McNeely, M.L., Parliament, M.B., Seikaly, H., Jha, N., Magee, D.J., Haykowsky, M.J., & Courneya, K.S. (2008). Effect of exercise on upper extremity pain and dysfunction in head and neck cancer survivors: A randomized controlled trial. Cancer, 113, 214–222.doi: 10.1002/cncr.23536
To examine the effects of progressive resistance exercise training on upper extremity pain and dysfunction in postsurgical head and neck cancer survivors
Participants were randomly assigned to either standard therapeutic exercise or progressive resistance exercise training (PRET). All were asked to attend at least two supervised sessions per week for 12 weeks. Standard exercise involved active and passive range of motion and stretching, postural exercise, and strengthening with light weights (1–5 kg) and elastic resistance bands targeting specific muscle groups. The PRET group received the same exercises except that the strengthening was replaced with individualized exercise on the same muscle groups designed with the intent to provide progressive overload to those muscles. Outcomes were assessed at baseline and postintervention.
The study was a prospective randomized controlled trial.
The PRET program significantly reduced shoulder pain and disability (p = 0.001) and improved upper extremity muscular strength and endurance. Patients participating in the PRET program had a 52% reduction in pain. The effect size for change in pain was d = 0.84. PRET was better than the standard exercise for all strength endpoints measured, and endurance was more improved with PRET (p = 0.039).
Findings show that a program of individualized progressive resistance exercise in patients with specific shoulder dysfunction postsurgery for head and neck cancer as provided here can reduce pain and disability.
Survivors of head and neck cancer can be burdened with pain and loss of strength and function associated with damage to the spinal accessory nerve. It is important that nurses consider means that will help to minimize these residual effects. Exercise is a noninvasive tool that enables patients to actively participate in their recovery. This study shows that a PRET program had a beneficial effect, with reduction in pain of 52% in the PRET group. Improvement in pain was also associated with increases in upper extremity strength and endurance.