Background and Purpose: Rehabilitation research in people with head and neck cancer undergoing neck dissection (ND) surgery has been largely confined to evaluation of shoulder dysfunction. Balance and broader physical functioning variables were evaluated in this patient group. Case Description: This case series presents 4 patients scheduled for ND surgery who completed a comprehensive battery of balance and physical functioning assessments preoperatively and 6 weeks postoperatively. Outcomes: Post-ND surgery, the majority (n = 3) of patients reported increased upper-quadrant pain, with proprioception and neck range-of-motion measurements showing a decreasing trend. One patient had no neck pain or changes in proprioception. The changes for standing balance and endurance varied across the patients, with no observable trend. Discussion: Quality of life, physical activity, and a number of physical functioning measures, including proprioception and physical activity, were lower after ND surgery. This case series identifies the adverse effects of ND surgery performed prior to the start of adjuvant therapy, with many deficits noted potentially amenable to therapeutic intervention. The clinical implication of this study is that physical therapists should assess physical functioning variables after ND surgery and intervene early if deficits are noted.
Purpose Prolonged bed rest and immobility in the intensive care units (ICU) increase the risk of ICU-acquired weakness (ICUAW) and other complications. Mobilisation has been shown to improve patient outcomes but may be limited by the perceived barriers of healthcare professionals to mobilisation. The Patient Mobilisation Attitudes and Beliefs Survey for the ICU (PMABS-ICU) was adapted to assess perceived barriers to mobility in the Singapore context (PMABS-ICU-SG). Methods The 26-item PMABS-ICU-SG was disseminated to doctors, nurses, physiotherapists, and respiratory therapists working in ICU of various hospitals across Singapore. Overall and subscale (knowledge, attitude, and behaviour) scores were obtained and compared with the clinical roles, years of work experience, and type of ICU of the survey respondents. Results A total of 86 responses were received. Of these, 37.2% (32/86) were physiotherapists, 27.9% (24/86) were respiratory therapists, 24.4% (21/86) were nurses and 10.5% (9/86) were doctors. Physiotherapists had significantly lower mean barrier scores in overall and all subscales compared to nurses (p < 0.001), respiratory therapists (p < 0.001), and doctors (p = 0.001). A poor correlation (r = 0.079, p < 0.05) was found between years of experience and the overall barrier score. There was no statistically significant difference in the overall barriers score between types of ICU (χ2(2) = 4.720, p = 0.317). Conclusion In Singapore, physiotherapists had significantly lower perceived barriers to mobilisation compared to the other three professions. Years of experience and type of ICU had no significance in relation to barriers to mobilisation.
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