Elise M Gane1,2, Steven M McPhail3,4, Anna L Hatton5, Benedict J Panizza6,7, Shaun P O'Leary5,8. 1. Division of Physiotherapy, School of Health and Rehabilitation Sciences, Therapies Building 84a, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia. e.gane@uq.edu.au. 2. Centre for Functioning and Health Research, Metro South Hospital and Health Service, P.O. Box 6053, Buranda, Brisbane, QLD, 4102, Australia. e.gane@uq.edu.au. 3. Centre for Functioning and Health Research, Metro South Hospital and Health Service, P.O. Box 6053, Buranda, Brisbane, QLD, 4102, Australia. 4. School of Public Health and Social Work and the Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, 4059, Australia. 5. Division of Physiotherapy, School of Health and Rehabilitation Sciences, Therapies Building 84a, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia. 6. School of Medicine, Herston Road, The University of Queensland, Herston, Brisbane, QLD, 4006, Australia. 7. Otolaryngology-Head and Neck Surgery Department, Princess Alexandra Hospital, 196 Ipswich Road, Woolloongabba, Brisbane, QLD, 4102, Australia. 8. Physiotherapy Department, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Brisbane, QLD, 4029, Australia.
Abstract
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Entities:
Keywords:
Head and neck neoplasms; Neck; Neck dissection; Pain; Quality of life; Shoulder
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