A pilot study of a randomized controlled trial to evaluate the effects of progressive resistance exercise training on shoulder dysfunction caused by spinal accessory neurapraxia/neurectomy in head and neck cancer survivors

• Published in: Head & neck Vol. 26; no. 6; pp. 518 - 530
• Main Authors: McNeely, Margaret L., Parliament, Matthew, Courneya, Kerry S., Seikaly, Hadi, Jha, Naresh, Scrimger, Rufus, Hanson, John
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-06-2004; John Wiley & Sons
• Subjects: accessory nerve; Accessory Nerve - surgery; Biological and medical sciences; exercise; Exercise Therapy - methods; Female; Head and Neck Neoplasms - physiopathology; Head and Neck Neoplasms - surgery; Humans; Male; Medical sciences; Middle Aged; neck dissection; Neck Dissection - adverse effects; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; physical therapy techniques; Pilot Projects; Prospective Studies; Rotation; Shoulder - innervation; Shoulder - physiopathology; shoulder pain; Shoulder Pain - physiopathology; Shoulder Pain - rehabilitation; Surveys and Questionnaires; Survivors; Treatment Outcome; Tumors; Physical exercise; Human; Stomatology; exercise; Accessory nerve; Progressive; Resistance; Pain; Treatment; Dysfunction; Surgery; Shoulder; ENT disease; Head and neck cancer; neck dissection; Neck; shoulder pain; Dissection; physical therapy techniques
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.20010

Background.
Shoulder dysfunction remains a frequent complication after neck dissection procedures for head and neck cancer.
Methods.
We conducted a pilot study to evaluate the effects of progressive resistance exercise training (PRET) on shoulder dysfunction caused by spinal accessory neurapraxia/neurectomy in patients with head and neck cancer. Twenty patients (mean age, 61 ± 7.7 years) were randomly assigned to PRET or standard care intervention. Subjects assigned to the PRET group exercised three times per week for 12 weeks. The goal of the exercise program was to enhance scapular stability and strength of the upper extremity. The resistance‐training program was progressive in terms of number of sets and repetitions performed, as well as the amount of weight lifted, depending on performance status.
Results.
The completion rate for the trial was 85% (17 of 20). The exercise group completed 93% of scheduled exercise sessions. Significant improvements were found in favor of the PRET group in active shoulder external rotation (p = .001), shoulder pain (p = .038), and overall score for shoulder pain and disability (p = .045).
Conclusions.
The study results demonstrate a high rate of completion and adherence with our PRET program among patients with head and neck cancer. The preliminary findings, although limited, also suggest a potential therapeutic role for resistance exercise as an adjunct to standard physical therapy treatment. © 2004 Wiley Periodicals, Inc. Head Neck 26: 518–530, 2004