Purpose: This study used a randomized control design to compare the effect of circadian-based exercise and massage intervention, exercise only, and massage only on sleep and fatigue in head and neck patients undergoing chemo-radiotherapy.
Methods: Sixty patients with head and neck carcinoma aged 53.5±9.5 years were randomly allocated to exercise group (EG, n=22), massage group (MG, n=17) or exercise and massage group (EMG, n=21). Exercise was performed at 8-10 am and 14-16 pm for 15 minute for 3 consecutive days. Massage was performed by using a massage cushion before bedtime (20-22 pm) for 15 minutes for 3 consecutive evenings after started chemo-radiation therapy. The Taiwan General Fatigue Scale (TGFS) and the Verramn & Snyder-Halpen scale (VSH) were administered to assess fatigue and sleep quality, respectively, before and after therapy starts for 4 days.
Results: All patients in three groups experienced low fatigue level (TGFS score 23.1~31.6±8.8~13.9), moderate sleep quality (VSH score 74.6~101.6±17.7~27.4). No significant differences at baseline among these three groups. During intervention, the fatigue level is linear decreased in EMG group (F=6.826, p=.017), quadratic decreased in the EG group (F=4.851, p=.039), but no changes in MG group (F=2.160, p=.161). There were no significant changes in sleep quality within and among groups (all p >.05).
Conclusion: A circadian-based intervention combined with exercise and massage may have better effect on decreasing the fatigue level than exercise or massage alone in head and neck cancer patients undergoing chemo-radiation therapies.
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