Effect of Muscle Energy Techniques V/S Active Range of Motion Exercises on Shoulder Function Post Modified Radical Neck Dissection in patients with Head and Neck Cancer - A Randomized Clinical Trial.

Anmol Thomas,Cherishma D’Silva,Stephen Rajan Samuel,Leah Mohandas,Sudeep M J Pais

doi:10.31557/apjcp.2020.21.8.2389

Abstract

Purpose:Shoulder and cervical pain, reduced mobility and disability are some of the major complications associated with surgeries of head and neck cancers affecting several domains of quality of life. In the present study we aimed to compare the effectiveness of Muscle Ener-gy Techniques (METS) and Active Range of Motion Exercises in reducing pain, improving shoulder mobility and function in patients post Modified Radical Neck Dissection (MRND). Methods:Forty eight subjects were randomly assigned to two groups. Group A received active range of motion (AROM) exercises and group B received Muscle energy techniques (METS). Both the groups were treated for a period of 10 consecutive days starting from the 3rd to 5th postoperative day. Data was collected on the 1st and 10th day of intervention. Results:Both groups showed highly significant improvements in shoulder range of motion , decrease in pain and better Global Rating Change cores(GRCS) (p=0.005). GRCS and shoul-der abduction showed significant improvement in group B when compared to group A, sug-gesting better clinical outcomes in those treated with Muscle Energy Techniques. Conclusion:This study showed that both METs and AROM exercises were effective in im-proving shoulder range of motion, function and reducing pain in patients post MRND but-Muscle Energy Techniques were more effective when compared to AROM exercises.

Highlights

Over 2 million cases of head and neck cancer occur each year in India
This study showed that both Muscle energy technique (MET) and active range of motion (AROM) exercises were effective in im-proving shoulder range of motion, function and reducing pain in patients post Modified Radical Neck Dissection (MRND) but-Muscle Energy Techniques were more effective when compared to AROM exercises
This study aimed at comparing the effectiveness of METs with AROM exercises in subjects who underwent MRND

Summary

Introduction

Over 2 million cases of head and neck cancer occur each year in India. Head and neck cancer accounts for 30% of all cancers in India and nearly 50% deaths occur within 12 months of diagnosis. Neck dissection followed by chemotherapy and radiotherapy is the treatment of choice for head and neck cancer (HNC) (Robbinsons et al.,1991) Radical neck dissection (RND) is one of the major treatment procedures used in the management of head and neck cancers but is known to have higher morbidity, greater post-operative complications and loss of function. It involves complete sacrifice of the sensory branches of the cervical plexus, and the C2, C3 and C4 branches that supply sternocleidomastoid and trapezius.

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