Prophylactic exercises among head and neck cancer patients during and after swallowing sparing intensity modulated radiation: adherence and exercise performance levels of a 12-week guided home-based program

Ingrid C Cnossen, Cornelia F. van Uden-Kraan, Birgit I. Witte, Yke J Aalders, Cees J T de Goede, Remco de Bree, Patricia Doornaert, Derek H F Rietveld, Jan Buter, Johannes A Langendijk, C René Leemans, Irma M Verdonck-de Leeuw

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The background and purpose of this paper is to investigate adherence, exercise performance levels and associated factors in head and neck cancer (HNC) patients participating in a guided home-based prophylactic exercise program during and after treatment [swallowing sparing intensity modulated radiation therapy (SW-IMRT)]. Fifty patients were included in the study. Adherence was defined as the percentage of patients who kept up exercising; exercise performance level was categorized as low: ≤1, moderate: 1–2, and high: ≥2 time(s) per day, on average. Associations between 6- and 12-week exercise performance levels and age, gender, tumour site and stage, treatment, intervention format (online or booklet), number of coaching sessions, and baseline HNC symptoms (EORTC-QLQ-H&N35) were investigated. Adherence rate at 6 weeks was 70% and decreased to 38% at 12 weeks. In addition, exercise performance levels decreased over time (during 6 weeks: 34% moderate and 26% high; during 12 weeks: 28% moderate and 18% high). The addition of chemotherapy to SW-IMRT [(C)SW-IMRT] significantly deteriorated exercise performance level. Adherence to a guided home-based prophylactic exercise program was high during (C)SW-IMRT, but dropped afterwards. Exercise performance level was negatively affected by chemotherapy in combination with SW-IMRT.

Original languageEnglish
Pages (from-to)1129-1138
Number of pages10
JournalEuropean Archives of Oto-Rhino-Laryngology
Issue number2
Publication statusPublished - 1 Feb 2017


  • (Chemo)radiation
  • Head and neck cancer
  • Prophylactic exercises
  • Speech problems
  • Swallowing problems

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