- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02647021
Therapeutic Resistance Group Exercise Training for Head & Neck Cancer Survivors (TARGET)
Evaluating Outcomes From a Combined Supervised Therapeutic and Physical Exercise Program for Post-surgical Head and Neck Cancer Survivors: A Randomized Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Participants will be stratified by early (within 18 months of surgery) and late (> 18 months of surgery) and randomized on a one-on-one basis to (1) a supervised therapeutic exercise program for the neck and shoulder (serving as standard care) or (2) a combined therapeutic and lower body resistance exercise program. The randomization sequence will be generated by staff in the Rehabilitation Research Centre at Corbett Hall and placed in sealed opaque envelopes.
The exercise program will be offered in a group setting. Participants will exercise 2 times per week for a 10-week session and will have the option to continue for an additional 10-week maintenance session. The primary outcome for the study will be quality of life as measured by the Functional Assessment of Cancer Therapy (FACT)-Fatigue Scale at 12-weeks.
At each measurement point following the baseline assessment, including the 12-week and 24-week and one year follow-ups, an Independent Assessor will perform the objective fitness measurements. The Independent Assessor will also administer the Neck Dissection Impairment Questionnaire and the FACT-Fatigue quality of life questionnaires. The Physical Activity Adherence Diary will be collected by a Research Coordinator at each follow-up visit.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
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Alberta
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Edmonton, Alberta, Canada, T6G 2G4
- University of Alberta/ Cross Cancer Institute
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Squamous cell carcinoma/ thyroid cancer/ melanoma or lymphoma involving: oral cavity, oropharynx, larynx or hypopharynx, or lymph nodes in the neck region
- Surgical treatment includes radical neck dissection, modified radical neck dissection and other variants of functional/selective neck dissection OR radiation therapy to lymph node regions
- Presenting with shoulder and/ or neck dysfunction related to cancer treatment
- Karnofsky Performance Status greater than or equal to 60%
- No evidence of residual cancer in the neck and no distant (M0) metastasis. Potential participants with symptoms suggestive of distant metastasis (M1) must have appropriate investigations (e.g. bone scan) to rule these out.
- Participants must have completed their head and neck/ thyroid/ melanoma/ lymphoma cancer treatment (minimum 4 weeks post treatment)
- Pre-participation Screening: Prior to participation in the exercise program, potential participants will complete general and cancer-specific Physical Activity Readiness Questionnaires (PAR-Q+) to determine appropriateness for the exercise program. Physician consent and approval for supervised exercise will be required prior to enrollment.
Exclusion Criteria:
- A participant will be ineligible if they present with medical illness or psychiatric illness, which, in the opinion of the investigators, would impact his/her ability to participate in exercise or interfere with follow-up.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Therapeutic Exercise
Therapeutic Exercise Program (standard care) will include:
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A specialized therapeutic exercise program to address neck and shoulder dysfunction due to spinal accessory nerve damage.
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Experimental: Therapeutic + Lower Body Exercise
The Therapeutic Exercise Program (standard care) will include:
The Resistance Exercise component will target 6-8 muscle groups of the lower extremities and core including gluteal, quadriceps, hamstrings, abdominals, and gastrocnemius muscles. A progressive introduction of exercises will occur over the first 3 weeks.
|
A specialized therapeutic exercise program to address neck and shoulder dysfunction due to spinal accessory nerve damage.
A combined therapeutic exercise program (as per the comparison arm) plus the addition of lower body resistance exercise
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Functional Assessment of Cancer Therapy: Fatigue Scale Questionnaire
Time Frame: change from baseline to 12 weeks.
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Cancer related fatigue
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change from baseline to 12 weeks.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Shoulder range of motion in degrees.
Time Frame: Change from baseline to one year
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Active and passive glenohumeral joint range of motion using standard 12 inch goniometer.
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Change from baseline to one year
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Body mass index
Time Frame: Change from baseline to 24 weeks.
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Derived from height and weight of the participant.
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Change from baseline to 24 weeks.
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1 repetition maximum (1RM) strength for seated row in pounds.
Time Frame: Change from baseline to 12 weeks.
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The maximal amount weight that can be pulled (seated row) and pushed (vertical bench) with proper form.
|
Change from baseline to 12 weeks.
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Neck Range of Motion in degrees.
Time Frame: Change from baseline to 12 weeks.
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Measures of neck flexion, side flexion, rotations and extension using myrin goniometer.
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Change from baseline to 12 weeks.
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Upper extremity muscular endurance: number of repetitions performed.
Time Frame: baseline, 12-weeks, 24-weeks, one year
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Maximal repetitions to fatigue based on 50% of 1 repetition maximum strength for seated row.
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baseline, 12-weeks, 24-weeks, one year
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Lower extremity flexibility in centimetres.
Time Frame: Change from baseline to 12-weeks.
|
Sit and reach test
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Change from baseline to 12-weeks.
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Functional capacity
Time Frame: Change from baseline to 24 weeks.
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6 minute walk test
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Change from baseline to 24 weeks.
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Neck Dissection Impairment Index
Time Frame: Change from baseline to one year.
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Neck dissection related quality of life
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Change from baseline to one year.
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Grip strength in pounds.
Time Frame: Change from baseline to 12-weeks.
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Maximal grip strength: composite score of both hands.
Best of three attempts for each side.
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Change from baseline to 12-weeks.
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1 repetition maximum leg press in pounds
Time Frame: Change from baseline to 12 weeks.
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The maximal amount of weight that can be moved with proper
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Change from baseline to 12 weeks.
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1 repetition maximum chest press in pounds.
Time Frame: Change from baseline to 12 weeks.
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The maximal amount of weight that can be pushed with proper form.
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Change from baseline to 12 weeks.
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30 second sit to stand (optional: in lieu of leg press)
Time Frame: Change from baseline to 12 weeks.
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number of repetitions performed in 30 seconds
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Change from baseline to 12 weeks.
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Functional Assessment of Cancer Therapy Questionnaire Trial Outcome Index
Time Frame: Baseline to 12-weeks.
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The composite score of physical, functional and fatigue subscales of the questionnaire.
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Baseline to 12-weeks.
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Physical activity level in minutes per week (average over the previous one month period).
Time Frame: Change in monthly average physical activity from baseline to one year.
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Godin Leisure Time Questionnaire: minutes of mild, moderate and strenuous exercise.
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Change in monthly average physical activity from baseline to one year.
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Cost of programming
Time Frame: one year
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costs to programming, institution and participants
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one year
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Exercise Adherence
Time Frame: Change from baseline to 1 year.
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Adherence to exercise programming: attendance at supervised exercise sessions and self-directed sessions over the 1 year period.
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Change from baseline to 1 year.
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Functional Assessment of Cancer Therapy Fatigue Scale at one year.
Time Frame: Change from baseline to 1 year.
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Cancer-related fatigue.
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Change from baseline to 1 year.
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Margaret L. McNeely, PhD, University of Alberta
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- HREBA.CC.15-0167
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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