Heavy Lifting Strength Training in Head and Neck Cancer Survivors (LIFTING)

Feasibility and Safety of Heavy Lifting Strength Training in Head and Neck Cancer Survivors Post-Surgical Neck Dissection

The LIFTING trial will examine the feasibility and safety of a heavy lifting strength training (HLST) program in head and neck cancer survivors (HNCS) at least 1 years post surgical neck dissection. The trial will determine whether this training style is safe and feasible in HNCS. Physical and psychosocial changes will also be reported.

Study Overview

• Status: Completed
• Conditions: Cancer of Head and Neck
• Intervention / Treatment: Behavioral: Exercise Intervention

Detailed Description

RATIONALE Despite improvements in treatments, HNCS still endure numerous acute and chronic side effects. Strength training has been shown to manage some of these side effects but most interventions have involved light-to-moderate resistance training programs. HLST may produce better outcomes but it is unknown if such a weight training program is feasible and safe for HNCS.

OBJECTIVE The primary aim of this proposed study is to examine the feasibility and safety of a HLST program in HNCS at least 1 year post-surgical neck dissection.

METHODS This single arm feasibility study will recruit 15-20 HNCS to complete the HLST program 2 times per week. The primary feasibility outcomes will include the eligibility rate (with reasons for ineligibility), recruitment rate (with reasons for refusal), 1 repetition maximum testing rate (with reasons for not completing the test), program adherence (including attendance, dose modifications, and progression), and follow-up assessment rate (with reasons for drop out). The primary efficacy outcome will be strength gains from baseline. Secondary efficacy outcomes will include physical functioning, quality of life, fear of cancer recurrence, pain, body composition, anxiety, fatigue, stress, shoulder mobility, self-esteem, sleep, and motivation to engage in a HLST program.

SIGNIFICANCE Weight training is an effective intervention in HNCS but the optimal weight training prescription is unknown. If heavy weight training is deemed safe and feasible in HNCS, it can be compared to light-to-moderate load weight training to determine if it is a better prescription for improving outcomes that are important to HNCS.

• Study Type: Interventional
• Enrollment (Actual): 9
• Phase: Phase 1

Contacts and Locations

Study Locations

• Canada
  • Alberta
    • Edmonton, Alberta, Canada, T6G 2H9
      • University of Alberta

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• previously diagnosed with any subtype and stage of head and neck cancer
• at least one year post surgical neck dissection for head and neck cancer and showing full shoulder range of motion or recovery of the spinal accessory nerve
• adults ages 18 and older
• no unmanaged medical conditions, alcohol, and drug abuse
• approved for a heavy lifting strength training program by the treating surgeon and a certified exercise physiologist
• ability to understand and communicate in English

Exclusion Criteria:

• having comorbidities or uncontrolled medical conditions that their referred clinicians indicate as inappropriate to participate in exercise

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Exercise Intervention; Single exercise arm	Behavioral: Exercise Intervention; Heavy Lifting Strength Training

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Recruitment Rate	Recruitment rate (with reasons for refusal). Recruitment minimum: 15 participants Recruitment maximum: 20 participants Higher number= better and more data	Over 12 weeks
Muscular Strength	Change in muscular strength from baseline to postintervention with be assessed using maximal strength tests. Minimum: none Maximum: none Higher score= better strength	Changes from baseline to 12 weeks
Program Adherence	Program adherence minimum: 80% Program adherence maximum: 100% Higher score= better adherence	Over 12 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physical functioning	Assessed using the Neck Dissection Impairment Index (NDII) and maximum strength tests. Minimum: 40 Maximum: 100 Higher score= worse impairment	Changes from baseline to 12 weeks
Fear of cancer recurrence	Assessed using the Fear of Cancer Recurrence Inventory (FCRI) Minimum: 0 Maximum: 36 Higher score= worse fear of cancer recurrence	Changes from baseline to 12 weeks
Post Traumatic Growth after cancer	How cancer has changed an individual's life will be assessed using the Post Traumatic Growth Inventory (PTGI) Minimum: 0 Maximum: 105 Higher score= better (positive) post traumatic growth transformation	Changes from baseline to 12 weeks
Waist to hip ratio (body composition)	Assessed using waist to hip ratio (WHR) measure. Minimum WHR: none Maximum WHR: none Higher score WHR= worse body composition	Changes from baseline to 12 weeks
Anxiety	Assessed using the Spielberger State Trait Anxiety Inventory (STAI) Minimum: 20 Maximum: 80 Higher score= worse anxiety	Changes from baseline to 12 weeks
Fatigue	Assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaire Minimum: 0 Maximum: 52 Higher score=worse fatigue	Changes from baseline to 12 weeks
Stress	Assessed using the Perceived Stress Scale (PSS) Minimum: 0 Maximum: 56 Higher score=worse perceived stress	Changes from baseline to 12 weeks
Shoulder Mobility	Changes in shoulder mobility Minimum: 150 degrees (18-50 years); 130 degrees (over 50 years) Maximum: none Higher score= better mobility	Changes from baseline to 12 weeks
Self-Esteem	Changes in level of self-esteem assessed using Rosenberg Self-Esteem (RSE) scale Minimum: 10 Maximum: 40 Higher score= better self-esteem	Changes from baseline to 12 weeks
Sleep	Changes in sleep patterns assessed using the insomnia severity index (ISI) Minimum: 0 Maximum: 28 Higher score= worse insomnia	Changes from baseline to 12 weeks
Motivation	Questions based on the theory of planned behaviour Minimum: 7 Maximum: 35 Higher score= better motivation	Changes from baseline to 12 weeks
Cancer specific quality of life	Assessed using the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N Symptom Index) Minimum: 0 Maximum: 40 Higher score= worse head and neck cancer symptoms	Changes from baseline to 12 weeks
Cancer Symptom Burden	Assessed using the revised Edmonton Symptom Assessment System (ESAS-r) Minimum: 0 Maximum: 100 Higher score= worse cancer symptoms	Changes from baseline to 12 weeks
Height	Assessed using standing height without shoes. Minimum height: none Maximum height: none Taller: not specifically better or worse	Changes from baseline to 12 weeks
Weight	Assessed using a digital scale without shoes. Minimum weight: none Maximum weight: none Higher weight: typically worse, but depends on other factors (ie. height, muscle mass, overall health status)	Changes from baseline to 12 weeks

Collaborators and Investigators

• Sponsor: University of Alberta
• Investigators: Principal Investigator: Kerry S Courneya, PhD, University of Alberta

Study record dates

Study Major Dates

• Study Start (Actual): November 24, 2020
• Primary Completion (Actual): July 31, 2022
• Study Completion (Actual): July 31, 2022

Study Registration Dates

• First Submitted: September 11, 2020
• First Submitted That Met QC Criteria: September 16, 2020
• First Posted (Actual): September 18, 2020

Study Record Updates

• Last Update Posted (Actual): September 6, 2022
• Last Update Submitted That Met QC Criteria: September 2, 2022
• Last Verified: September 1, 2022

More Information

Terms related to this study

• Keywords: exercise; surgery; strength training; neck dissection; survivors
• Additional Relevant MeSH Terms: Neoplasms; Neoplasms by Site; Head and Neck Neoplasms
• Other Study ID Numbers: 20-0169

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No