Feasibility of eccentric overloading and neuromuscular electrical stimulation to improve muscle strength and muscle mass
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Feasibility of eccentric overloading and neuromuscular electrical stimulation to improve muscle strength and muscle mass after treatment for head and neck cancer Colin Lavigne 1 & Rosie Twomey 1,2 & Harold Lau 3 & George Francis 4 & S. Nicole Culos-Reed 1,3,5 & Guillaume Y. Millet 1,6,7,8 Received: 18 December 2019 / Accepted: 7 May 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Treatment of head and neck cancer (HNC) results in severe weight loss, mainly due to the loss of lean body mass. Consequently, decreases in muscular strength and health-related quality of life (HRQL) occur. This study investigated the feasibility of a 12-week novel strength training (NST) and conventional strength training (CST) intervention delivered after HNC treatment. Methods Participants were randomized to a NST group (n = 11) involving eccentric overloaded strength training and neuromuscular electrical stimulation (NMES), or a CST group (n = 11) involving dynamic resistance exercises matched for training volume. Feasibility outcomes included recruitment, completion, adherence, and evidence of progression. A neuromuscular assessment involving maximal isometric voluntary contractions (MIVCs) in the knee extensors was evaluated prior to and during incremental cycling to volitional exhaustion at baseline and after the interventions. Anthropometrics and patient-reported outcomes (PROs) were also assessed. Results Although recruitment was challenging, completion was 100% in NST and 82% in CST. Adherence was 92% in NST and 81% in CST. Overall, MIVC increased by 19 ± 23%, muscle cross-sectional area improved 18 ± 22%, cycling exercise time improved by 18 ± 13%, and improvements in HRQL and fatigue were clinically relevant. Conclusions Both interventions were found to be feasible for HNC patients after treatment. Strength training significantly improved maximal muscle strength, muscle cross-sectional area, and PROs after HNC treatment. Future research should include fully powered trials and consider the use of eccentric overloading and NMES during HNC treatment. Implications for Cancer Survivors Eccentric- and NMES-emphasized strength training may be useful alternatives to conventional strength training after HNC treatment. Keywords Cancer rehabilitation . Electromyostimulation . Exercise oncology
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11764-020-00893-9) contains supplementary material, which is available to authorized users. * Guillaume Y. Millet [email protected] 1
Faculty of Kinesiology, University of Calgary, Calgary, Canada
2
Ohlson Research Initiative, Arnie Charbonneau Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
3
Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
4
Division of Physical Medicine & Rehabilitation, Cumming School of Medicine, University of Calgary, Calgary, Canada
5
Department of Psychosocial Resources, Cancer Car
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