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研究生：	鄭惠靖 Cheng, Hui-Ching
論文名稱：	運動介入在頭頸癌病人接受化療和放療後體適能表現之效果探討 The Fitness Performance in Patients with Head and Neck Cancer Receiving Chemoradiotherapy and the Therapeutic Effects of the Exercise Intervention
指導教授：	蔡昆霖 Tsai, Kun-Ling
學位類別：	碩士 Master
系所名稱：	醫學院 - 物理治療學系 Department of Physical Therapy
論文出版年：	2018
畢業學年度：	106
語文別：	英文
論文頁數：	77
中文關鍵詞：	頭部和頸部癌症、多模式運動訓練、身體適能
外文關鍵詞：	Head and Neck Cancer, Multimodal Exercise Training, Physical Fitness
相關次數：	點閱：95 下載：0
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背景
頭頸癌是目前全球常見癌症類型的第六名，並且每年新診斷超過65萬人，而在臨床診斷出癌症後會進行一連串的抗癌治療，包括: 放療、化療、靶向治療、和手術治療。然而，在接受完放療和化療之後頭頸癌病人會經歷廣泛的治療相關副作用，其中包括了體適能下降。根據美國運動醫學學會表示，癌症患者體適能有四大組成，包括: 肌肉適能，心肺適能，柔軟度和平衡。另外，運動訓練的好處可以增加體適能組成的任何一項。因此，本研究的目的是為探討多模式運動訓練是否可以改善頭頸癌病患的身體適能。
方法
這項研究設計為參與者的重複之組內和組間測量，並且納入22位頭頸癌病患分為控制組和運動組。而運動組介入8周多模式運動訓練，包含:有氧運動、阻力運動、和柔軟度訓練。而控制組則是接受一般衛教。本研究於8周前記錄病患基本數字，包括身體組成、柔軟度、肌肉適能、心肺適能，和平衡。研究數據由SPSS 22.0版軟體進行統計分析。比較組間和組內的差異。
結果
在我們的研究中，運動組和控制組之間所觀察到的臨床特徵都沒有顯著的差異。另外，運動組和控制組的運動介入前和運動介入後之肌肉適能、心肺適能、柔軟度和平衡的參數存在顯著差異，經過8個禮拜的運動訓練後，我們觀察到統計學上有顯著差異，頭頸癌病患在運動介入後有利於所有體適能測量，控制組則是相反的情況。
結論
在這項研究中，多模式運動訓練可以改善頭頸癌患者的身體適能，我們希望這項研究將有助於提供頭頸癌患者介入多模式運動訓練的支持。

Background and Purpose:
Head and neck cancer is the sixth most common type of cancer globally and over 650 000 people are diagnosed per year. Anti-cancer treatment includes radiotherapy, chemotherapy, target therapy and surgery. After accepting chemoradiotherapy, many head and neck cancer patients experience a wide range of cancer and treatment-related side effects including declining physical fitness. According to American College of Sports Medicine (ACSM), four components of cancer-patient-physical fitness include muscle fitness, cardiovascular fitness, balance, and flexibility. In addition, the benefits of exercise have increased in physical fitness. Therefore, the purpose of this study is to determine whether exercise training could improve the physical fitness of head and neck cancer patients.
Methods:
This study is a repeated measure within and between subject design, and recruit 22 head and neck cancer patients dividing into an intervention group and control group. Patients from intervention group received multimodel exercise for 8 weeks containing aerobic exercise, resistance training, balance training and flexibility training. Patients from control groups received general health education. The study recorded basic parameters of the patient before the 8-week exercise intervention, including muscle fitness, cardiopulmonary fitness, softness and balance. Statistical analysis was operated by SPSS version 22.0.
Results:
In our study, there are no significant differences between the intervention and control conditions were observed for any clinical characteristics. There are significant differences between baseline and post-exercise re-assessments both in intervention group and control group, including muscle fitness, cardiovascular fitness, flexibility, and balance. After 8 weeks exercise training, statistically significant differences between conditions were observed, in favour of head and neck patients in the intervention condition for all measures of physical fitness, and vice versa.
Conclusions:
In this study, the multi-model exercise training can improve physical fitness in head and neck cancer patients. We hope that this study will help provide additional support for multimodal exercise programming for head and neck cancer patients as well as suggesting relevant other available outcome measures for measuring program effectiveness.

Contents
摘要	I
ABSTRACT	II
致謝	IV
ABBREVIATION	V
CHAPTER I INTRODUCTION	1
	1.1 PREVALENCE OF CNACER	1
1.2 CHEMORADIOTHERAPY INDUCES DECLINE IN CARDIOVASCULAR FITNESS AND THE THERAPEUTIC EFFECTS OF EXERCISE INTERVENTION 	2
1.3 CHEMORADIOTHERAPY INDUCES DECLINE IN MUSCLE FITNESS AND FLEXIBILITY AND THE THERAPEUTIC EFFECTS OF EXERCISE INTERVENTION	3
1.4 CHEMORADIOTHERAPY INDUCES DECLINE IN BALANCE AND THE THERAPEUTIC EFFECTS OF EXERCISE INTERVENTION	5
	1.5 THE EFFECT OF EXERCISE ON CANCER PATIENTS	6
CHAPTER II MATERIALS AND METHODS	8
	2.1 STUDY DESIGN	8
	2.2 STUDY PARTICIPANTS	8
	2.3 PRODUCES	9
	2.4 INSTRUMENTS	9
	2.5 PHYSICAL FITNESS MEASUREMENT PROJECTS	10
2.6 SUTDY PROTOCOL FOR THE EXERCISE GROUP- MULTIMODAL EXERCISE GROUP	12
		2.6.1 AEROBIC EXERCISE TRAINING	13
		2.6.2 RESISTANCE EXERCISE TRAINING	13
		2.6.3 FLEXIBILITY EXERCISE TRAINING	14
	2.7 STATISTICAL ANALYSIS	14
CHAPTER III RESULTS	16
3.1 DEMOGRAPHIC, CLINICAL CHARACTERISTICS AND BODY COMPOSITION OF THE CONTROL AND EXERCISE GROUPS	16
	3.2 PRIMARY OUTCOME- PHYSICAL FITNESS PERFORMANCE	16
		3.2.1 FLEXIBILITY FITNESS IN CONTROL AND EXERCISE GROUPS	17
		3.2.2 MUSCLE FITNESS IN CONTROL AND EXERCISE GROUPS	17
		3.2.3 BALANCE IN CONTROL AND EXERCISE GROUPS	18
3.2.4 CARDIOVASCULAR FITNESS IN CONTROL AND EXERCISE GROUPS	18
			3.2.4.1 BLOOD PRESSURE IN CONTROL AND EXERCISE GROUPS	18
			3.2.4.2 HEART RATE IN CONTROL AND EXERCISE GROUPS	20
3.2.4.3 TIME OF COMPLETION AND COMPLETION RATE IN CONTROL AND EXERCISE GROUPS	22
			3.2.4.4 PHYSICAL INDEX IN CONTROL AND EXERCISE GROUPS	22
3.2.4.5 OXYGEN SATURATION IN CONTROL AND EXERCSIE GROUPS	22
3.2.4.6 RATE OF PERCEIVED EXERTION (RPE) IN CONTROL AND EXERCISE GROUPS	23
	3.3 SECONDARY OUTCOME- RESPIRATORY PRESSURE	23
3.3.1 RESPIRATORY PRESSURE IN CONTROL AND EXERCISE GROUPS	24
	3.4 SECONDARY OUTCOME- QUESTIONNAIRE	24
		3.4.1 EORTC QLQ-H&N 35 IN CONTROL AND EXERCISE GROUPS 	24
3.5 THE EXERCISE CAPACITY OF EXERCISE GROUP IN PRE-TRAINING AND POST-TRAINING	25
		3.5.1 BLOOD PRESSURE OF EXERCISE CAPACITY	25
		3.5.2 HEART RATE OF EXERCISE CAPACITY	26
3.5.3 OXYGEN SATURATION AND RATE PERCEIVED EXERTION OF EXERCISE CAPACITY 	26
CHAPTER IV DISCUSSION	27
4.1 CLINICAL CHARACTERISTICS AND BODY COMPOSITION OF HEAD AND NECK CANCER PATIENTS	27
4.2 EFFECT OF MULTIMODAL EXERCISE TRAINING ON THE FLEXIBILITY OF THE HEAD AND NECK CANCER PATIENTS	28
4.3 EFFECT OF MULTIMODAL EXERCISE TRAINING ON THE MUSCLE FITNESS OF THE HEAD AND NECK CANCER PATIENTS	30
4.4 EFFECT OF MULTIMODAL EXERCISE TRAINING ON THE BALANCE OF THE HEAD AND NECK CANCER PATIENTS	31
4.5 EFFECT OF MULTIMODAL EXERCISE TRAINING ON THE CARDIOVASCULAR FITNESS OF THE HEAD AND NECK CANCER PATIENTS	32
CHAPTER V CONCLUSIONS	34
REFERENCES 	35
TABLE AND FIGURE	38
TABLE 1. DEMOGRAPHIC, AND CLINICAL CHARACTERISTICS OF THE EXERCISE GROUP AND CONTROL GROUP	38
TABLE 2. BODY COMPOSITION OF THE EXERCIE GROUP AND CONTROL AT PRETEST AND POSTTEST	39
	TABLE 3. BODY COMPOSITION OF THE EXERCISE GROUP AND CONTROL GROUP WITH MEAN DIFFERENCE	40
TABLE 4. PHYSICAL FITNESS PERFORMANCE OF THE EXERCISE GROUP AND CONTROL GROUP AT PRETEST AND POSTTEST	41
TABLE 5. PHYSICAL FITNESS PERFORMANCE OF THE EXERCISE GROUP AND CONTROL GROUP WITH MEAN DIFFERENCE	42
TABLE 6. CARDIOVASCULAR FITNESS OF PHYSICAL FITNESS PERFORMANCE OF THE EXERCISE GROUP AND CONTROL GROUP AT PRETEST AN POSTTEST	43
TABLE 7. CARDIOVASCULAR FITNESS OF PHYSICAL FITNESS PERFORMANCE OF THE EXERCISE GROUP AND CONTROL GROUP AT PRETEST AND POSTTEST	44
TABLE 8. CARDIOVASCULAR FITNESS OF PHYSICAL FITNESS PERFORMANCE OF THE EXERCISE GROUP AND CONTROL GROUP AT PRETEST AND POSTTEST	45
TABLE 9. CARDIOVASCULAR FITNESS OF PHYSICAL FITNESS PERFORMANCE OF THE EXERCISE GROUP AND CONTROL GROUP WITH MEAN DIFFERENCE	46
TABLE 10. CARDIOVASCULAR FITNESS OF PHYSICAL FITNESS PERFORMANCE OF THE EXERCISE GROUP AND CONTROL GROUP PRETEST AND POSTTEST	47
TABLE 11. RESPIRATORY PRESSURE OF THE EXERCISE GROUP AND CONTROL GROUP AT PRETEST AND POSTTEST	48
TABLE 12. RESPIRATORY PRESSURE OF THE EXERCISE GROUP AND CONTROL GROUP WITH MEAN DIFFERENCE	49
TABLE 13. QUESTIONNAIRE OF THE EXERCISE GROUP AND CONTROL GROUP WITH MEAN DIFFERENCE AT PRETEST AND POSTTEST	50
TABLE 14. THE EXERCISE CAPACITY: BLOOD PRESSURE IN EXERCISE GROUP AT PRE-TRAINING AND POST-TRAINING	51
TABLE 15. THE EXERCISE CAPACITY: HEART RATE IN EXERCISE GROUP AT PRE-TRAINING AND POST-TRAINING	52
TABLE 16. THE EXERCISE CAPACITY: OXYGEN SATURATION AND RATE OF PERCEIVED EXERTION IN EXERCISE GROUP AT PRE-TRAINING AND POST-TRAINING	53
FIUGRE 1. FLOW CHART FOR RECRUITING HEAD AND NECK CANCER PATIENTS	54
FIGURE 2. EORTC QLQ H&N 35 QUESTIONNAIRE	55
FIGURE 3. RESISTANCE EXERCISE TRAINING	56
FIGURE 4. THE PHYSICAL FITNESS PERFORMANCE: MEAN DIFFERENCE OF FLEXIBILITY OF THE CONTROL GROUP AND EXERCISE GROUP	57
FIGURE 5. THE PHYSICAL FITNESS PERFORMANCE: STRENGTH OF THE CONTROL GROUP AND EXERCISE GROUP	58
FIGURE 6. THE PHYSICAL FITNESS PERFORMANCE: MEAN DIFFERENCE OF STRENGTH OF THE CONTROL GROUP AND EXERCISE GROUP	59
FIGURE 7. THE PHYSICAL FITNESS PERFORMANCE: DYNAMIC BALANCE OF THE CONTROL GROUP AND EXERCISE GROUP 	60
FIGURE 8. THE PHYSICAL FITNESS PERFORMANCE: MEAN DIFFERENCE OF DYNAMIC BALANCE OF THE CONTROL GROUP AND EXERCIS GROUP 	61
FIGURE 9. THE PHYSICAL FITNESS PERFORMANCE: BLOOD PRESSURE OF CARDIOVASCULAR FITNESS OF THE CONTROL GROUPO AND EXERCISE GROUP	62
FIGURE 10. THE PHYSICAL FITNESS PERFORMANCE: BLOOD PRESSURE OF CARDIOVASCULAR FITNESS OF THE CONTROL AND EXERCISE GROUP	63
FIGURE 11. THE PHYSICAL FITNESS PERFORMANCE: MEAN ARTERIAL PRESSURE OF CARDIOVASCULAR FITNESS OF THE CONTROL GROUP AND EXERCISE GROUP	64
FIGURE 12. THE PHYSICAL FITNESS PERFORMANCE: MYOCARDIAL OXYGEN CONSUMPTION OF CARDIOVASCULAR FITNESS OF THE CONTROL GROUP AND EXERCISE GROUP	65
FIGURE 13. THE PHYSICAL FITNESS PERFORMANCE: HEART RATE OF CARDIOVASCULAR FITNESS OF THE CONTROL GROUP AND EXERCISE GROUP	66
FIGURE 14. THE PHYSICAL FITNESS PERFORMANCE: HEART OF CARDIOVASCULAR FITNESS OF THE CONTROL GROUP AND EXERCISE GROUP	67
FIGURE 15. THE PHYSICAL FITNESS PERFORMANCE: MEAN DIFFERENCE OF HEAR RATE OF CARDIOVASCULAR GITNESS OF THE CONTROL GROUP AND EXERCISE GROUP	68
FIGURE 16. THE PHYSICAL FITNESS PERFORMANCE: TIME OF COMPLETION OF CARDIOVASCULAR FITNESS OF THE CONTROL GROUP AND EXERCISE GROUP	69
FIGURE 17. THE PHYSICAL FITNESS PERFORMANCE: MEAN DIFFERENCE OF TIME COMPLETION OF CARDIOVASCULAR FITNESS OF THE CONTROL GROUP AND EXERCISE GROUP	70
FIGURE 18. THE PHYSICAL FITNESS PERFORMANCE: MEAN DIFFERENCE OF TIME OF COMPLETION OF CARDIOVASCULAR FITNESS OF THE CONTROL GROUP AND EXERCISE GROUP	71
FIGURE 19. THE EXERCISE CAPACITY: BLOOD PRESSURE IN EXERCISE GROUP AT PRE-TRAINING AND POST-TRAINING	72
FIGURE 20. THE EXERCISE CAPACITY: BLOOD PRESSURE IN EXERCISE GROUP AT PRE-TRAINING AND POST-TRAINING	73
FIGURE 21. THE EXERCISE CAPACITY: MEAN ARTERIAL PRESSURE IN EXERCISE GROUP AT PRE-TRAINING AND POST-TRAINING	74
FIGURE 22. THE EXERCISE CAPACITY: HEART RATE IN EXERCISE GROUP AT PRE-TRAINING AND POST-TRAINING	75
FIGURE 23. FLOW CHART FOR RECRUITING HEAD AND NECK CANCER PATIENTS	76
                                    

References

1. Jemal, A., et al., Cancer statistics, 2005. CA Cancer J Clin, 2005. 55(1): p. 10-30.
2. Chiang, C.J., et al., Incidence and survival of adult cancer patients in Taiwan, 2002-2012. J Formos Med Assoc, 2016. 115(12): p. 1076-1088.
3. Argiris, A., et al., Head and neck cancer. Lancet, 2008. 371(9625): p. 1695-709.
4. Colagiuri, B., et al., Does Assessing Patients' Expectancies About Chemotherapy Side Effects Influence Their Occurrence? Journal of Pain and Symptom Management, 2013. 46(2): p. 275-281.
5. Josée, S., et al., Cancer treatments and their side effects are associated with aggravation of insomnia: Results of a longitudinal study. Cancer, 2015. 121(10): p. 1703-1711.
6. Capozzi, L.C., et al., A clinic-supported group exercise program for head and neck cancer survivors: managing cancer and treatment side effects to improve quality of life. Support Care Cancer, 2015. 23(4): p. 1001-7.
7. Angsutararux, P., S. Luanpitpong, and S. Issaragrisil, Chemotherapy-Induced Cardiotoxicity: Overview of the Roles of Oxidative Stress. Oxid Med Cell Longev, 2015. 2015: p. 795602.
8. Mostarda, C., et al., Short-term combined exercise training improves cardiorespiratory fitness and autonomic modulation in cancer patients receiving adjuvant therapy. J Exerc Rehabil, 2017. 13(5): p. 599-607.
9. Christensen, J.F., et al., Muscle dysfunction in cancer patients. Ann Oncol, 2014. 25(5): p. 947-58.
10. Repka, C.P. and R. Hayward, Oxidative Stress and Fitness Changes in Cancer Patients after Exercise Training. Med Sci Sports Exerc, 2016. 48(4): p. 607-14.
11. Lonkvist, C.K., et al., Progressive resistance training in head and neck cancer patients undergoing concomitant chemoradiotherapy. Laryngoscope Investig Otolaryngol, 2017. 2(5): p. 295-306.
12. Foley, M.P. and S.M. Hasson, Effects of a Community-Based Multimodal Exercise Program on Health-Related Physical Fitness and Physical Function in Breast Cancer Survivors: A Pilot Study. Integr Cancer Ther, 2016. 15(4): p. 446-454.
13. Henke, C.C., et al., Strength and endurance training in the treatment of lung cancer patients in stages IIIA/IIIB/IV. Support Care Cancer, 2014. 22(1): p. 95-101.
14. Duregon, F., et al., Effects of exercise on cancer patients suffering chemotherapy-induced peripheral neuropathy undergoing treatment: A systematic review. Crit Rev Oncol Hematol, 2018. 121: p. 90-100.
15. Mizrahi, D., et al., An Exercise Intervention During Chemotherapy for Women With Recurrent Ovarian Cancer: A Feasibility Study. Int J Gynecol Cancer, 2015. 25(6): p. 985-92.
16. Rikli, R.E. and C.J. Jones, Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. Gerontologist, 2013. 53(2): p. 255-67.
17. Gallant, N.R., et al., Adaptation of an evidence-based intervention for Appalachian women: new STEPS (Strength Through Education, Physical fitness and Support) for breast health. J Cancer Educ, 2013. 28(2): p. 275-81.
18. Jones, C.J., et al., A comparison of women with fibromyalgia syndrome to criterion fitness standards: a pilot study. J Aging Phys Act, 2015. 23(1): p. 103-11.
19. Mathias, S., U.S. Nayak, and B. Isaacs, Balance in elderly patients: the "get-up and go" test. Arch Phys Med Rehabil, 1986. 67(6): p. 387-9.
20. DeNysschen, C.A., et al., Nutritional symptom and body composition outcomes of aerobic exercise in women with breast cancer. Clin Nurs Res, 2011. 20(1): p. 29-46.
21. Newton, R.U., et al., Body composition, fatigue and exercise in patients with prostate cancer undergoing androgen-deprivation therapy. BJU Int, 2018.
22. Nguyen, M.H. and A. Kruse, The effects of Tai Chi training on physical fitness, perceived health, and blood pressure in elderly Vietnamese. Open Access J Sports Med, 2012. 3: p. 7-16.
23. Kirkham, A.A., et al., Clinically Relevant Physical Benefits of Exercise Interventions in Breast Cancer Survivors. Curr Oncol Rep, 2016. 18(2): p. 12.
24. Lee, S.A., et al., Effects of a scapula-oriented shoulder exercise programme on upper limb dysfunction in breast cancer survivors: a randomized controlled pilot trial. Clin Rehabil, 2010. 24(7): p. 600-13.
25. Eickmeyer, S.M., et al., Quality of life, shoulder range of motion, and spinal accessory nerve status in 5-year survivors of head and neck cancer. PM R, 2014. 6(12): p. 1073-80.
26. Foley, M.P., S.M. Hasson, and E. Kendall, Effects of a Translational Community-Based Multimodal Exercise Program on Quality of Life and the Influence of Start Delay on Physical Function and Quality of Life in Breast Cancer Survivors: A Pilot Study. Integr Cancer Ther, 2018. 17(2): p. 337-349.
27. Reis, A.D., et al., Effect of exercise on pain and functional capacity in breast cancer patients. Health Qual Life Outcomes, 2018. 16(1): p. 58.
28. Leclerc, A.F., et al., Multidisciplinary rehabilitation program after breast cancer: benefits on physical function, anthropometry and quality of life. Eur J Phys Rehabil Med, 2017. 53(5): p. 633-642.
29. Kirkham, A.A., et al., Health-related physical fitness assessment in a community-based cancer rehabilitation setting. Support Care Cancer, 2015. 23(9): p. 2525-33.
30. Almstedt, H.C., et al., Training-related improvements in musculoskeletal health and balance: a 13-week pilot study of female cancer survivors. Eur J Cancer Care (Engl), 2017. 26(2).

校內：2023-07-31公開
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