The relationship between physical impairments, quality of life and disability of the neck and upper limb in patients following neck dissection
The purpose of this study was to examine the relationship between physical impairments, quality of life and disability in patients following neck dissection, with consideration of patient and clinical characteristics.
Cross-sectional study of patients < 5 years after neck dissection for head and neck cancer. Quality of life and self-reported disability were measured with the Neck Dissection Impairment Index, Quick Disabilities of the Arm, Shoulder and Hand, and Neck Disability Index. Active neck and shoulder range of motion and isometric muscle strength were also assessed. Generalised linear modelling was used to explore relationships between variables.
Eighty-four participants (68% male, median age 61 years) demonstrated reduced quality of life (median (interquartile range) score = 76 (49, 93) from 0 (worst) to 100 (best)), and mild levels of upper limb (14 (2, 32)) and neck disability (14 (6, 28)) (from 0 (best) to 100 (worst)). Bilateral neck dissection was associated with reduced quality of life (coeff (95% CI) = − 12.49 (− 24.69, − 0.29)). Post-operative chemoradiation therapy was associated with reduced quality of life (− 21.46 (− 37.57, − 5.35)) and neck disability (0.71 (0.10, 1.32)). Measures of shoulder flexibility or strength were associated with quality of life and self-reported disability.
Quality of life and musculoskeletal disability after neck dissection are associated with factors from multiple domains including physical motor function and treatment modality.
Implications for Cancer Survivors
Having reduced shoulder flexibility or strength is related to functional deficits and quality of life after neck dissection for head and neck cancer.
KeywordsHead and neck neoplasms Neck dissection Shoulder Neck Pain Quality of life
The authors wish to thank research assistant Annette Stouter for her contribution to this study (data entry and data management); and the Medical, Nursing, Physiotherapy and Administrative staff from the participating hospitals.
Sources of funding
This study was supported by the Physiotherapy Research Foundation (grant no. S15-029). E.G. is supported by an Australian Government Research Training Program Scholarship. S.M.P. is supported by a National Health and Medical Research Council (of Australia) Fellowship (no. 1090440).
Role of funders
The Physiotherapy Research Foundation, the Australian Government and the National Health and Medical Research Council did not have any influence over the study design, data collection, analysis or manuscript preparation.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Research involving human participants
This study was approved by the Royal Brisbane and Women’s Hospital Human Research Ethics Committee (reference no. HREC/14/QRBW/71).
Informed consent was obtained from all individual participants included in this study.
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