# A Motion Exergaming Approach to Promote Self-Managing Fatigue and Pain after Head and Neck Cancer Treatment

> **NIH NIH R01** · UNIVERSITY OF SOUTH FLORIDA · 2022 · $1

## Abstract

Project Summary/Abstract
Among head and neck cancer (HNC) patients, 92% report fatigue and 73% have pain. A 10% increase in
fatigue or pain is associated with a 10-25% reduction in HNC survival. During the critical transition period from
the end of active treatment to 3 months post-treatment (during which patients begin symptom self-
management), untreated physical symptoms negatively impact functional status (ADL) and quality of life
(QOL). Fatigue and musculoskeletal pain (related to tissue damage from surgery and radiation) are known to
improve in response to physical activity (PA). However, 51% of HNC survivors rarely engage in any type of PA
because of complicated PA barriers: impaired fitness, severe physical symptoms, and poor PA health beliefs.
A critical gap in our science is that no home-based behavioral PA intervention effectively addresses these PA
barriers in HNC patients. To address this gap, our overall objective is to test an intervention to overcome these
PA barriers for HNC patients during the critical transition period to self-management. PAfitME, a personalized
Physical Activity intervention with fitness graded Motion Exergames, is a telehealth program built on Social
Cognitive Theory and the exercise principal of adaptation. PAfitME is personalized to the HNC patient's PA
barriers. PAfitME, delivered via a tested mix of FaceTime calls and home visits, uses commercially available
exergaming platforms (Wii Fit and Xbox Kinect). Our pilot study generated impressive within-group effect sizes
for fatigue, pain, and ADL (d≥0.9). The feasibility and acceptability of PAfitME were also strong in patients with
several physical limitations. Attendance (98%) and attrition (20%) were much better than previous HNC studies
without adverse events. We propose the following specific aims: (1) When compared to an attention control
group, determine the effect of PAfitME on fatigue and musculoskeletal pain at week 6, when controlling for age
and sex; (2) when compared to an attention control group, determine the effect of PAfitME on functional status
and QOL at week 6, when controlling for age and sex; and (3) explore if PA self-efficacy, PA enjoyment, and
exergame minutes mediate the effect of PAfitME on fatigue and musculoskeletal pain. This study will evaluate
150 post-treatment (radiation or chemoradiation) HNC patients in an RCT with an attention control. For 6
weeks, the experimental (PAfitME) group will receive the PAfitME intervention, and the attention control group
will receive NCI-based survivorship education and exergame equipment (Wii Fit or Xbox Kinect without
PAfitME). For Aims 1 and 2, using an ITT framework, we will fit a series of linear mixed effects models with
each of the outcome variables. For Aim 3, we will conduct our exploratory analyses in ml_mediation (STATA
15), which will compute direct and indirect effects for multi-level data. This study aligns with the NCI Cancer
Moonshot goal to minimize cancer treatment-associate...

## Key facts

- **NIH application ID:** 10311089
- **Project number:** 5R01CA244947-03
- **Recipient organization:** UNIVERSITY OF SOUTH FLORIDA
- **Principal Investigator:** Hsiao-Lan Wang
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $1
- **Award type:** 5
- **Project period:** 2019-12-13 → 2021-12-02

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10311089

## Citation

> US National Institutes of Health, RePORTER application 10311089, A Motion Exergaming Approach to Promote Self-Managing Fatigue and Pain after Head and Neck Cancer Treatment (5R01CA244947-03). Retrieved via AI Analytics 2026-06-14 from https://api.ai-analytics.org/grant/nih/10311089. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*