Motor and Functional Recovery Post Radical Thyroidectomy: A Comparative Study of Two Types of Physical Exercises

Abstract

Bakeground:Thyroidectomy is one of the standard surgical procedures worldwide. Although mortality and morbidity of thyroidectomy are low, some long-term complications continue to represent significant health and social problem. Early physical exercises for these patients are effective in enhancing the neck and shoulder motor function and improving quality of life. Aim: Assess the efficacy of early exercise programs (self rang of motion and active rang of motion exercises) on radical thyroidectomy patients' motor and functional abilities. Design: the researchers used a a comparative design. setting:The researcher conducted the study at the Head and Neck Surgery Unit in Alexandria Main University Hospital, Egypt. Sample:50 radical thyroidectomy patients were included, and each patient was randomly selected to be allocated to one of the two groups, 25 patients each. Tools: Four tools were used: Socio-demographic and clinical data structured interview schedule, The disabilities of the arm, shoulder and outcome questionnaire, shoulder recovery outcome and neck recovery outcome. Methods: researchers used four tools for data collection. exercise programs were applied one week before the operation and continued for two months postoperative. researchers developed verbal and written instruction and gave it preoperatively, and patients were re-assessed by utilizing tools II, III, and IV after applying the program for each group. Results: 88% of self exercises patients were holding against maximal resistance of muscles strength after two months postoperatively compared to 48% of active exercises patients were holding against gravity elimination. Arm circumference measurements were not statistically significant differences between the two groups, neither preoperatively nor postoperatively. In contrast, range of motion of shoulders, shoulder pain, Disailities of Arm,Shoulder and Hand score, ability to lift objects, ability to do work, and overall activity were significantly improved among self-exercise patients than active exercise patients. Conclusion: Significant improvement of the self exercises group concerning functional and motor activity of the shoulder, arm, and neck. Modification of the disabilities of the arm, shoulder, and hand score of self exercises patients. Statistically significant differences between self and active exercise group regarding Neck Dissection Impairment Index after two months postoperative. Recommendations: Patients and their families must be involved in early rehabilitation to prevent complications and improve their daily living activity.