Pilates Exercises Versus Mirror Therapy on Shoulder Dysfunction Post Neck Dissection Surgeries

Pilates Exercises Versus Mirror Therapy on Shoulder Dysfunction Post Neck Dissection Surgeries

The purpose of this study is to compare the therapeutic effects of pilates exercises and mirror therapy on shoulder dysfunction post-neck dissection surgeries.

Shoulder morbidity is a significant concern for patients undergoing neck dissection in head and neck cancer treatment, with more extensive surgeries correlated with higher postoperative shoulder issues. Preservation of the spinal accessory nerve during modified radical neck dissection reduces shoulder dysfunction. Shoulder pain often results from trapezius deficits due to nerve injury, leading to symptoms like shoulder droop and loss of function. Current management of oral and oropharyngeal carcinoma focuses on selective procedures that maintain nonlymphatic structures in the neck, as extended dissections are linked to increased shoulder dysfunction. This study aims to compare the effectiveness of pilates exercises and mirror therapy in improving shoulder dysfunction after neck dissection surgeries.

Inclusion Criteria:

1. Patient's age ranged between 35-55 years.
2. Both genders will participate in the study.
3. All patients suffering from shoulder dysfunction post-unilateral neck dissection surgeries ( modified radical and selective neck dissection surgeries).
4. All patients will have shoulder pain, limited ROM (flexion, abduction, external rotation) and limited shoulder function.
5. All patients will begin the treatment program 1-3 months after neck dissection surgeries.
6. All patients enrolled in the study will have their informed consent.

Exclusion Criteria:

1. Subjects suffering from active malignant tumors.
2. Subjects with rotator cuff tears or other shoulder ligaments injuries.
3. A history of neck or ipsilateral shoulder injuries, pain in the last 6-month prior neck dissection surgeries.
4. Adhesive capsulitis secondary to diabetes mellitus or fractures.
5. Recurrent shoulder dislocation.
6. Recent fractures or surgeries in the shoulder.
7. Neurological disorder
8. The presence of residual local regional cancer or distant metastases to other regions.
9. Comorbid medical illness or psychiatric illness and visual disturbance that would prevent completion of treatment.