie Charbonneau Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada.
J Cancer Surviv. 2020 Dec;14(6):790-805. doi: 10.1007/s11764-020-00893-9. Epub 2020 May 24.
Treatment of head and neck cancer (HNC) results in severe weight loss, mainly due to the 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 novel strength training (NST) and conventional strength training (CST) intervention delivered after HNC treatment.
Participants were randomized to a NST group (n = 11) involving eccentric overloaded strength training and neuromuscular electrical stimulation (NMES), or a CST group (n = 11) involving dynamic resistance exercises 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.
Although recruitment was challenging, completion was 100% in NST and 82% in CST. Adherence was 92% in NST and 81% in CST. Overall, MIVC increased by 19 ± 23%, muscle cross-sectional area improved 18 ± 22%, cycling exercise time improved by 18 ± 13%, and improvements in HRQL and fatigue were clinically relevant.
Both interventions were found to be feasible for HNC patients after treatment. Strength training significantly improved maximal muscle strength, muscle cross-sectional area, and PROs after HNC treatment. Future research should include fully powered trials and consider the use of eccentric overloading and NMES during HNC treatment.
Eccentric- and NMES-emphasized strength training may be useful alternatives to conventional strength training after HNC treatment.
头颈部癌症（HNC）的治疗会导致严重的体重减轻，主要是由于瘦体重的损失。因此，肌肉力量和健康相关生活质量（HRQL）下降。本研究调查了在 HNC 治疗后进行为期 12 周的新型力量训练（NST）和传统力量训练（CST）干预的可行性。
参与者随机分为 NST 组（n = 11），包括离心过载力量训练和神经肌肉电刺激（NMES），或 CST 组（n = 11），包括动态阻力运动，训练量匹配。可行性结果包括招募、完成、依从性和进展证据。在基线和干预后，进行神经肌肉评估，包括膝关节伸肌的最大等长随意收缩（MIVC），并在递增循环至自愿衰竭时进行评估。还评估了人体测量学和患者报告的结果（PROs）。
尽管招募具有挑战性，但 NST 的完成率为 100%，CST 为 82%。NST 的依从性为 92%，CST 为 81%。总体而言，MIVC 增加了 19±23%，肌肉横截面积改善了 18±22%，循环运动时间提高了 18±13%，HRQL 和疲劳的改善具有临床意义。
两种干预措施在 HNC 治疗后均被发现对 HNC 患者可行。力量训练显著改善了 HNC 治疗后的最大肌肉力量、肌肉横截面积和 PROs。未来的研究应包括完全功率试验，并考虑在 HNC 治疗期间使用离心过载和 NMES。
在 HNC 治疗后，强调离心和 NMES 的力量训练可能是传统力量训练的有用替代方法。
