Resistance exercise for post neck dissection shoulder pain: three case reports

Abstract

Nodal dissection of the neck is often performed in conjunction with surgical resection of the primary tumour site for head and neck cancers. A major complication of neck dissection procedures is loss of trapezius muscle function due to temporary damage to, or resection of, the spinal accessory nerve. Over time, the resulting shoulder dysfunction may deteriorate to a chronic state that includes glenohumeral joint restriction and marked deformity of the shoulder complex. Patients with severe discomfort may require long-term use of narcotic analgesics. Although successful outcomes from physiotherapy have been reported in the literature for over 20 years, research in the area is sparse and uncertainty remains over the most effective therapeutic interventions. We present 3 case reports that illustrate the beneficial role of progressive resistance exercise training (PRET) to alleviate shoulder pain and dysfunction in head and neck cancer patients with spinal accessory nerve damage.

Notes

Margaret McNeely, BScPT, MSc, Rehabilitation Department, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta, T6G 1Z2 Canada. Phone: [phone], Fax: [phone], [email protected]

Matthew Parliament, MD, FRCPC, Radiation Oncology, Cross Cancer Institute, Associate Professor, Department of Oncology, Faculty of Medicine, University of Alberta, Cross Cancer Institute, 11560 University Ave, Edmonton, AB, T6G 1Z2 Canada.

Kerry S. Courneya, Ph.D., Professor, Faculty of Physical Education, University of Alberta, Faculty of Physical Education, E-401 Van Vliet Center, Edmonton, Alberta, T6G 2H9 Canada.

Mark Haykowsky, Ph.D. Assistant Professor, Faculty of Rehabilitation Medicine, University of Alberta, Department of Physical Therapy, 2-50 Corbett Hall, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4 Canada.