ORIGINAL RESEARCH article
Front. Oncol.
Sec. Head and Neck Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1602532
This article is part of the Research TopicMultidisciplinary Management of Oral Cancer: Diagnosis, Treatment, and RehabilitationView all 10 articles
Individualized home training in head and neck cancer patients is safe and has positive short-und medium term effects -results of a multicenter, single-arm intervention trial (OSHO #94)
Provisionally accepted- 1Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
- 2Institut for Biostatistic and Informatics in Medicine, Rostock University Medical Center, Rostock, Germany
- 3Department of Otorhinolaryngology, Head and Neck Surgery "Otto Koerner", Rostock University Medical Center, Rostock, Germany
- 4Krukenberg Cancer Center Halle, University Hospital Halle, Halle (Saale), Germany
- 5Department of Internal Medicine, Medical Clinic II, Carl-von-Basedow-Klinikum, Merseburg, Germany
- 6Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Greifswald, Greifswald, Mecklenburg-Vorpommern, Germany
- 7Department of Orthopedics, Trauma and Rehabilitation Medicine, Physical and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
- 8Hematology and Oncology Practice, Rostock, Germany
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Introduction Despite targeted exercise interventions alleviating functional deficits in head and neck cancer (HNC) patients, many patients are insufficiently physically active. A promising approach to reducing barriers could be individually adaptable home training. The "OSHO #94" study examined the short-term effectiveness, the medium-term sustainability, and the safety of an individualized home exercise program.Methods This three-center, single-arm, interventional study included patients in aftercare or stable remission under immunotherapy. Participants were advised to perform an individualized home exercise program (mobilization, coordination, strengthening, and stretching) at least three times a week and moderate-intensity endurance training two to three times a week. During the 12-week intervention, they kept a training diary and received weekly physiotherapist calls. In the subsequent 12-week followup (FU), participants were asked to continue training. The evaluation of short-term effects (between pre-and post-intervention) and medium-term effects (incl. FU), included the assessment of quality of life (QoL), physical activity levels (Leisure Score Index (LSI); weekly amount), body composition, shoulder/cervical spine range of motion, fall risk, and aerobic performance. Adverse events were recorded.Fifty-three patients (57% male) were enrolled, 83% completed the post assessment, and 72% completed FU. During the intervention, participants exercised for 257 min/week (with 95 minutes individual and 162 minutes endurance). The pre-post intervention effect on the global QoL was small (rw=0.20, p=0.186). Moderate effects were found in emotional (rw=0.38, p=0.011) and social functioning (rw=0.46, p=0.002), fatigue (rw=0.37, p=0.013), and dyspnea (rw=0.32, p=0.035). LSI increased significantly (25 vs. 39, p=0.003), whereas total physical activity duration remained unchanged (280 vs. 290 min/week, p=0.160). Small effects were observed on body composition. The largest effects were found in physical functioning, particularly aerobic performance (rw=0.67, p<0.001). Nine participants (17%) reported training-related adverse events, primarily pain. Half of participants (48%) continuing with individual training during FU. Some short-term effects could be detected medium-term. Discussion Physical activity levels improved despite an unchanged activity duration suggesting an increased training intensity. With individualized home exercises and remote support, home training was effective and safe. After support ended, patients maintained their activity level and the effects were sustained, suggesting suitability for routine care.
Keywords: EORTC QLQ-C30 (version 3), EORTC QLQ-HN35, head and neck cancer, Health-related quality of life (QOL), home-based exercise, physical functionality, Physical activity (exercise)
Received: 29 Mar 2025; Accepted: 21 May 2025.
Copyright: © 2025 Felser, Bonke, Glass, Strüder, Stolle, Schulze, Blaurock, Steinmetz, Daunheimer, Kriesen, Grosse-Thie and Junghanss. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sabine Felser, Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
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