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Uncertain effect of preventative shoulder rehabilitation for patients who underwent total laryngectomy with neck dissection

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Abstract

Introduction

Total laryngectomy (TL) with neck dissection (ND) is considered as crucial management for advanced-stage of laryngeal cancer. Shoulder dysfunction has long been recognized as a potential complication resulting from neck dissection. The aim of this study was to evaluate the effect of early prophylactic rehabilitation program in patients who underwent TL with ND.

Methods

A prospective, nonrandomized design was used. Seventy-six participants who underwent TL with ND were assigned into either an intervention or a control group. The control group received current standard care with no formal shoulder exercise provided, while the intervention group attended early preventive rehabilitation lasting 12 weeks. Participants were assessed at baseline, and at 3 and 6 months after surgery. Measured outcomes included shoulder function and patient-reported quality of life. General linear models with repeated measures were used to examine outcome changes in both groups over the designated assessment intervals.

Results

Improvement in shoulder function and patient-reported quality of life were both statistically significant over time, with no significant difference between control or intervention groups, indicating little or no benefit of preventative intervention on shoulder function outcomes. Analysis involving five subscales and the summary score of the quality of life questionnaire had only statistically significant improvement over time for both the control or intervention groups, except for physical well-being domain which had statistical significance both over time and between the control and intervention groups.

Conclusion

In this study, preventative exercise program initiated immediately after surgery had a limited impact on both shoulder function and perceived quality of life.

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Funding

This study was supported by Shanghai Municipal Health Bureau Project for Youth (Grant No. 20134y161).

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Authors and Affiliations

  1. Department of Operation Room, Eye and ENT Hospital, Fudan University, 83 Fenyan road, Shanghai, 200032, People’s Republic of China

    Peixia Wu

  2. Department of Intensive Care Unit, Eye and ENT Hospital, Fudan University, 83 Fenyan road, Shanghai, 200032, People’s Republic of China

    Zhengrong Peng

  3. School of Nursing, Fudan University, 305 Fenglin road, Shanghai, 200031, People’s Republic of China

    Junyi Chen & Yan Hu

Authors
  1. Peixia Wu
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  2. Zhengrong Peng
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  3. Junyi Chen
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  4. Yan Hu
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Corresponding author

Correspondence to Peixia Wu.

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Conflict of interest

Peixia Wu declares that she has no conflict of interest. Zhengrong Peng declares that she has no conflict of interest. Junyi Chen declares that she has no conflict of interest. Yan Hu declares that she has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all participants included in this study.

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Wu, P., Peng, Z., Chen, J. et al. Uncertain effect of preventative shoulder rehabilitation for patients who underwent total laryngectomy with neck dissection. Eur Arch Otorhinolaryngol 275, 795–801 (2018). https://doi.org/10.1007/s00405-018-4875-x

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  • DOI: https://doi.org/10.1007/s00405-018-4875-x

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