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Multiphasic exercise prehabilitation for patients undergoing surgery for head and neck cancer: a hybrid effectiveness-implementation study protocol

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Abstract

Head and neck cancer (HNC) treatment often consists of major surgery followed by adjuvant therapy, which can result in treatment-related side effects, decreased physical function, and diminished quality of life. Perioperative nutrition interventions and early mobilization improve recovery after HNC treatment. However, there are few studies on prehabilitation that include exercise within the HNC surgical care pathway. We have designed a multiphasic exercise prehabilitation intervention for HNC patients undergoing surgical resection with free flap reconstruction. We will use a hybrid effectiveness-implementation study design guided by the RE-AIM framework to address the following objectives: (1) to evaluate intervention benefits through physical function and patient-reported outcome assessments; (2) to determine the safety and feasibility of the prehabilitation intervention; (3) to evaluate the implementation of exercise within the HNC surgical care pathway; and (4) to establish a post-operative screening and referral pathway to exercise oncology resources. The results of this study will provide evidence for the benefits and costs of a multiphasic exercise prehabilitation intervention embedded within the HNC surgical care pathway. This paper describes the study protocol design, multiphasic exercise prehabilitation intervention, planned analyses, and dissemination of findings.

Trial registration: https://clinicaltrials.gov/NCT04598087

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Author information

Authors and Affiliations

  1. Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, T2N IN4, Calgary, Alberta, Canada

    Chad W. Wagoner, Julia T. Daun, Jessica Danyluk, Rosie Twomey, Elaine Gentleman & S. Nicole Culos-Reed

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

    Chad W. Wagoner, Megan Peterson, Shamir P. Chandarana, Robert D. Hart, T. Wayne Matthews, David McKenzie, Jennifer Matthews, Steven C. Nakoneshny, Christiaan Schrag, Khara M. Sauro & Joseph C. Dort

  3. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Chad W. Wagoner & Khara M. Sauro

  4. Physical Medicine & Rehabilitation, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

    Lisa Murphy, Lauren C. Capozzi & George J. Francis

  5. Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Shamir P. Chandarana, Robert D. Hart, T. Wayne Matthews, David McKenzie, Jennifer Matthews, Christiaan Schrag, Khara M. Sauro & Joseph C. Dort

  6. Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Khara M. Sauro, Harold Lau & S. Nicole Culos-Reed

  7. O’Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Khara M. Sauro

  8. Acute Care, Alberta Health Services, Calgary, Canada

    Vida Manaloto, Lindsay Burnett & Alex Chisholm

  9. Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB, Canada

    S. Nicole Culos-Reed

Authors
  1. Chad W. Wagoner
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  2. Julia T. Daun
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  3. Jessica Danyluk
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  4. Rosie Twomey
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  5. Lisa Murphy
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  6. Megan Peterson
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  7. Elaine Gentleman
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  8. Lauren C. Capozzi
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  9. George J. Francis
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  10. Shamir P. Chandarana
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  11. Robert D. Hart
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  12. T. Wayne Matthews
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  13. David McKenzie
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  14. Jennifer Matthews
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  15. Steven C. Nakoneshny
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  16. Christiaan Schrag
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  17. Khara M. Sauro
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  18. Joseph C. Dort
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  19. Vida Manaloto
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  20. Lindsay Burnett
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  21. Alex Chisholm
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  22. Harold Lau
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  23. S. Nicole Culos-Reed
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Contributions

S. NC-R, J. Dort, and RT developed the study concept and protocol. S. NC-R and CW drafted the manuscript in addition to J. Daun, J. Danyluk, RT, EG, LM, LC, SC, WM, and KS contributing to major manuscript revisions and providing critical feedback. CW, J. Daun, J. Danyluk, RT, and LM all contribute to the acquisition of data for the study outcomes and deliver the intervention. We want to emphasize that every author listed has read and agreed with the manuscript and will oversee the implementation of the protocol and contribute to the analysis and interpretation/application of study data.

Corresponding author

Correspondence to Chad W. Wagoner.

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Ethical approval

This study will be performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Health Research Ethics Board of Alberta: Cancer Committee (HREBA.CC-20-0013).

Competing Interest

The authors declare no competing interests.

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Wagoner, C.W., Daun, J.T., Danyluk, J. et al. Multiphasic exercise prehabilitation for patients undergoing surgery for head and neck cancer: a hybrid effectiveness-implementation study protocol. Support Care Cancer 31, 726 (2023). https://doi.org/10.1007/s00520-023-08164-w

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