Prophylactic Home-Based Exercises During Radiotherapy in Head and Neck Cancer: A Randomized Controlled Trial.

OBJECTIVE: This study investigated the efficacy of a prophylactic, home-based exercise program administered concomitantly with radiotherapy in patients with head and neck cancer to preserve swallowing function, postural alignment, and cervical range of motion, while assessing lymphedema safety. STUDY DESIGN: Randomized controlled trial. SETTING: Outpatient clinics of an academic university hospital. METHODS: Twenty-four patients undergoing radiotherapy for head and neck cancer were allocated to an exercise group (n = 12; receiving a swallowing, posture, range of motion, and strengthening protocol) or a control group (n = 12; receiving standard care). Baseline and postradiotherapy outcomes were assessed using the Swallowing Quality of Life questionnaire, photogrammetric posture analysis, digital goniometry for cervical mobility, and circumference measurements for lymphedema. RESULTS: Swallowing Quality of Life was maintained in the exercise group but deteriorated significantly in controls (P < .001). The exercise group significantly preserved neck lateral tilt compared to controls (P < .001). Furthermore, the intervention group demonstrated significant preservation of cervical flexion, extension, rotation, and lateral flexion (P < .05). Facial edema metrics increased slightly in both groups with no significant inter-group differences, confirming intervention safety (P > .05). High adherence rates were reported. CONCLUSION: A prophylactic, home-based exercise program is a safe and effective strategy to mitigate functional decline in patients undergoing radiotherapy. The intervention preserves swallowing, posture, and cervical mobility without exacerbating lymphedema, supporting early prehabilitation in oncological care. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT07376213.