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Feasibility of eccentric overloading and neuromuscular electrical stimulation to improve muscle strength and muscle mass after treatment for head and neck cancer

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Abstract

Purpose

Treatment of head and neck cancer (HNC) results in severe weight loss, mainly due to the loss of lean body mass. Consequently, decreases in muscular strength and health-related quality of life (HRQL) occur. This study investigated the feasibility of a 12-week novel strength training (NST) and conventional strength training (CST) intervention delivered after HNC treatment.

Methods

Participants were randomized to a NST group (n = 11) involving eccentric overloaded strength training and neuromuscular electrical stimulation (NMES), or a CST group (n = 11) involving dynamic resistance exercises matched for training volume. Feasibility outcomes included recruitment, completion, adherence, and evidence of progression. A neuromuscular assessment involving maximal isometric voluntary contractions (MIVCs) in the knee extensors was evaluated prior to and during incremental cycling to volitional exhaustion at baseline and after the interventions. Anthropometrics and patient-reported outcomes (PROs) were also assessed.

Results

Although recruitment was challenging, completion was 100% in NST and 82% in CST. Adherence was 92% in NST and 81% in CST. Overall, MIVC increased by 19 ± 23%, muscle cross-sectional area improved 18 ± 22%, cycling exercise time improved by 18 ± 13%, and improvements in HRQL and fatigue were clinically relevant.

Conclusions

Both interventions were found to be feasible for HNC patients after treatment. Strength training significantly improved maximal muscle strength, muscle cross-sectional area, and PROs after HNC treatment. Future research should include fully powered trials and consider the use of eccentric overloading and NMES during HNC treatment.

Implications for Cancer Survivors

Eccentric- and NMES-emphasized strength training may be useful alternatives to conventional strength training after HNC treatment.

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Acknowledgments

The authors sincerely thank Erin MacDonald (Head & Neck Tumor Group Coordinator, Tom Baker Cancer Centre) for her contributions to participant recruitment and all the volunteers who participated in the study.

Author information

Authors and Affiliations

  1. Faculty of Kinesiology, University of Calgary, Calgary, Canada

    Colin Lavigne, Rosie Twomey, S. Nicole Culos-Reed & Guillaume Y. Millet

  2. Ohlson Research Initiative, Arnie Charbonneau Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada

    Rosie Twomey

  3. Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada

    Harold Lau & S. Nicole Culos-Reed

  4. Division of Physical Medicine & Rehabilitation, Cumming School of Medicine, University of Calgary, Calgary, Canada

    George Francis

  5. Department of Psychosocial Resources, Cancer Care, Alberta Health Services, Tom Baker Cancer Centre, Calgary, Canada

    S. Nicole Culos-Reed

  6. Inter-university Laboratory of Human Movement Biology, Univ Lyon, UJM-Saint-Etienne, EA 7424, F-42023, Saint-Etienne, France

    Guillaume Y. Millet

  7. Institut Universitaire de France (IUF), Paris, France

    Guillaume Y. Millet

  8. Jean Monnet University Saint-Etienne, 10 rue de la Marandière, 42270, Saint Priest en Jarez, France

    Guillaume Y. Millet

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  1. Colin Lavigne
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Correspondence to Guillaume Y. Millet.

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Lavigne, C., Twomey, R., Lau, H. et al. Feasibility of eccentric overloading and neuromuscular electrical stimulation to improve muscle strength and muscle mass after treatment for head and neck cancer. J Cancer Surviv 14, 790–805 (2020). https://doi.org/10.1007/s11764-020-00893-9

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