Affiliations: Physiotherapy Department, St. James's Hospital, Dublin, Ireland | Department of Otolaryngology, Head and Neck and the National Centre for Maxillofacial Surgery, St James's Hospital, Dublin, Ireland
Abstract: Background: Neck and shoulder pain are recognized complications of surgery for head and neck cancer. As such, a need for a dedicated out-patient physiotherapy service was identified and this service was established in February 2008. The following is an audit of this physiotherapy service from February 2008 – January 2009. Methods: Patients reporting neck and shoulder pain following neck dissection were referred to a dedicated physiotherapist who performed a comprehensive musculoskeletal assessment including shoulder and neck range of motion (ROM), Neck Dissection Impairment Index (NDII), Shoulder Disability Questionnaire (SDQ) and the University of Washington Quality of Life Questionnaire (UWQOL). Patients received physiotherapy treatment including an exercise program, scar management and advice. They were asked to repeat the above questionnaires six months later. Results: Data from the first 12 patients enrolled into the study was collated. Of this 12, 83% of subjects stated their shoulder to be the most important issue affecting quality of life. A mean deficit in ROM of shoulder flexion and abduction was noted (18° and 28° respectively) between affected and non-affected side. Initial mean (SD) SDQ, NDII and UWQOL scores were 32% (24), 37 (17) and 32 (13) respectively, where a higher score indicated greater disability. Following six months of treatment no improvements in shoulder ROM were observed. Mean SDQ, NDII and UWQOL scores improved to 23% ± 27%, 39 ± 28 and 28 ± 13. Conclusion: The results indicate an improvement in shoulder function and quality of life following physiotherapy intervention. This audit highlights the critical importance of physiotherapists working as part of the multidisciplinary team during the diagnosis and management of patients with head and neck cancers.