Abstract
Head and neck cancer (HNC) is the sixth most common cancer worldwide. Yet, less than 60% of HNC survivors receive adequate therapy for treatment-related sequelae. The objective of this study was to determine the efficacy of myofascial induction therapy (MIT) in improving cervical and shoulder pain and range of motion, maximal mouth opening, and cervical muscle function in HNC survivors. This crossover, blinded, placebo-controlled study involved 22 HNC survivors (average age 56.55 ± 12.71) of which 13 were males (59.1%) who received, in a crossover fashion, both a single 30-min session of MIT in the form of manual unwinding and simulated pulsed shortwave therapy (placebo), with a 4-week washout interval between the two. Cervical and shoulder pain (visual analogue scale) and range of motion (cervical range of motion device and goniometer), maximum mouth opening (digital caliper), and cervical muscle function (deep cervical flexor endurance test) were measured before and after the treatment and placebo sessions. A single session of MIT improved cervical and affected side shoulder pain, cervical range of motion, maximum mouth opening, and cervical muscle function. The associated effect sizes ranged from moderate to large. The present study suggests that MIT, in the form of manual unwinding, improves cervical (−3.91 ± 2.77) and affected-side shoulder (−3.64 ± 3.1) pain, cervical range of motion (flexion: 8.41 ± 8.26 deg; extension: 12.23 ± 6.55; affected-side rotation: 14.27 ± 11.05; unaffected-side rotation: 11.73 ± 8.65; affected-side lateroflexion: 7.95 ± 5.1; unaffected-side lateroflexion: 9.55 ± 6.6), maximum mouth opening (3.36 ± 3.4 mm), and cervical muscle function (8.09 ± 6.96 s) in HNC survivors.
Highlights
Head and neck cancer (HNC) refers to any malignant tumor arising above the thoracic inlet and below the base of the skull
Pairwise comparisons revealed a significant reduction in the cervical (−3.91 points) and affected-side shoulder (−3.64 points) pain scores after the myofascial induction therapy (MIT) session, and in cervical pain (−2.09) after the placebo session (p < 0.004), the latter change did not reach the minimum required to be clinically meaningful (3 points) [36]
After the MIT session, 15 patients (68.2%) saw their scores surpass this threshold with respect to cervical pain, and
Summary
Head and neck cancer (HNC) refers to any malignant tumor arising above the thoracic inlet and below the base of the skull. It includes the oral cavity, pharynx, larynx, salivary glands and sinonasal cavities [1]. Location and stage, guide the decision to treat via surgery and/or radiotherapy and chemotherapy; more advanced tumors commonly require combined treatments [3]. Surgical treatment involves tumor resection, plus neck dissection if the lymph nodes are affected. This procedure can leave sequelae such as pain and lack of mobility, leading to neck and shoulder dysfunction [4]. The risk of developing significant functional deficiencies is even higher with concurrent chemoradiotherapy [7]
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