Comparison of Early Versus Late Referral for Scapular-Focused Exercise on Shoulder Function in Head and Neck Cancer Patients Following Neck Dissection
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 30
- 试验地点
- 2
- 主要终点
- Active range of motion (AROM) of shoulder abduction
研究概览
简要总结
This study aims to investigate the effects of comparing early versus late referrals for scapular-focused exercise on shoulder function in head and neck cancer patients following neck dissection.
详细描述
This study will recruit 30 head and neck cancer patients with spinal accessory nerve shoulder dysfunction based on the timing of referral, which will be divided into early (within 2 months post-surgery) and late (after 2 months post-surgery) referral groups. Both groups will receive conventional physical therapy (e.g., shoulder joint mobility training, electrical stimulation, or laser therapy for pain relief) and scapular-focused exercises. Scapular-focused exercise primarily targets the trapezius muscle, 60 minutes each session, once a week for 12 weeks.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 20 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age between 20 and 65 years.
- •Newly diagnosed with head and neck cancer and experiencing clinical symptoms of accessory nerve dysfunction after unilateral neck dissection, such as shoulder drooping, restricted active range of motion in shoulder abduction, or insufficient muscle strength against gravity in shoulder abduction.
- •Scapular dyskinesia, such as asymmetrical scapular movement in multiple planes.
- •Scapular asymmetry, defined as a bilateral difference of more than 1.5 cm between the inferior angle of the scapula and the spinous process of the seventh thoracic vertebra when performing 90° shoulder abduction in the scapular plane under a 1 kg load.
排除标准
- •Presence of distant metastasis or cancer recurrence.
- •Inability to communicate or comprehend the questionnaire.
- •History of shoulder pain within one year before neck dissection.
- •Any condition that may affect motor performance.
- •History of neuromuscular disorders or tendon pathology in the affected shoulder, other than accessory nerve dysfunction.
研究组 & 干预措施
early (within 2 months post-surgery) referral groups.
干预措施: Scapular-focused exercise (Behavioral)
late (after 2 months post-surgery) referral groups
干预措施: Scapular-focused exercise (Behavioral)
结局指标
主要结局
Active range of motion (AROM) of shoulder abduction
时间窗: Baseline (before the first exercise intervention), 12 weeks of exercise intervention
Shoulder abduction AROM is measured in degrees three times using a universal goniometer and full-circle manual protractor, with the subject supine, shoulder in lateral rotation, and palm facing anteriorly. The protractor fulcrum is placed on the anterior acromial process, one arm aligned with the midline of the sternum, and the other with the anterior midline of the humerus, while keeping the thorax immobile to prevent vertebral lateral flexion.
scapular position
时间窗: Baseline (before the first exercise intervention), 12 weeks of exercise intervention
The modified lateral scapular slide test (MLSST) measures the medio-lateral displacement of the inferior scapular angle and asymmetry at three shoulder abduction angles. The distance between the inferior scapular angle and the spinous process of the seventh thoracic vertebra is measured three times on each side using a vernier caliper, and the average difference is calculated. The MLSST is conducted in three positions: arms at the sides (position 1), hands on hips (position 2), and holding a 1 kg dumbbell at 90° shoulder abduction with maximal internal rotation in the scapular plane (position 3).
次要结局
- ultrasonography of upper and middle trapezius morphology(Baseline (before the first exercise intervention), 12 weeks of exercise intervention)
- electromyography signals during maximum isometric contraction of the trapezius(Baseline (before the first exercise intervention), 12 weeks of exercise intervention)
- shoulder pain(Baseline (before the first exercise intervention), 12 weeks of exercise intervention)
- upper extremity function(Baseline (before the first exercise intervention), 12 weeks of exercise intervention)