Effect of exercise on upper extremity pain and dysfunction in head and neck cancer survivors - A randomized controlled trial
Effect of exercise on upper extremity pain and dysfunction in head and neck cancer survivors - A randomized controlled trial
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DOI：
10.1002/cncr.23536
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发表时间：
2008-07-01
期刊：
影响因子：
6.2
通讯作者：
Courneya, Kerry S.
中科院分区：
文献类型：
--
作者：
McNeely, Margaret L.;Parliament, Matthew B.;Courneya, Kerry S.
背景肩痛和残疾是公认的与头颈癌手术相关的并发症。本研究旨在探讨渐进式抗阻运动训练（PRET）对头颈部癌术后患者上肢疼痛和功能障碍的影响。52名头颈部癌症幸存者被随机分配到PRET（n = 27）或标准化治疗运动方案（TP）（n = 25），为期12周。主要终点是患者评定的肩痛和残疾从基线到干预后的变化。次要终点是上肢力量和耐力、活动范围、疲劳和生活质量。主要结局的随访评估为92%，对监督的PRET和TP计划的依从性分别为95%和87%。基于意向治疗分析，PRET在改善肩痛和残疾方面优于TP，但优于TP的上级疗效（-9.6; 95%置信区间[95%CI]，-16.4至-4.5; P = .001），上肢力量（+10.8 kg; 95% CI，5.4-16.2 kg; P < .001）和上肢耐力（+194次重复X kg; 95% CI，10-378次重复X kg; P = .039）。颈清扫术损伤、疲劳和生活质量的变化有利于PRET组，但未达到统计学显著性。PRET计划显着减少肩痛和残疾，改善上肢肌肉力量和耐力的头部和颈部癌症幸存者谁有肩功能障碍，因为脊髓副神经损伤。临床医生应考虑在头颈部癌术后幸存者的康复中加入PRET。
BACKGROUND. Shoulder pain and disability are well recognized complications associated with surgery for head and neck cancer. This study was designed to examine the effects of progressive resistance exercise training (PRET) on upper extremity pain and dysfunction in postsurgical head and neck cancer survivors.METHODS. Fifty-two head and neck cancer survivors were assigned randomly to PRET (n = 27) or a standardized therapeutic exercise protocol (TP) (n = 25) for 12 weeks. The primary endpoint was change in patient-rated shoulder pain and disability from baseline to postintervention. Secondary endpoints were upper extremity strength and endurance, range of motion, fatigue, and quality of life.RESULTS. Follow-up assessment for the primary outcome was 92%, and adherence to the supervised PRET and TP programs were 95% and 87%, respectively. On the basis of intention-to-treat analyses, PRET was superior to TP for improving shoulder pain and disability (-9.6; 95% confidence interval [95% CI], -16.4 to -4.5; P = .001), upper extremity strength (+10.8 kg; 95% CI, 5.4-16.2 kg; P < .001), and upper extremity endurance (+194 repetitions X kg; 95% CI, 10-378 repetitions X kg; P = .039). Changes in neck dissection impairment, fatigue, and quality of life favored the PRET group but did not reach statistical significance.CONCLUSIONS. The PRET program significantly reduced shoulder pain and disability and improved upper extremity muscular strength and endurance in head and neck cancer survivors who had shoulder dysfunction because of spinal accessory nerve damage. Clinicians should consider the addition of PRET in the rehabilitation of postsurgical head and neck cancer survivors.