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Unsupervised exercise in survivors of human papillomavirus related head and neck cancer: how many can go it alone?

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Abstract

Purpose

Patients with human papillomavirus (HPV)-related head and neck cancer (HNC) have a better prognosis relative to other types of HNC, making survivorship an emerging and critical issue. Exercise is a core component of survivorship care, but little is known about how many survivors of HPV-related HNC can safely be advised to start exercising on their own, as opposed to needing further evaluation or supervised exercise.

Methods

We utilized guidelines to identify health issues that would indicate value of further evaluation prior to being safely prescribed unsupervised exercise. We performed a retrospective chart review of 150 patients with HPV-related HNC to assess health issues 6 months after completing definitive therapy. Patients with at least one health issue were deemed appropriate to receive further evaluation prior to prescription for unsupervised exercise. We utilized logistic regression to identify clinical and demographic factors associated with the need for further evaluation, likely performed by outpatient rehabilitation clinicians.

Results

In this cohort of patients, 39.3% could safely be prescribed unsupervised exercise 6 months after completing definitive therapy. On multivariable regression, older age, BMI >30, and receipt of radiation were associated with an increased likelihood for requiring further evaluation or supervised exercise.

Conclusions

Over half of patients with HPV-related HNC would benefit from referral to physical therapy or an exercise professional for further evaluation to determine the most appropriate level of exercise supervision, based upon current guidelines.

Implications for cancer survivors

Development of such referral systems will be essential to enhance survivorship outcomes for patients who have completed treatment.

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Authors and Affiliations

  1. Perelman Center for Advanced Medicine, Perelman School of Medicine at the University of Pennsylvania, South Pavilion, Floor 10, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA

    Joshua Bauml, Jiyoung Kim, Charu Aggarwal & Roger B. Cohen

  2. Penn State College of Medicine, Hershey, PA, USA

    Xiaochen Zhang & Kathryn Schmitz

Authors
  1. Joshua Bauml
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  2. Jiyoung Kim
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  3. Xiaochen Zhang
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  4. Charu Aggarwal
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  5. Roger B. Cohen
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  6. Kathryn Schmitz
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Corresponding author

Correspondence to Joshua Bauml.

Ethics declarations

The institutional review board at the University of Pennsylvania approved this study.

Funding

This work was supported by the NIH, grant number U54-CA155850 (KS).

Conflict of interest

The authors declare that they have no relevant conflicts of interest.

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Bauml, J., Kim, J., Zhang, X. et al. Unsupervised exercise in survivors of human papillomavirus related head and neck cancer: how many can go it alone?. J Cancer Surviv 11, 462–468 (2017). https://doi.org/10.1007/s11764-017-0604-5

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  • DOI: https://doi.org/10.1007/s11764-017-0604-5

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