Neck treatment and shoulder morbidity: Still a challenge

Bradley, Patrick J.; Ferlito, Alfio; Silver, Carl E.; Takes, Robert P.; Woolgar, Julia A.; Strojan, Primož; Suárez, Carlos; Çoşkun, Hakan; Zbären, Peter; Rinaldo, Alessandra

doi:10.1002/hed.21495

Cited by 125 publications

(84 citation statements)

References 79 publications

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“…A neck dissection performed after radiotherapy is associated with significant quality-of-life impacts due to impaired neck and shoulder function [10]. An appropriate evaluation of the neck node response after organ preservation therapy is therefore crucial in order to select patients who would potentially benefit from an additional neck dissection and conversely, allow patients to avoid surgery when it is likely to be of no value.…”

Section: Discussionmentioning

confidence: 99%

Long-term results of positron emission tomography-directed management of the neck in node-positive head and neck cancer after organ preservation therapy

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Long-term results of positron emission tomography-directed management of the neck in node-positive head and neck cancer after organ preservation therapy

et al. 2015

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“…Others have shown that disability improved with time, and rehabilitation played an important role in promoting function and reducing pain. 9,[21][22][23][24] Some studies have focused on wrist mobility, but the effect of RFF flap harvest on this parameter is unclear. [7][8][9][10] In addition, it has been shown that objective measurements do not accurately reflect the patient's experience.…”

Section: Discussionmentioning

confidence: 99%

Upper extremity morbidity after radial forearm flap harvest: a prospective study

et al. 2013

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Objective: To determine the effect of radial forearm free (RFF) flap harvest on patient-reported postoperative upper extremity disability. Methods: Patients undergoing RFF flap reconstruction following resection of head and neck cancer were recruited and matched with similar patients undergoing non-RFF reconstruction. All subjects completed the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire preoperatively and at least 1 year postoperatively. Results: Postoperative DASH scores were significantly higher (more severe disability) in patients undergoing RFF flap reconstruction (6.93 AE 5.54; n ¼ 52) compared with those undergoing non-RFF flap surgeries (2.95 AE 4.42; n ¼ 52). Preoperative DASH score, flap size, patient age and tumour stage were significantly correlated with postoperative DASH score. Conclusion: Excluding the effect of neck dissection, RFF flap reconstruction has a significant deleterious effect on upper extremity function.

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“…9,10 Once developed, shoulder-related symptoms have been found to persist rather than improve even in cases of SAN recovery, and little is known about effective management of this condition over the long term. 2,11 The results from our randomized controlled trial of upper extremity (UE) progressive resistance exercise training (PRET) demonstrated significant improvements in patient-rated shoulder pain and disability, UE strength and endurance, and range of motion in post-surgical HNC survivors. 12 All other outcomes, including fatigue, neck dissection impairment, and quality of life (QOL), favoured the PRET group at the end of the 12-week intervention but did not reach statistical significance.…”

Section: Ré Sumémentioning

confidence: 99%

Sustainability of Outcomes after a Randomized Crossover Trial of Resistance Exercise for Shoulder Dysfunction in Survivors of Head and Neck Cancer

McNeely

Parliament

Seikaly³

et al. 2015

Physiotherapy Canada

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Purpose: Shoulder pain and dysfunction may occur after surgery for head and neck cancer (HNC) as a result of damage to or resection of the spinal accessory nerve. Previous research found that 12 weeks of upper extremity progressive resistance exercise training (PRET) improved shoulder outcomes in survivors of HNC; the purpose of this study was to determine whether benefits persisted over the longer term. Methods: Survivors of HNC were assigned at random to PRET (n ¼ 27) or a standard therapeutic protocol (TP; n ¼ 25), with an opportunity for crossover in the TP group after 12 weeks. At 12-month follow-up, participants were mailed a questionnaire that assessed quality of life (QOL), shoulder outcomes, and exercise behaviour. Results: Of the 52 participants enrolled in the study, 44 were eligible at 12-month follow-up, and 37 (71%) completed the questionnaires. Overall, self-reported outcomes were largely sustained over the follow-up period. After 12 months, regardless of original group allocation, participants who continued resistance exercise training during the follow-up period reported better neck dissection-related functioning (p ¼ 0.021) and better QOL (p ¼ 0.011) than those who did not. Conclusions: Benefits of PRET were sustained at 12-month follow-up. Ongoing participation in resistance exercise training may prove valuable as a supportive care intervention for survivors of HNC.Key Words: exercise therapy; follow-up studies; head and neck neoplasms; quality of life; shoulder pain RÉ SUMÉObjet : Une douleur à l'é paule et une dysfonction peuvent faire leur apparition aprè s une intervention chirurgicale pour un cancer de la tê te et du cou (CTC) parce que le nerf spinal accessoire a é té endommagé ou ré sé qué . Des recherches anté rieures ont ré vé lé que 12 semaines d'exercice contre ré sistance progressive (ERP) des membres supé rieurs amé lioraient le ré sultat pour l'é paule chez les survivants d'un CTC. Cette é tude visait à dé terminer si les bienfaits persistaient à long terme. Mé thodes : Les survivants d'un CTC ont é té ré partis au hasard pour suivre un programme d'ERP (n ¼ 27) ou un protocole thé rapeutique habituel (PT; n ¼ 25) et ont pu passer au groupe PT aprè s 12 semaines. Au suivi à 12 mois, on a envoyé par la poste aux participants un questionnaire d'é valuation de la qualité de vie (QDV), des ré sultats pour l'é paule et du comportement lié à l'exercice. Ré sultats : Sur les 52 participants inscrits à l'é tude, 44 é taient admissibles au suivi à 12 mois et 37 (71 %) ont ré pondu aux questionnaires. Dans l'ensemble, les ré sultats autodé claré s ont é té maintenus en grande partie au cours de la pé riode de suivi. Aprè s 12 mois, sans é gard à leur affectation au groupe original, les participants qui ont poursuivi leur entraînement par l'exercice à ré sistance au cours de la pé riode de suivi ont signalé un meilleur fonctionnement lié à la dissection subie au cou (p ¼ 0,021) et une meilleure QDV (p ¼ 0,011) que ceux qui ne l'ont pas fait. Conclusions : Les bienfaits de l'ERP persi...

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Neck treatment and shoulder morbidity: Still a challenge

Cited by 125 publications

References 79 publications

Long-term results of positron emission tomography-directed management of the neck in node-positive head and neck cancer after organ preservation therapy

Long-term results of positron emission tomography-directed management of the neck in node-positive head and neck cancer after organ preservation therapy

Upper extremity morbidity after radial forearm flap harvest: a prospective study

Sustainability of Outcomes after a Randomized Crossover Trial of Resistance Exercise for Shoulder Dysfunction in Survivors of Head and Neck Cancer

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