Physical Therapy Management of a Manual Laborer Following a Modified Radical Neck Dissection

Application of Manual Therapy for Dysphagia in Head and Neck Cancer Patients: A Preliminary National Survey of Treatment Trends and Adverse Events

“…42–44 Furthermore, MT techniques are an integral part of proactive burn management performed by PTs to prevent contractures, or contractile tension, caused by the aberrant scarring process. 22 These interventions begin as soon as the patient is able to tolerate them, often with the support of pain medication. 23 Since RT for HNC is similar to a prolonged and compounded burn, 32 similar protocols offered to HNC patients during RT, within patient tolerance, may also be effective.…”

“…MT represents a broad range of techniques that generally include passive and active stretching, light and deep soft tissue mobilization, and joint manipulation. MT techniques have been shown to prevent contractile tension from scars, increase tissue and muscle extensibility, promote joint range of motion, 22–24 attenuate acute toxicities such as pain, 25–27 and reduce inflammation. 28–30 By extension, since fibrosis-associated dysphagia is caused by an abnormal wound healing response characterized by excessive inflammation followed by marked scar tissue deposition and anatomic immobility, 31–34 it makes sense that MT techniques may be useful in treating fibrosis-associated dysphagia in the HNC patient population.…”

A novel manual therapy programme during radiation therapy for head and neck cancer – our clinical experience with five patients

“…Given that proactive manual therapy is provided to acute burn patients to prevent hypertrophic contractures, it is conceivable that a proper manual therapy programme could be administered to head and neck cancer patients during radiation therapy as well. If applied properly, these techniques have the potential to reduce pain, contractile tensions, inflammation and hypoxia . If these acute (and pro‐fibrotic) effects of radiation therapy can be reduced, then it may be possible to mitigate downstream long‐term effects such as fibrosis and dysphagia.…”

“…To date, manual therapy has not been used proactively in this population, likely due to concerns over patient tolerability and safety. Given that proactive manual therapy is provided to acute burn patients to prevent hypertrophic contractures, 1 it is conceivable that a proper manual therapy programme could be administered to head and neck cancer patients during radiation therapy as well. If applied properly, these techniques have the potential to reduce pain, [2][3][4] contractile tensions, 1,5 inflammation 6 and hypoxia.…”