An exploratory trial of preventative rehabilitation on shoulder disability and quality of life in patients following neck dissection surgery

Abstract

Patients commonly develop shoulder disability and reduction in quality of life (QOL) following neck dissection surgery. There is a lack of studies investigating the impact of preventative rehabilitation to prevent shoulder disability in this population. An exploratory trial was undertaken to investigate this gap in the head and neck cancer literature. Thirty-two subjects were randomly assigned to either one of two groups: early physiotherapy for a period of 3 months following surgery and current routine inpatient care and advice. Blinded measurement of shoulder function and QOL were recorded pre-operatively and at 1 year following surgery. No difference was found using between-group analysis (Mann-Whitney U-Test) for any outcome measures observed. Descriptive data analysis suggests that subjects receiving early physiotherapy had a perception of increased physical well-being when compared with subjects receiving routine care. There may be some clinical significance that subjects receiving a course of physiotherapy did appear to rate their physical well-being higher than those subjects not undergoing rehabilitation. Further research to investigate the preventative effects of physiotherapy on this population should consider the use of head and neck cancer-specific outcome measurement of both shoulder disability and QOL.

A comprehensive review of head and neck cancer rehabilitation: Physical therapy perspectives

“…[24] Lauchlan et al .,[57] found while investigating the impact of preventative rehabilitation to prevent shoulder disability in HNC population that out of 32 subjects, the patients received a course of early physiotherapy for a period of 3 months following surgery rated their physical wellbeing higher than those subjects not undergoing rehabilitation.…”

Maximizing shoulder function after accessory nerve injury and neck dissection surgery: A multicenter randomized controlled trial

“…Optimal evidence-based management of accessory nerve shoulder dysfunction is inconclusive. 14 However, with the analyzed sample size being only 24 participants, and a high risk of bias resulting from methodological flaws, the study outcome is considered to be of limited value. 13 However, as the authors acknowledge, the study lacked prospective recruitment, with a median time since surgery >18 months for 44% of the participants.…”

Physical Therapy Interventions are Beyond Adjunct Care in Improving Quality of Life and Alleviating Pain Related to Cancer and its Treatment: Perspectives and Confronts

“…A Cochrane review of randomized trials of very low risk of bias on exercise interventions for shoulder dysfunction in patients with head and neck cancer reported that the pooled data of included trails demonstrated that progressive resisted training improves shoulder pain, shoulder disability and active range of motion in comparison with standard care [53,54].…”