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Development and Pilot Results of a Cancer Prehabilitation Study Protocol for Patients Diagnosed with Head and Neck Cancer.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Development and Pilot Results of a Cancer Prehabilitation Study Protocol for Patients Diagnosed with Head and Neck Cancer./
作者:	Boright, Lori Elizabeth.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2019,
面頁冊數:	78 p.
附註:	Source: Dissertations Abstracts International, Volume: 81-09, Section: B.
Contained By:	Dissertations Abstracts International81-09B.
標題:	Physical therapy. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=27543171
ISBN:	9781392662410

Development and Pilot Results of a Cancer Prehabilitation Study Protocol for Patients Diagnosed with Head and Neck Cancer.
Boright, Lori Elizabeth.

Development and Pilot Results of a Cancer Prehabilitation Study Protocol for Patients Diagnosed with Head and Neck Cancer. - Ann Arbor : ProQuest Dissertations & Theses, 2019 - 78 p.

Source: Dissertations Abstracts International, Volume: 81-09, Section: B.

Thesis (Ph.D.)--Oakland University, 2019.

This item must not be sold to any third party vendors.

Purpose/Hypothesis: Head and neck (H&N) cancers account for 4% of total cancers diagnosed. However, the quality of life (QoL) implications are more severe for this patient population due to the complexity, extent and tissue structure changes after treatment interventions. Disabling complications arising from H&N cancers include decreased functional walking capacity, cervical range of motion (ROM), scapular strength and QoL. An extensive literature search revealed a paucity of evidence regarding protocols utilizing the assessment and intervention skills of a physical therapist that were aimed at this population. Therefore, the primary purpose of this study was to describe the development of a multimodal prehabilitation study protocol and the secondary purpose was to report pilot results of that protocol in remediating complications among patients diagnosed with H&N cancers. Subjects: A convenience sample of subjects from one H&N surgeon's office; male or female, > 18 years of age; able to speak/read the English language, ambulate independently; diagnosed with H&N cancer and scheduled for surgical intervention including selective, radical or modified radical neck dissection. Materials/Methods: A review of the literature revealed 28 prehabilitation studies of various cancer diagnosis utilizing physical therapy exercise but no studies were identified that described prehabilitation among patients diagnosed with H&N cancers. The studies demonstrated that multimodal prehabilitation protocols that included more than one domain of interventions (e.g. targeted exercises, psychological interventions and/or nutrition counseling) were reported to have the most positive clinical outcomes. Twelve of the 28 studies were identified as multimodal. Based on the findings of this narrative review, a multimodal prehabilitation protocol was developed and included H&N cancer diagnosis-specific education and exercise (aerobic, resistance, range of motion (ROM)). After Institutional Review Board approval, a power analysis for this randomized controlled trial established a target sample size of 136 subjects. For the purpose of this pilot study, findings of the first five participants will be reported. Pre/post-surgical measurements included: Six minute walk test (6MWT), cervical ROM scapular strength via manual muscle testing, physical activity history, health behaviors questionnaire and the Functional Assessment of Cancer Therapy - Head and Neck QoL survey. Results: Five participants (control=1, intervention group=4) were enrolled however two participants were lost in follow up. Therefore, results from the remaining three intervention group participants included two males and one female all identifying as Caucasian and between 60-90 years of age. All reported not participating in regular exercise; pre to post cervical ROM demonstrated a decline in extension/bilateral rotation for two of three participants. Two participants demonstrated a decrease in the 6MWT while one increased. No participants experienced any adverse effects of the prehabilitation program. Clinical Relevance: This is the first study protocol to describe a physical therapist-administered cancer H&N prehabilitation programs. It is of paramount importance that rehabilitation professionals lead the effort to unify theory and clearly define parameters for oncology prehabilitation. Additional research is clearly needed to define the importance of prehabilitation relative to cost savings, improved outcomes, QoL, and survival rates. Conclusion: This newly developed prehabilitation protocol is feasible to complete and can be replicated at other institutions. Prehabilitation for patients diagnosed with H&N cancer has the potential to mitigate treatment side effects and improve QoL across the cancer survivorship continuum.

ISBN: 9781392662410Subjects--Topical Terms:

588713
Physical therapy.
Subjects--Index Terms:

Cancer

Development and Pilot Results of a Cancer Prehabilitation Study Protocol for Patients Diagnosed with Head and Neck Cancer.
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500 $a Source: Dissertations Abstracts International, Volume: 81-09, Section: B.
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506 $a This item must not be sold to any third party vendors.
520 $a Purpose/Hypothesis: Head and neck (H&N) cancers account for 4% of total cancers diagnosed. However, the quality of life (QoL) implications are more severe for this patient population due to the complexity, extent and tissue structure changes after treatment interventions. Disabling complications arising from H&N cancers include decreased functional walking capacity, cervical range of motion (ROM), scapular strength and QoL. An extensive literature search revealed a paucity of evidence regarding protocols utilizing the assessment and intervention skills of a physical therapist that were aimed at this population. Therefore, the primary purpose of this study was to describe the development of a multimodal prehabilitation study protocol and the secondary purpose was to report pilot results of that protocol in remediating complications among patients diagnosed with H&N cancers. Subjects: A convenience sample of subjects from one H&N surgeon's office; male or female, > 18 years of age; able to speak/read the English language, ambulate independently; diagnosed with H&N cancer and scheduled for surgical intervention including selective, radical or modified radical neck dissection. Materials/Methods: A review of the literature revealed 28 prehabilitation studies of various cancer diagnosis utilizing physical therapy exercise but no studies were identified that described prehabilitation among patients diagnosed with H&N cancers. The studies demonstrated that multimodal prehabilitation protocols that included more than one domain of interventions (e.g. targeted exercises, psychological interventions and/or nutrition counseling) were reported to have the most positive clinical outcomes. Twelve of the 28 studies were identified as multimodal. Based on the findings of this narrative review, a multimodal prehabilitation protocol was developed and included H&N cancer diagnosis-specific education and exercise (aerobic, resistance, range of motion (ROM)). After Institutional Review Board approval, a power analysis for this randomized controlled trial established a target sample size of 136 subjects. For the purpose of this pilot study, findings of the first five participants will be reported. Pre/post-surgical measurements included: Six minute walk test (6MWT), cervical ROM scapular strength via manual muscle testing, physical activity history, health behaviors questionnaire and the Functional Assessment of Cancer Therapy - Head and Neck QoL survey. Results: Five participants (control=1, intervention group=4) were enrolled however two participants were lost in follow up. Therefore, results from the remaining three intervention group participants included two males and one female all identifying as Caucasian and between 60-90 years of age. All reported not participating in regular exercise; pre to post cervical ROM demonstrated a decline in extension/bilateral rotation for two of three participants. Two participants demonstrated a decrease in the 6MWT while one increased. No participants experienced any adverse effects of the prehabilitation program. Clinical Relevance: This is the first study protocol to describe a physical therapist-administered cancer H&N prehabilitation programs. It is of paramount importance that rehabilitation professionals lead the effort to unify theory and clearly define parameters for oncology prehabilitation. Additional research is clearly needed to define the importance of prehabilitation relative to cost savings, improved outcomes, QoL, and survival rates. Conclusion: This newly developed prehabilitation protocol is feasible to complete and can be replicated at other institutions. Prehabilitation for patients diagnosed with H&N cancer has the potential to mitigate treatment side effects and improve QoL across the cancer survivorship continuum.
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