ACTivity as medicine In Oncology for Head and Neck (ACTIOHN): a feasibility study investigating a patient-centred approach to exercise for head and neck cancer patients
ObjectiveTo determine the feasibility and acceptability of integrating a remote, personalised, collaborative, and flexible exercise programme into the head and neck cancer (HNC) care pathway.DesignA single arm mixed-methods feasibility study across two UK NHS hospitals.ProcedureEligible HNC patients...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1525512/full |
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| author | Joanne M. Patterson Mary G. Cherry Andrew Levy Simon N. Rogers Rachel C. Brooker Valerie M. Bryant Steven Lane Michael M. Nugent Ruth Price Andrew G. Schache Jennifer A. Kirton Bridget Young Debra Fisher Adrian W. Midgely |
| author_facet | Joanne M. Patterson Mary G. Cherry Andrew Levy Simon N. Rogers Rachel C. Brooker Valerie M. Bryant Steven Lane Michael M. Nugent Ruth Price Andrew G. Schache Jennifer A. Kirton Bridget Young Debra Fisher Adrian W. Midgely |
| author_sort | Joanne M. Patterson |
| collection | DOAJ |
| description | ObjectiveTo determine the feasibility and acceptability of integrating a remote, personalised, collaborative, and flexible exercise programme into the head and neck cancer (HNC) care pathway.DesignA single arm mixed-methods feasibility study across two UK NHS hospitals.ProcedureEligible HNC patients (aged ≥ 16 years old, treated with curative intent and classified as low/medium risk according to an exercise risk stratification tool) were invited to participate between diagnosis and 8 weeks post-treatment. Patients treated with palliative intent and those identified as high risk on an exercise risk stratification tool were excluded. Following initial assessment, Cancer Exercise Specialists (CESs) and patients collaboratively devised a personalised exercise programme based on a needs analysis, preferences and goals, and informed by physical activity cancer guidelines and theory. CESs were trained in behaviour change techniques. The intervention was flexible and delivered remotely across 8 weeks, with weekly meetings and texts, and an exercise maintenance plan agreed in the final session.OutcomesEligibility, recruitment, retention and exercise adherence were primary outcomes. Quantitative outcomes included quality-of-life, fatigue and physical activity questionnaires and physical fitness tests. A qualitative sub-study explored patients’ and healthcare professionals’ (HCPs’) views on feasibility and acceptability.Results98% of patients screened were eligible; 107 patients were approached, and 76 consented (71%). Most (43%) were recruited pre-treatment. Three quarters were male and just over half had oropharyngeal cancer. Thirteen patients (17.1%) were withdrawn due to ill-health. Twenty-three (30.3%) patients dropped out, 13 after assessment but before the intervention, and ten during the intervention. Forty patients (52.6%) completed the intervention. Three quarters of exercise sessions were completed as prescribed. Patient interviews found the flexible, personalised approach valuable. Those not identifying as an ‘exerciser’ found the intervention more difficult to understand. The need for more education for both HCPs and patients regarding the benefits of exercise and its ‘fit’ within the HNC pathway was highlighted.ConclusionThis is a feasible and acceptable intervention, but some adjustments are required, to improve acceptability, recruitment processes, retention and adherence, before examining effectiveness in a definitive trial.Clinical Trial Registrationhttps://www.isrctn.com/ISRCTN82505455, identifier ISRCTN82505455. |
| format | Article |
| id | doaj-art-b4bf6cb9e2e34806a12153436a3931da |
| institution | DOAJ |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-b4bf6cb9e2e34806a12153436a3931da2025-08-20T03:17:50ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-07-011510.3389/fonc.2025.15255121525512ACTivity as medicine In Oncology for Head and Neck (ACTIOHN): a feasibility study investigating a patient-centred approach to exercise for head and neck cancer patientsJoanne M. Patterson0Mary G. Cherry1Andrew Levy2Simon N. Rogers3Rachel C. Brooker4Valerie M. Bryant5Steven Lane6Michael M. Nugent7Ruth Price8Andrew G. Schache9Jennifer A. Kirton10Bridget Young11Debra Fisher12Adrian W. Midgely13Liverpool Head and Neck Centre, School of Allied Healthcare Professionals and Nursing, University of Liverpool, Liverpool, United KingdomInstitute of Population Health, University of Liverpool, Liverpool, United KingdomDepartment of Psychology, Edge Hill University, Ormskirk, United KingdomArrowe Park Hospital, Wirral University Teaching Hospital National Health Service (NHS) Foundation Trust, Liverpool, United KingdomHead and Neck Oncology, The Clatterbridge Cancer Centre National Health Service (NHS) Foundation Trust, Liverpool, United KingdomCancer of Head and Neck Group Experience (CHANGE) Patient and Public Involvement Group, Sunderland Royal Hospital, Sunderland, United KingdomInstitute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, United KingdomOral and Maxillofacial Surgery, Sunderland Royal Hospital, South Tyneside and Sunderland National Health Service (NHS) Foundation Trust, Sunderland, United KingdomLiverpool Head and Neck Centre, Liverpool University Hospitals National Health Service (NHS) Foundation Trust, Liverpool, United Kingdom0Liverpool Head and Neck Centre, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, United KingdomInstitute of Population Health, University of Liverpool, Liverpool, United KingdomInstitute of Population Health, University of Liverpool, Liverpool, United KingdomInstitute of Population Health, University of Liverpool, Liverpool, United Kingdom1Department of Sport and Physical Activity, Edge Hill University, Ormskirk, United KingdomObjectiveTo determine the feasibility and acceptability of integrating a remote, personalised, collaborative, and flexible exercise programme into the head and neck cancer (HNC) care pathway.DesignA single arm mixed-methods feasibility study across two UK NHS hospitals.ProcedureEligible HNC patients (aged ≥ 16 years old, treated with curative intent and classified as low/medium risk according to an exercise risk stratification tool) were invited to participate between diagnosis and 8 weeks post-treatment. Patients treated with palliative intent and those identified as high risk on an exercise risk stratification tool were excluded. Following initial assessment, Cancer Exercise Specialists (CESs) and patients collaboratively devised a personalised exercise programme based on a needs analysis, preferences and goals, and informed by physical activity cancer guidelines and theory. CESs were trained in behaviour change techniques. The intervention was flexible and delivered remotely across 8 weeks, with weekly meetings and texts, and an exercise maintenance plan agreed in the final session.OutcomesEligibility, recruitment, retention and exercise adherence were primary outcomes. Quantitative outcomes included quality-of-life, fatigue and physical activity questionnaires and physical fitness tests. A qualitative sub-study explored patients’ and healthcare professionals’ (HCPs’) views on feasibility and acceptability.Results98% of patients screened were eligible; 107 patients were approached, and 76 consented (71%). Most (43%) were recruited pre-treatment. Three quarters were male and just over half had oropharyngeal cancer. Thirteen patients (17.1%) were withdrawn due to ill-health. Twenty-three (30.3%) patients dropped out, 13 after assessment but before the intervention, and ten during the intervention. Forty patients (52.6%) completed the intervention. Three quarters of exercise sessions were completed as prescribed. Patient interviews found the flexible, personalised approach valuable. Those not identifying as an ‘exerciser’ found the intervention more difficult to understand. The need for more education for both HCPs and patients regarding the benefits of exercise and its ‘fit’ within the HNC pathway was highlighted.ConclusionThis is a feasible and acceptable intervention, but some adjustments are required, to improve acceptability, recruitment processes, retention and adherence, before examining effectiveness in a definitive trial.Clinical Trial Registrationhttps://www.isrctn.com/ISRCTN82505455, identifier ISRCTN82505455.https://www.frontiersin.org/articles/10.3389/fonc.2025.1525512/fullhead and neck cancerrehabilitationprehabilitationphysical exercisefeasibilitypersonalisation |
| spellingShingle | Joanne M. Patterson Mary G. Cherry Andrew Levy Simon N. Rogers Rachel C. Brooker Valerie M. Bryant Steven Lane Michael M. Nugent Ruth Price Andrew G. Schache Jennifer A. Kirton Bridget Young Debra Fisher Adrian W. Midgely ACTivity as medicine In Oncology for Head and Neck (ACTIOHN): a feasibility study investigating a patient-centred approach to exercise for head and neck cancer patients Frontiers in Oncology head and neck cancer rehabilitation prehabilitation physical exercise feasibility personalisation |
| title | ACTivity as medicine In Oncology for Head and Neck (ACTIOHN): a feasibility study investigating a patient-centred approach to exercise for head and neck cancer patients |
| title_full | ACTivity as medicine In Oncology for Head and Neck (ACTIOHN): a feasibility study investigating a patient-centred approach to exercise for head and neck cancer patients |
| title_fullStr | ACTivity as medicine In Oncology for Head and Neck (ACTIOHN): a feasibility study investigating a patient-centred approach to exercise for head and neck cancer patients |
| title_full_unstemmed | ACTivity as medicine In Oncology for Head and Neck (ACTIOHN): a feasibility study investigating a patient-centred approach to exercise for head and neck cancer patients |
| title_short | ACTivity as medicine In Oncology for Head and Neck (ACTIOHN): a feasibility study investigating a patient-centred approach to exercise for head and neck cancer patients |
| title_sort | activity as medicine in oncology for head and neck actiohn a feasibility study investigating a patient centred approach to exercise for head and neck cancer patients |
| topic | head and neck cancer rehabilitation prehabilitation physical exercise feasibility personalisation |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1525512/full |
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