Safety and feasibility of cardiopulmonary exercise testing in head and neck cancer survivors

Midgley, Adrian W, Levy, Andrew R, Cunha, Felipe A, Key, Angela, Patterson, Joanne M ORCID: 0000-0001-8898-8292 and Rogers, Simon N (2023) Safety and feasibility of cardiopulmonary exercise testing in head and neck cancer survivors. CLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, 43 (3). pp. 170-180.

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Official URL: http://dx.doi.org/10.1111/cpf.12807

Abstract

<h4>Purpose</h4>Assess safety and feasibility of the cardiopulmonary exercise test (CPET) for evaluating head and neck cancer (HaNC) survivors. Also compare their cardiorespiratory fitness to age and sex-matched norms and establish current physical activity levels.<h4>Methods</h4>Fifty HaNC survivors [29 male; mean (SD) age, 62 (8) years], who had completed treatment up to 1 year previously, were recruited. Participants performed a CPET on a cycle ergometer to symptom-limited tolerance. Participants completed a questionnaire to report contributory factors they perceived as influencing test termination. Physical activity levels were determined using a self-reported physical activity questionnaire.<h4>Results</h4>Three participants did not complete the CPET because (1) poor fitting mouthpiece and naso-oral mask due to facial disfiguration from surgery; (2) knee pain elicited by cycling; and (3) early CPET termination due to electrocardiogram artefacts. Participants reached a mean peak oxygen uptake that was 34% lower than predicted and the mean (SD) CPET duration of 7:52 (2:29) min:s was significantly lower than the target test duration of 10 min (p < 0.001). Leg muscle aches and/or breathing discomfort were major contributory factors influencing test termination for 78% of participants, compared to 13% for dry mouth/throat and/or drainage in the mouth/throat. No major adverse events occurred. Participants were categorised as 26% active, 8% moderately active, and 66% insufficiently active.<h4>Conclusion</h4>These preliminary data suggest the CPET appears safe and feasible for most HaNC survivors when strict exclusion criteria are applied; however, low levels of cardiorespiratory fitness should be considered when calculating an appropriate ramp rate.

Item Type:	Article
Uncontrolled Keywords:	cardiorespiratory fitness, CPET, CPX, oncology, peak oxygen uptake, risk
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health Faculty of Health and Life Sciences > Institute of Population Health > School of Health Sciences
Depositing User:	Symplectic Admin
Date Deposited:	16 Feb 2023 14:24
Last Modified:	04 May 2023 04:52
DOI:	10.1111/cpf.12807
Open Access URL:	https://doi.org/10.1111/cpf.12807
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3168448