Upper body motor function and swallowing impairments and its association in survivors of head and neck cancer: A cross-sectional study

• Published in: PloS one Vol. 15; no. 6; p. e0234467
• Main Authors: Ortiz-Comino, Lucía, Fernández-Lao, Carolina, Speksnijder, Caroline M, Lozano-Lozano, Mario, Tovar-Martín, Isabel, Arroyo-Morales, Manuel, Martín-Martín, Lydia
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 19-06-2020; Public Library of Science (PLoS)
• Subjects: Age; Alcohol; Arm; Biology and Life Sciences; Cancer; Cancer survivors; Cancer therapies; Chemotherapy; Complications and side effects; Correlation; Cross-sectional studies; Deglutition disorders; Diagnosis; Disability evaluation; Head; Head & neck cancer; Head and neck cancer; Larynx; Lymphatic system; Medical examination; Medicine and Health Sciences; Pain; Pain perception; Patient outcomes; Patients; Physical therapy; Radiation therapy; Range of motion; Research and Analysis Methods; Risk factors; Shoulder; Strength; Surgery; Swallowing; Spain; Netherlands
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0234467

Background Upper body motor function and swallowing may be affected after curative treatment for head and neck cancer. The aims of this study are to compare maximum mouth opening (MMO), temporomandibular dysfunction (TMD), cervical and shoulder active range of motion (AROM) and strength, and swallowing difficulty between survivors of head and neck cancer (sHNC) and healthy matched controls (HMC) and to examine the correlations between these outcomes in sHNC. Methods Thirty-two sHNC and 32 HMC participated on the study. MMO, TMD, cervical and shoulder AROM, cervical and shoulder strength, the SPADI shoulder pain and disability indices, the Eating Assessment Tool (EAT-10) score, swallowing difficulty as determined using a visual analogue scale (VAS), and the location of disturbances in swallowing, were recorded. Results MMO and cervical and shoulder AROM and strength were significantly lower in sHNC, whereas FAI, SPADI score, EAT-10 and VAS were higher. The MMO, TMD, cervical and shoulder AROM, and cervical shoulder strength values showed significant correlations (some direct, others inverse) with one another. Swallowing difficulty was inversely associated with the MMO, cervical AROM and shoulder strength. Conclusion Compared with controls, sHNC present smaller MMO, lower cervical and shoulder AROM, lower cervical and shoulder strength and higher perception of TMD, shoulder pain and disability and swallowing difficulty. sHNC suffer impaired swallowing related to lower MMO, presence of TMD, cervical AROM and shoulder strength values. Improving these variables via physiotherapy may reduce the difficulty in swallowing experienced by some sHNC.