Feasibility and efficacy of telerehabilitation in the management of patients with head and neck cancer during and after oncological treatment: A systematic review

Feasibility of a comprehensive supervised exercise program during and after treatment of head and neck cancer: a mixed-methods study

PURPOSE

This study evaluates the feasibility of a comprehensive supervised exercise program (CSEP) for head and neck cancer (HNC) patients during and after (chemo)radiotherapy, integrating quantitative and qualitative data to identify participation barriers and facilitators.

METHODS

To investigate the feasibility of the CSEP, a mixed-method study was performed. For the quantitative part, first, adherence to and safety of the CSEP were considered as quantitative feasibility outcome measures. Second, two questionnaires evaluated acceptability, adherence, feasibility, therapeutic support, and overall evaluation at 12 weeks and 6 months after the start of the radiotherapy. Additionally, focus groups were held to discuss acceptability, adherence, expectations, feasibility, therapeutic support, and overall evaluation. The quantitative and qualitative data were integrated and discussed via a joint display table.

RESULTS

Quantitative data were available from 32 participants. Three focus groups with in total 11 participants were organized. Overall adherence to the CSEP was 72%, and no serious adverse events were reported, confirming the program's safety. Adherence and feasibility posed challenges; hospital sessions had higher adherence due to better motivation and guidance, whereas home sessions faced issues like lack of motivation and time constraints. Participants highlighted the program's individualization as a significant strength.

CONCLUSION

The CSEP was positively received, deemed safe, and feasible during and after HNC treatment, with participants recommending it to other HNC patients.

TRIAL REGISTRATION

Trial Registration: ClinicalTrials.gov Identifier: NCT05256238 (Registered on February 25, 2022).

Role of telemedicine in head neck cancer

Chemo-radiotherapy and head and neck cancers are common adverse outcomes that impact patients' quality of life. The increasing cancer incidence and healthcare service shortages necessitate new strategies for optimal treatments and follow-ups. Digitalized healthcare, including digital health, telemedicine, and telemonitoring, is promising. HNC requires multidisciplinary team intervention, including speech language pathology telepractice models. Mobile health-based interventions can help cancer survivors increase physical activity and improve rehabilitation services. Effective self-management skills can improve outcomes. Advancements in communication technologies have led to telecommunication-based interventions incorporating swallowing exercises, education, monitoring, feedback, self-management, and communication. Home-based remote rehabilitation is urgent, especially during the COVID-19 pandemic, but the optimal strategy and effectiveness of remote interventions remain unclear. Telehealth interventions represent a possible novel approach to increase access to care across the cancer continuum, strengthen patients' knowledge and self-management, provide continuity of services, and enable remote monitoring of symptoms and response to treatment. Telehealth patients are typically younger, more likely to be English-speaking, and more likely to be female. These disparities widened slightly after the start of the pandemic but were also present prior to the pandemic.

Development of mobile health-based interventions to promote physical activity in patients with head and neck cancer: a qualitative study

Background

Despite the well-grounded benefits of physical activity (PA), poor compliance with the PA guidelines has been reported among head and neck cancer (HNC) patients. Mobile health (mHealth)-based interventions can help cancer survivors increase their PA levels and increase the reach or efficiency of rehabilitation services. However, there is limited knowledge about the needs and perceptions of HNC patients regarding these interventions. This study explored the perceptions and needs of HNC patients regarding mHealth-based PA programs before developing such interventions to ensure their improved effectiveness.

Study design

A constructivist qualitative study.

Methods

We purposively selected 17 adult HNC patients aged 40-80 years to determine their needs and perceptions of future mHealth-based PA programs. Semi-structured face-to-face interviews were conducted, and the data were analyzed via thematic analysis. The report followed the Consolidated Criteria for Qualitative Research Reports guidelines.

Results

Four themes were analyzed from the interview transcripts regarding the needs and perceptions of mHealth-based PA programs: (1) functionality needs; (2) system usage requirements; (3) social support; and (4) perceived barriers and facilitators. HNC patients expect highly customized and specialized mHealth interventions that consider individual factors, address their concerns about security, network, and cost, and prefer improved comfort. Moreover, they expect to receive support from their healthcare providers, families, and peers.

Conclusion

The study provides pragmatic ready-to-use recommendations to design interventions for inactive HNC patients to achieve the recommended PA levels. Future mHealth interventions should be tailored according to the needs of the HNC patients by utilizing perceived facilitators and removing perceived barriers to help them engage in PA actively.