Effect of Exergaming Exercises and Mediterranean Diet on Thyroid Cancer Patients Following Total Thyroidectomy

Outcome measures

• Flow cytometry analyzer for NKC (CD3- CD16+ CD56+).
• Immunoassay analyzer for thyroid profile (TSH,T3,T4)
• Quality of life questionnaire
• Fatigue questionnaire
• PREDIMED questionnaire to asses diet adherence. Outcome measures will be measured at baseline and after 3 months of the treatement intervention

A) assessment

• Quality of life questionnaire questionnaire
• .Fatigue questionnaire
• Adherence to diet A validated 14-item questionnaire for the assessment of adherence to the Mediterranean Diet (PREDIMED) will be recorded for all the enrolled subjects

• Biochemical Analysis. [B] Intervention

• Exergaming The practice of exergaming was performed using the Xbox 360 Kinect console (Microsoft, Albuquerque, NM)
• Mediterranean diet All participants participated in the Mediterranean diet intervention for 12 weak and received dietary training from professional nutritionists at the baseline visit and samples of a Mediterranean diet for three times during the trial.

4 groups will be randomly assigned Group A: Control group No intervention was provided for 12 weeks except thyroid hormone replacement therapy Group B: Exergaming exercise The volunteers carried out 36 exergaming sessions, with progressive increase in the duration of the games according to their tolerance,and reached a maximum duration of 50 minutes per session, included the realization of the games and the rest between activities. The exergaming protocol was performed three times a week, for a total of 12 weeks Group C: Mediterranean diet All participants participated in the Mediterranean diet intervention for 12 weak and received dietary training from professional nutritionists at the baseline visit and samples of a Mediterranean diet for three times during the trial.PREDIMED questionnaire is used To assess adherence to the Mediterranean diet Group D: Exergaming exercises and Mediterranean diet Exergaming exercises are used in addition to Mediterranean diet

Inclusion criteria

• Diagnosis of thyroid papillary carcinoma as it is the most common type
• Treatment with thyroid hormone medication after thyroidectomy
• Lack of radioactive iodine treatment within the past 6 months
• Blood hemoglobin level >10 g/dL.
• Not taking drugs that could affect their immune function (e.g., immunosuppressants such as cyclosporin and steroids .
• Lack of regular exercise
• Age 18~45 years
• Dose should be controlled at the first one year

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Exclusion criteria

• Abscess or inflammation suspected by preoperative tests 2) Patients with stage IV cancer and with limited understanding of assessment systems 3) History of head or neck malignancy . 4) Radiation therapy 5) Graves disease 6) Thyroiditis 7) Orthopaedic and rheumatic conditions of the neck . 8) The patient's inability to cooperate

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