Comparison of hospital based and home based exercise on quality of life, and neck and shoulder function in patients with spinal accessary nerve injury after head and neck cancer surgery

Hwa, Jung; Yoon, In Jin; Cho, Young Ki; Ahn, Jun Su; Kim, Jung Kyo; Jeon, Jae Yong

doi:10.1016/j.oraloncology.2018.06.019

Cited by 12 publications

(31 citation statements)

References 32 publications

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“…Again, EMG can help in detecting different degrees of nerve dysfunction, and it is recommended in the follow-up evaluation. An intensive program of rehabilitation with specific physiotherapy and physical therapy can improve shoulder function [ 11 , 18 , 39 , 40 , 41 , 42 ], as we also experienced in our current analysis and in a previous series [ 3 ], and should always be recommended [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of IONM in Reducing the Occurrence of Shoulder Syndrome Following Lateral Neck Dissection for Thyroid Cancer

Polistena

Ranalli

Avenia

et al. 2021

JCM

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Lateral neck dissection (LND) leads to a significant morbidity involving accessory nerve injury. Modified radical neck dissection (MRND) aims at preservation of the accessory nerve, but patients often present with negative functional outcomes after surgery. The role of neuromonitoring (IONM) in the prevention of shoulder syndrome has not yet been defined in comparison to nerve visualization only. We retrospectively analyzed 56 thyroid cancer patients who underwent MRND over a period of six years (2015–2020) in a high-volume institution. Demographic variables, type of surgical procedure, removed lymph nodes and the metastatic node ratio, pathology, adoption of IONM and shoulder functional outcome were investigated. The mean number of lymph nodes removed was 15.61, with a metastatic node ratio of 0.2745. IONM was used in 41.07% of patients, with a prevalence of 68% in the period 2017–2020. IONM adoption showed an effect on post-operative shoulder function. There were no effects in 89.29% of cases, and temporary and permanent effects in 8.93% and 1.79%, respectively. Confidence intervals and two-sample tests for equality of proportions were used when applicable. Expertise in high-volume centres and IONM during MRND seem to be correlated with a reduced prevalence of accessory nerve lesions and limited functional impairments. These results need to be confirmed by larger prospective randomized controlled trials.

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Section: Discussionmentioning

confidence: 99%

The Role of IONM in Reducing the Occurrence of Shoulder Syndrome Following Lateral Neck Dissection for Thyroid Cancer

Polistena

Ranalli

Avenia

et al. 2021

JCM

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“…These investigators [ 38 ] proposed that the link between exercise and the immune system can be exploited in cancer therapy and that exercise may not just be “healthy”, but may in fact be therapeutic. Previous studies on the effectiveness of postoperative exercise training on SP, SD, QOL, and functional capacity in HNC survivors revealed positive results [ 13 , 14 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. Although many authors have studied the effectiveness of hospital-based exercise training in this research area [ 16 , 17 , 18 , 19 , 20 , 24 , 25 , 26 ], relatively few investigations have been conducted to explore the clinical benefit of HBET [ 21 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative exercise training has been advocated to improve severe pain, disability, and QOL associated with HNC therapy [ 13 , 14 , 15 ]. Although some studies [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ] reported that postoperative exercise training reduces SP and SD, and improves the functional capacity and QOL of HNC survivors, others [ 24 , 25 , 26 ] failed to detect its beneficial effects. As such, investigations optimizing the exercise program to improve these postoperative complications in patients with HNC are warranted.…”

Section: Introductionmentioning

confidence: 99%

“…Several aspects of nurse-led interventions aiming to improve postoperative outcomes in patients with HNC have been reported [ 30 , 31 , 32 , 33 ]. Additionally, some promising results regarding the beneficial effects of HBET on SP, SD, QOL, or functional capacity have been obtained in this patient population [ 21 , 22 , 23 ]. However, the benefits of the nurse-led counseling intervention of HBET on postoperative complications for patients with HNC remain to be explored.…”

Section: Introductionmentioning

confidence: 99%

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Nurse-Led Counseling Intervention of Postoperative Home-Based Exercise Training Improves Shoulder Pain, Shoulder Disability, and Quality of Life in Newly Diagnosed Head and Neck Cancer Patients

Hong

Hsieh

Chen

et al. 2022

JCM

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This randomized controlled trial investigated the effectiveness of the nurse-led counseling intervention (NLCI) of postoperative home-based exercise training (HBET) on functional outcomes in patients with newly diagnosed head and neck cancer (NDHNC). Forty NDHNC patients were randomly and equally divided into the control and intervention groups. Both groups received routine care, and were instructed to undergo a HBET program with 40 min moderate-intensity exercise 3–4 times per day for 12 weeks after their surgery. Only the intervention group received the NLCI with a bedside demonstration, coaching, consultation, and a weekly telephone follow-up. Shoulder pain (SP), shoulder disability (SD), and quality of life (QOL) scores were assessed using questionnaires at 2 weeks presurgery and at several timepoints postsurgery. Over the 12-week study period, all three scores remained relatively stable in the control group. By contrast, the SP, SD, and QOL scores significantly improved in the intervention group. The generalized estimating equation analysis revealed a significant time effect, group effect, and group–time interaction. The analysis of covariance revealed that all three scores significantly improved in the intervention group compared with those in the control group at 12 weeks postsurgery. We concluded that the NLCI of postoperative HBET improved the SP, SD, and QOL of NDHNC patients.

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“…11 Do et al demonstrated that supervised physiotherapy was superior to unsupervised outpatient physiotherapy, although the lack of randomisation is a significant source of bias. 16 These three studies add some weight to the conclusion that physiotherapy is beneficial for shoulder dysfunction following neck dissection. However, given the weaknesses in their design, it is not possible to quantify the scale of the benefit; a properly orchestrated control group, matched or statistically allowing for variables, would be needed for this.…”

Section: Summary and Comparisonmentioning

confidence: 99%

Do patients benefit from physiotherapy for shoulder dysfunction following neck dissection? A systematic review

Harris

2020

J. Laryngol. Otol.

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ObjectiveAccessory nerve palsy affects a proportion of patients following neck dissection, and results in shoulder dysfunction and regional pain. This project aimed to establish the evidence supporting post-operative physiotherapy for the shoulder following neck dissection.MethodA systematic review was conducted of prospective trials investigating the efficacy of rehabilitation for shoulder or upper limb dysfunction and pain following any type of neck dissection.ResultsA total of 820 papers were identified; through a staged review process, 7 trials were found that fulfilled the inclusion criteria. These included three randomised, controlled trials and four non-randomised studies. Five out of the seven trials demonstrated a statistically significant benefit of physiotherapy.ConclusionCurrent evidence shows a benefit from physiotherapy in patients with shoulder dysfunction following neck dissection. Some evidence suggests progressive resistance is superior to other types of physiotherapy. Long-term benefit and cost efficacy have not been studied.

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Comparison of hospital based and home based exercise on quality of life, and neck and shoulder function in patients with spinal accessary nerve injury after head and neck cancer surgery

Cited by 12 publications

References 32 publications

The Role of IONM in Reducing the Occurrence of Shoulder Syndrome Following Lateral Neck Dissection for Thyroid Cancer

The Role of IONM in Reducing the Occurrence of Shoulder Syndrome Following Lateral Neck Dissection for Thyroid Cancer

Nurse-Led Counseling Intervention of Postoperative Home-Based Exercise Training Improves Shoulder Pain, Shoulder Disability, and Quality of Life in Newly Diagnosed Head and Neck Cancer Patients

Do patients benefit from physiotherapy for shoulder dysfunction following neck dissection? A systematic review

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