2011-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/648277摘要：口腔癌為台灣男性最常見的癌症之一，由於疾病病灶位置及伴隨著同步化學合併頭頸部放射線之相關治療，病患將經歷一連串急性症狀困擾及體能活動受限的問題，受限的體能活動將可能造成日後病患頭頸部及張口之問題，及上半身與一般性的身體功能下降；然而，系統性的文獻資料回顧後發現，目前並未有研究針對口腔癌病患全位體能及頭頸肩功能失調及運動之探討，像是體適能的下降問題，尤其在病患第一年的癌症治療歷程中。因此，本三年期計劃案將有三大目的：（1）以縱貫性研究探討口腔癌病患診斷後第一年的身體活動現況、困難及喜好；（2）以縱貫性研究探討上半身身體功能（張口能力／牙關緊閉、頸部活動、肩功能、筋膜疼痛、及上肢肌力）及一般性體適能的狀態；（3）發展六個月連續性活動方案，並以RCT 測試其改善上半身功能、一般性身體功能、疲倦、及生活品質於診斷後第一年可開刀之口腔癌病患之成效。此六個月的”多面向持續性運動計畫” (Multi-Faced ContinuousExercise Program) 基植於整合「連續性癌症照護」及「結合結構性及病患喜好之運動」兩大概念而發展，於癌症治療至治療結束共持續六個月之運動方案，將追蹤12 個月間之成效。納入本研究之病患條件為新診斷可開刀之口腔癌病患，針對研究目的（1）及（2），將會連續追蹤病患12 個月（開刀前及術後第1、3、6、12 個月/ T1-T5），收案內容包括身體活動、疲倦、上半身身體功能、一般性體適能、及生活品質，亦將評估於癌症治療期間，病患運動喜好及執行體能活動的障礙。針對研究目的（3），從第二年起，六個月的“多面向持續性運動計畫”將運用於可開刀的口腔癌病患中，與接受目前醫院常態照顧的控制組進行比較，於12 個月期間（開刀前及術後第1、3、6、12 個月/ T1-T5），探討在預防身體功能不良及增加身體功能的差異。資料將以描述性統計及廣義線性推估模式進行分析，預計將有130位個案納入於第一年計畫中，260 位個案納入第二年的計畫中，收錄之個案數皆依據檢力（power analysis）原則估算。研究結果將有助於建構臨床醫護人員對身體活動、身體功能及不良狀況改變之相關知識，並提昇對連續性運動方案對促進口腔癌病患身體功能及生活品質之成效的認識。<br> Abstract: Oral cavity cancer is one of the most prevalent cancers in male in Taiwan.Due to the disease location and related treatments in head and neck areasfollowing with concurrent chemoradiation therapy (CCRT), patients might sufferseries of acute distress and limit their physical activities. Limited physicalactivities might further cause dysfunction in both upper body and general physicalfunction. However, lack of systematically documented information about theseproblems in oral cavity caner patients in Taiwan. It is also lack of effectiveexercise program to help oral cavities cancer patients to prevent dysfunction aswell as declining physical fitness in the cancer process, particularly, in the firstyear of their cancer process. Therefore, this 3-year project will be conducted forthree folds, with the purposes to (1) longitudinally explore the levels and types ofphysical activities applied by oral cavity cancers patients across the first year oftheir cancer diagnosis;(2) longitudinally examine the upper body function (mouthopen abilities/trismus, neck stiffness/flexibility, shoulder function, myofascialpain, and upper arm muscle strengths) and general physical fitness; and (3)develop a 6-month continuous exercise program and test of its effects onimproving upper body function, general physical function, fatigue and quality oflife in operable oral cavity cancers in the first year of being diagnosed as cancer.A 6-month“Multi-Faced Continuous Exercise Program” would be developedbased on two major concepts of “Cancer care as a continuous process” and“combining structured and patients preferred exercises” and further be testedacross the 6 month from pre-operation, CCRT phase to off treatment survivalprocess.The eligible subjects will be newly diagnosed operable oral cavity cancerpatients. For research purpose (1) & (2), we will conduct the data collection forcontinuous and follow patients for 12 months (Pre-operation, post-op 1, 3, 6, 12months,/ T1-T5, respectively) for the physical activities, fatigue, upper bodyfunction and general physical fitness, and quality of life. Eligible subjects will beassessed of the preferences and perceived barriers of doing physical activities inthe cancer process. A total of 130 subjects are planned to be recruited based on thesample size calculation. For research purpose (3), from the second year, the6-month “Multi-Faced Continuous Exercise Program” will be developed andtested in newly diagnosed operable oral cavity cancer patients, while compare tothose standard care control group of their differences in preventing physicaldysfunction and increasing physical function for 12-month period onpre-operation, post-op 1, 3, 6, & 12 months (T1-T5, respectively). Data will beanalyzed by both descriptive analysis and the Generalized Estimating Equation (GEE). There will be 130 subjects in each group (N=260 total) based on poweranalysis principles. The results will increase our knowledge about the changes ofphysical activities, physical function, and dysfunction; and the levels of theeffectives of a continuous exercise program on increasing oral cavity cancerpatients’ physical function and quality of life.口腔癌運動疲倦ORal Cavity Cancerexercisefatigue