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Head and neck cancer is prevalent in Taiwan, and oral cancer is the most common location. Advanced treatment of oral cancer increases survival rates; however, it also increases the risk of developing shoulder dysfunction, dysphagia, oral dysfunction, donor site morbidity and psychological issues. The probability of shoulder dysfunction after neck dissection is as high as 70%. Rehabilitation effects on shoulder function for head and neck survivors are needed for further studied.The purpose of this randomized clinical trial is to explore the effects of rehabilitation for shoulder function in oral cancer survivors.
Head and neck cancer is prevalent in Taiwan, and oral cancer is the most common location. Advanced treatment of oral cancer increases survival rates; however, it also increases the risk of developing shoulder dysfunction, dysphagia, oral dysfunction, donor site morbidity and psychological issues. The probability of shoulder dysfunction after neck dissection is as high as 70%. Rehabilitation effects on shoulder function for head and neck survivors are needed for further studied.
The purpose of this randomized clinical trial is to explore the effects of rehabilitation for shoulder function in oral cancer survivors. We will recruit 60 newly diagnosed oral cancer subjects through the plastic surgeon's referral from April 2018 to March 2020. The participants will be randomized separated into experimental or control group. Each group would receive regular physical therapy for shoulder function (i.e., transcutaneous electrical stimulation, shoulder joint range of motion exercise, scapular muscle strengthening training). Experimental group would be supplemented by motor control therapy targeting the scapular muscle progressive resistance exercise (exercise plus manual therapy).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| experimental group | Experimental | motor control therapy |
|
| control group | Active Comparator | regular physical therapy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| motor control therapy | Other | scapular muscle progressive resistive exercise(PRE) |
| |
| Measure | Description | Time Frame |
|---|---|---|
| shoulder pain | Visual Analog Scale, the *total* range = 0-10 | 1 year |
| shoulder joint range of motion | abduction measured by goniometer | 1 year |
| shoulder function | the Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Measure for upper extremity function | 1 year |
| maximal isometric muscle strength | measurement for the upper trapezius, middle trapezius, lower trapezius and serrates anterior at the moment of SEMG | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| surface electromyography (SEMG) | measure the muscle activities of the upper trapezius, middle trapezius, lower trapezius and serrates anterior | 1 year |
| quality of life C-30 | European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Yueh-Hsia Chen, Master | Chang Gung Memorial Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Plastic and Reconstructive Surgery Rehabilitation Center, Chung Gung Memorial Hospital | Taoyuan | 333 | Taiwan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20014446 | Result | Wong CH, Wei FC. Microsurgical free flap in head and neck reconstruction. Head Neck. 2010 Sep;32(9):1236-45. doi: 10.1002/hed.21284. | |
| 15979480 | Result | Lutz BS, Wei FC. Microsurgical workhorse flaps in head and neck reconstruction. Clin Plast Surg. 2005 Jul;32(3):421-30, vii. doi: 10.1016/j.cps.2005.02.006. |
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| ID | Term |
|---|---|
| D009062 | Mouth Neoplasms |
| ID | Term |
|---|---|
| D006258 | Head and Neck Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D009059 | Mouth Diseases |
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| regular physical therapy |
| Other |
transcutaneous electrical nerve stimulation(TENS), shoulder joint ROM, scapular muscle PRE |
|
| 1 year |
| quality of life H&N35 | European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-H&N35 | 1 year |
| return to work | duration between return-to-work and operation | 1 year |
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| 34412536 | Derived | Chen YH, Huang CY, Liang WA, Lin CR, Chao YH. Effects of Conscious Control of Scapular Orientation in Oral Cancer Survivors With Scapular Dyskinesis: A Randomized Controlled Trial. Integr Cancer Ther. 2021 Jan-Dec;20:15347354211040827. doi: 10.1177/15347354211040827. |
| D009057 |
| Stomatognathic Diseases |