Journal of Cancer Survivorship

, Volume 12, Issue 5, pp 619–631 | Cite as

The relationship between physical impairments, quality of life and disability of the neck and upper limb in patients following neck dissection

  • Elise M. Gane
  • Steven M. McPhail
  • Anna L. Hatton
  • Benedict J. Panizza
  • Shaun P. O’Leary



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.


Head 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

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


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Elise M. Gane
    • 1
    • 2
  • Steven M. McPhail
    • 2
    • 3
  • Anna L. Hatton
    • 1
  • Benedict J. Panizza
    • 4
    • 5
  • Shaun P. O’Leary
    • 1
    • 6
  1. 1.Division of Physiotherapy, School of Health and Rehabilitation Sciences, Therapies Building 84aThe University of QueenslandBrisbaneAustralia
  2. 2.Centre for Functioning and Health ResearchMetro South Hospital and Health ServiceBrisbaneAustralia
  3. 3.School of Public Health and Social Work and the Institute of Health and Biomedical InnovationQueensland University of TechnologyBrisbaneAustralia
  4. 4.School of Medicine, Herston RoadThe University of QueenslandBrisbaneAustralia
  5. 5.Otolaryngology–Head and Neck Surgery DepartmentPrincess Alexandra HospitalBrisbaneAustralia
  6. 6.Physiotherapy DepartmentRoyal Brisbane and Women’s HospitalBrisbaneAustralia

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