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5.5.3.1.1 Fatigue\u000DFatigue is one of the most prevalent symptoms experienced by cancer patients (Curt, Breitbart et al. 2000, Hofman, Ryan et al. 2007, IKNL 2011, Kapoor, Singhal et al. 2015, Ream, Gargaro et al. 2015). During radiotherapy or concomitant chemoradiation treatment 80-99% report issues with fatigue (Curt, Breitbart et al. 2000, Hofman, Ryan et al. 2007, Kapoor, Singhal et al. 2015). Statistics on persistent fatigue after treatment (rehabilitation/chronic/palliative phase) vary between 34 and 94% (Curt, Breitbart et al. 2000, Hofman, Ryan et al. 2007, IKNL 2011). In a recent study indications were found of an increase in fatigue in head and neck cancer patients who had undergone IMRT treatment (Gulliford, Miah et al. 2012, Powell, Schick et al. 2014). In drawing up the radiation plan, organs at risk (OAR) such as the parotid glands are spared. This increases the radiation strain on, for instance, the cerebellum, which is not marked as an OAR (Gulliford, Miah et al. 2012, Powell, Schick et al. 2014).\u000DAt the intake for rehabilitation fatigue is mapped out in more detail, using the Multidimensional Fatigue Inventory (MFI) (Smets, Garssen et al. 1995). The MFI was developed in the Netherlands to measure fatigue in cancer patients (Smets, Garssen et al. 1995, Smets, Garssen et al. 1996). The MFI is a 20-item self-report instrument, which measures the following five domains: general fatigue, physical fatigue, mental fatigue, and reduced activity. Besides also a sum score will be calculated.\u000DThe psychometric qualities of the MFI have been tested in, amongst others, cancer patients during radiotherapy or chemotherapy treatment and patients with chronic fatigue syndrome (Alexander, Minton et al. 2009).\u000D5.5.3.1.2 Assessing physical exercise capacity and functioning\u000DTo assess the patient\u0027s level of physical functioning, several objective functional capacity tests can be used. Although a maximal incremental exercise test with breath-gas analysis and ECG are the gold standard for determining maximal functional capacity, these tests need not be performed in all patients. Two practicable functional capacity tests in this population are:\u000D1. The six-minute walk test: the six-minute walk test (6MWT) is a submaximal functional capacity test that offers insight into the patient\u0027s functional capacity. The 6MWT has been shown to be reliable and valid in a large number of patient groups (Takken 2005). Detailed guidelines and indications for measuring clinically significant improvement have been published by the American Thoracic Society (ATS 2002)(ATS 2002)(ATS 2002)(ATS 2002)(2002)(2002)(ATS 2002). The test has not been validated specifically for use in cancer patients, but it has been used before as an outcome measure in studies on oncological rehabilitation (Mutrie, Campbell et al. 2007). One study on the feasibility of the 6MWT in glioma patients showed that the test had strong correlations with performance status and quality of life (Jones, Cohen et al. 2009). Reference values are available for healthy adults. An increase of 50 meters is generally considered a clinically significant improvement (Redelmeier, Bayoumi et al. 1997). 2. The steep ramp test: the steep ramp test (SRT) is a short cycle ergometer test with a quick increase of load (25W per 10 seconds). The test results are subsequently used to estimate the VO2max and Wmax as measured in a regular maximal functional capacity test, using regression analysis. It should be noted, however, that the prediction rules overestimate VO2peak and Wpeak in cancer survivors with lower cardiorespiratory fitness, and underestimate it in those with high cardiorespiratory fitness. For most people, peripheral muscle strength/endurance is the limiting factor, which means that the load on the cardiovascular system is not maximal.\u000DThe SRT has recently been validated in a study involving a heterogeneous group of cancer survivors. The test appears to offer an acceptable alternative for determining the correct wattage for cycle\u000D126\u000D