Effect of Structured Exercise-based rehabilitation on Sarcopenia and Quality of life among Head and Neck Cancer...

Sarcopenia is considered an independent prognostic factor for overall survival and performance status in head and neck cancer (HNC) receiving chemo-radiotherapy (CRT). CRT is known to cause sleep disturbances, increased pain perception, depression leading to reduced quality of life (QOL). Exercise-based rehabilitation has emerged as a promising strategy for improving outcomes in HNC. Our study aimed to evaluate effect of exercise on sarcopenia and QOL in patients with HNC receiving CRT.

Seventy HNC patients, aged 40-70 years TNM stage III- IVb receiving CRT, were randomized into two groups and received intervention for seven weeks. Intervention Group, IG (n=40) received combined aerobic and resistance training according to the ACSM guidelines. Control Group, CG (n=40) were advised to walk according to the NCCN guidelines. Sarcopenia was assessed using Bio Impedance Analyser (BIA), muscle strength using JAMAR hand dynamometer and QOL by FACT H&N on pre CRT day 1 and post 7 weeks. Wilcoxon signed-rank test and Mann-Whitney U test were used to assess within-group differences and  between-group comparisons respectively.

80 participants with a mean age of 58.44 ±3.75 years were included. IG showed a smaller decrease in total skeletal muscle mass compared to CG with IGs total skeletal muscle mass decreasing from 35 to 30 and CGs muscle mass decreasing from 40 to 21 (p<0.001). QOL showed significant improvement in CG from 66 to 61 (p < 0.001). In contrast, IGs quality of life saw a minor, non-significant change from 62 to 61.

Sarcopenia was lesser in IG compared to CG, highlighting the favourable impact of resistance training and its inclusion in the HNC rehabilitation. However, CG demonstrated significant improvements in quality of life as compared to IG suggesting that quality of life is a multifaceted construct that may not be directly correlated with physical improvements alone.