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The study aims to evaluate the morphological changes of upper trapezius muscle, using B-mode ultrasonography, in patients with oral cancer undergone neck dissection and physiotherapy. It also investigates the relationship between morphological changes and shoulder active range of motion in abduction. Furthermore , the study assesses the potential of B-mode ultrasonography as an objective tool for monitoring outcomes of the rehabilitation in this population.
The study aims to investigate the effect of 8-week physiotherapy on morphological change of upper trapezius muscle in oral cancer patients who have undergone neck dissection. Key outcome measurements include the muscle's thickness and cross-sectional area (CSA), measured via B-mode ultrasonography, as well as the active range of motion (AROM) in shoulder abduction. Neck dissections may result in spinal accessory nerve (CN XI) injury, often leading to shoulder pain, upper trapezius weakness and impaired shoulder mobility. Therefore, understanding the relationship between muscle thickness, CSA, and AROM is important. The study's goal is to explore the correlation between muscle morphological changes and functional outcomes, and further evaluate the role of B-mode ultrasonography as a non-invasive tool in monitoring muscle morphology in shoulder rehabilitation progress with post-surgical oral cancer patients with shoulder dysfunction.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| B-mode ultrasonography | Diagnostic Test | Thickness and cross-sectional area of upper trapezius muscle |
| Measure | Description | Time Frame |
|---|---|---|
| Cross-sectional area of upper trapezius muscle | CSA of the upper trapezius muscle is measured via B-mode panoramic ultrasonography. Panoramic B-mode ultrasonography will be performed by placing the probe at the spinous process of the fourth cervical vertebra (C4) and moving it laterally toward the posterior margin of the sternocleidomastoid muscle. | Pre-intervention, 8 weeks post-intervention |
| Thickness of upper trapezius muscle | Thickness of upper trapezius muscle is measured via B-mode ultrasonography. The ultrasound probe will be positioned at the midpoint between the spinous process of the seventh cervical vertebra (C7) and the acromion, aligned parallel to the muscle fibers. | Pre-intervention, 8 weeks post-intervention |
| Active range of motion in shoulder abduction | AROM in shoulder abduction is measured by a goniometer, with the fulcrum positioned over the anterior aspect of the acromial process. The proximal arm is aligned parallel to the midline of the anterior aspect of the sternum, while the distal arm is aligned with the anterior midline of the humerus. | Pre-intervention, 8 weeks post-intervention |
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Inclusion Criteria:
Exclusion Criteria:
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A total of 10 newly diagnosed oral cancer patients who received neck dissection with scapular dyskinesis
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yueh-Hsia Chen, PhD | Contact | +886-2-33668133 | yuehhsiachen@ntu.edu.tw |
| Name | Affiliation | Role |
|---|---|---|
| Yueh-Hsia Chen, PhD | National Taiwan University, College of Medicine | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 7211339 | Background | Carenfelt C, Eliasson K. Occurrence, duration and prognosis of unexpected accessory nerve paresis in radical neck dissection. Acta Otolaryngol. 1980 Nov-Dec;90(5-6):470-3. doi: 10.3109/00016488009131750. | |
| 18804401 | Background | Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol. 2009 Apr-May;45(4-5):309-16. doi: 10.1016/j.oraloncology.2008.06.002. Epub 2008 Sep 18. |
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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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| 12576033 | Background | van Wilgen CP, Dijkstra PU, van der Laan BF, Plukker JT, Roodenburg JL. Shoulder complaints after neck dissection; is the spinal accessory nerve involved? Br J Oral Maxillofac Surg. 2003 Feb;41(1):7-11. doi: 10.1016/s0266-4356(02)00288-7. |
| 27331047 | Background | Adigozali H, Shadmehr A, Ebrahimi E, Rezasoltani A, Naderi F. Ultrasonography for the assessment of the upper trapezius properties in healthy females: a reliability study. Muscles Ligaments Tendons J. 2016 May 19;6(1):167-72. doi: 10.11138/mltj/2016.6.1.167. eCollection 2016 Jan-Mar. |
| 32947195 | Background | Valera-Calero JA, Gallego-Sendarrubias G, Fernandez-de-Las-Penas C, Cleland JA, Ortega-Santiago R, Arias-Buria JL. Cross-sectional area of the cervical extensors assessed with panoramic ultrasound imaging: Preliminary data in healthy people. Musculoskelet Sci Pract. 2020 Dec;50:102257. doi: 10.1016/j.msksp.2020.102257. Epub 2020 Sep 11. |
| D009057 |
| Stomatognathic Diseases |