Resistance Exercise, Muscle Strength, Physical Function and Quality of Life in Head and Neck Cancer Patients Undergoing Chemoradiation

Chemoradiation therapy (CRT) is the standard of care treatment for Head and Neck Cancer (HNCa) patients. Despite its established therapeutic efficacy, adverse effects accompanying CRT result in clinically-meaningful declines in muscle strength, physical function and quality of life (QOL). The adverse effects observed during CRT place HNCa patients at heightened risk for functional decline, mortality, and morbidity. Accordingly, there is a pressing need to evaluate the utility of supportive care interventions, such as resistance exercise (RE), to attenuate the deleterious effects observed during CRT. PURPOSE: Determine the utility of implementing a group-mediated cognitive behavioral (GMCB) RE intervention in the treatment of HNCa patients undergoing CRT. In the current study, we evaluated the effects of the RE intervention for attenuating the typical declines observed in satisfaction with life (SWL), quality of life (QOL), muscle strength, and physical function. METHODS: The HNCaRE study was a single-arm, pilot trial in 20 HNCa patients undergoing CRT. Assessment of outcomes were obtained at baseline, 3-months, and 6-month follow-up visits. RESULTS: Results of a completer’s (n=11) repeated measures ANOVA analysis yielded a non-significant effect for satisfaction with life (p=0.19), upper body strength (p=0.57), and physical function (p=0.38). Significant results were found for QOL (p=0.04). Although the results of the ANOVA analysis were non-significant for muscular strength, physical function, and SWL, the effect size calculations revealed meaningful declines in SWL from baseline to 3-months (d = -.373) and 6-months (d = -.138). Significant decrease in QOL ratings from baseline to 3-months (d = -1.632) and 6-months (d = -1.162). Small increase in chest press from baseline to 3-months (d = .237) and a large decrease from baseline to 6-months (d = -.080). Small increase in 400 meter walk from baseline to 3-months (d = .156) and a slight decrease from baseline to 6-months (d = -.206). CONCLUSION: Findings from the HNCaRE pilot trial support the feasibility of implementing a GMBC-based RE intervention among HNCa patients undergoing CRT and provide evidence of the preliminary efficacy of this approach for meaningfully attenuating the magnitude of the declines in strength, physical function, QOL, and SWL. These promising results underscore the potential utility of integrating the GMCB RE intervention in the supportive care of HNCa patients undergoing CRT

Students’ Perceptions of an Applied Research Experience in an Undergraduate Exercise Science Course

International Journal of Exercise Science 10(7): 926-941, 2017. Applied research experiences can provide numerous benefits to undergraduate students, however few studies have assessed the perceptions of Exercise Science (EXS) students to an applied research experience. The purpose of this study was two-fold: 1) to describe the rationale and implementation of an applied research experience into an EXS curriculum and 2) to evaluate EXS undergraduate students’ perceptions of an applied research experience. An EXS measurement course was chosen for implementation of an applied research experience. The applied research experience required groups of students to design, implement, and evaluate a student-led research project. Fourteen questions were constructed, tailored to EXS undergraduate students, to assess students’ perceptions of the experience. Qualitative analysis was used for all applicable data, with repeated trends noted; quantitative data were collapsed to determine frequencies. There was an overall positive student perception of the experience and 85.7% of students agreed an applied research experience should be continued. 84.7% of students perceived the experience as educationally enriching, while 92.8% reported the experience was academically challenging. This experience allowed students to develop comprehensive solutions to problems that arose throughout the semester; while facilitating communication, collaboration, and problem solving. Students believed research experiences were beneficial, but could be time consuming when paired with other responsibilities. Results suggest an applied research experience has the potential to help further the development of EXS undergraduate students. Understanding student perceptions of an applied research experience may prove useful to faculty interested in engaging students in the research process

Feasibility and Preliminary Efficacy of Implementing a Group-Mediated Cognitive Behavioral Resistance Exercise Intervention in Head and Neck Cancer Patients Undergoing Chemoradiation Treatment

Head and neck cancer (HNCa) patients report some of the lowest quality of life (QOL) compared to other cancer populations, due to the clinically meaningful deficits in muscle mass, called cancer cachexia, and physical function that are associated with the established standard of care, which includes Chemoradiation therapy (CRT). PURPOSE: Determine the feasibility and preliminary efficacy of implementing a group-mediated cognitive behavioral (GMCB) resistance exercise (RE) intervention in HNCa patients undergoing CRT. METHODS: The HNCaRE study was a single-arm, pilot trial designed to evaluate the safety, feasibility, and preliminary efficacy of implementing a GMCB personalized RE intervention in nine HNCa patients undergoing CRT. Assessment of all functional, anthropometric, and patient-reported outcomes were obtained at baseline, 3-months, and 6-month follow-up visits. RESULTS: Findings from the initial cohort of the HNCaRE pilot trial (n=9) suggest that the GMCB RE intervention was a feasible, safe, and well-tolerated intervention for HNCa patients undergoing CRT. The Cohen’s d effect sizes were calculated by taking the mean difference and diving by the pooled standard deviation to determine the magnitude. Percent change was determined by calculating the mean difference from baseline at each assessment and dividing by the baseline value. Evaluation of the effect sizes and percent change indicate the RE intervention attenuated the deleterious effects that have been observed upon muscle mass (d=-0.74), physical function (d=0.28), and QOL (d=-0.65) previously among HNCa patients undergoing CRT. Patients who demonstrated the greatest adherence to the intervention sessions yielded the most favorable changes in these outcomes. CONCLUSION: Findings from the HNCaRE pilot trial provide evidence of the feasibility, safety, and preliminary efficacy of implementing a GMBC-based RE intervention among HNCa patients undergoing CRT. The RE intervention shows promise for countering the well-established deleterious effects upon body composition, physical function, and QOL accompanying CRT

Effects of Bingocize® on Quality of Life, Fall Risk, and Health Knowledge in Community-Dwelling Older Adults

Quality of life (QOL) is an important aspects of overall well-being in older adults. QOL is associated with functional, physical, and psychological health; all of which can be improved with increased physical activity. A high fall risk is associated with low physical function and QOL. One in four older adults experiences a fall each year, making it necessary to focus public health interventions towards decreasing fall risk and improving QOL in older adults. Bingocize® is a health promotion program designed to promote health, health knowledge, physical activity, and social engagement among older adults. The purpose of this study was to determine the effects of the new version of Bingocize® on QOL and fall risk in community-dwelling older adults (N=36; mean age 73.63 ± 6.97). Participants were clustered and randomly assigned to (a) experimental (n=19; participating in Bingocize® program, which included the bingo game, exercise, and health education) or (b) control (n=17; only played bingo). Each group completed a 12-week intervention that consisted of two 45-60 minute sessions per week. Pre and post data assessments included the TUG, 30-second chair stand, 4-staged balance, handgrip strength, WHOQOL-BREF, PANAS, and a health knowledge quiz. A mixed design analysis of variance (ANOVA) was used to compare intervention effects. There were no significant interactions for any of the variables, with the exception of positive affect (PA) (F (1,34) = 5.66, p = 0.02, 2 = 0.15, power = 0.64) and handgrip strength (F (1,34) = 8.31, p = 0.007, 2 = 0.196, power = 0.80).. There was also a significant main effect for time for health knowledge. Post hoc analysis using independent samples t-tests were conducted on PA (t (33) = 2.39, p = 0.023, two-tailed) and handgrip strength (t (34) = 2.85, p = 0.007, two-tailed). Participating in the Bingocize® health promotion program can produce a meaningful and detectable change in handgrip strength and PA in community-dwelling older adults

Design and methods of a translational, community-based, lifestyle weight management pilot intervention trial in breast cancer survivors with overweight or obesity

Background: Breast cancer survivors (BCS) with overweight or obesity are at heightened risk of cancer recurrence, cardiometabolic disease, and compromised quality of life. Given the prevalence of significant weight gain during and following breast cancer treatment, there is growing recognition of the need to develop efficacious, widely-accessible, weight management programs for BCS. Unfortunately, access to evidence-based weight management resources for BCS remains limited and little is known of the optimal theoretical basis, program components, and mode of delivery for community-based interventions. The primary aim of the Healthy New Albany Breast Cancer (HNABC) pilot trial was to determine the safety, feasibility, and preliminary efficacy of delivering a translational, evidence-based, and theory-driven lifestyle weight management intervention to BCS with overweight or obesity in the community setting. Methods: HNABC was a single-arm, pilot trial evaluating a 24-week, multi-component intervention leveraging exercise, dietary modification, and group-mediated cognitive behavioral (GMCB) counseling components designed to facilitate lifestyle behavior change and promote sustained independent adherence. Assessments of various objectively-determined and patient-reported outcomes and theory-derived determinants of behavioral adoption and maintenance were obtained at baseline, 3- and 6-month follow-up. Measures of trial feasibility were calculated prospectively throughout the study. Conclusion: Findings from the HNABC pilot trial will provide evidence demonstrating the feasibility and preliminary efficacy of a multi-component, community-based, GMCB lifestyle weight management intervention for BCS. Results will inform the design of a future, large-scale, randomized controlled efficacy trial. If successful, this approach could offer a widely accessible, community-based intervention model for weight management programs in BCS