Sustainability of outcomes after a randomized crossover trial of resistance exercise for shoulder dysfunction in survivors of head and neck cancer

Abstract

Purpose: Shoulder pain and dysfunction may occur after surgery for head and neck cancer (HNC) as a result of damage to or resection of the spinal accessory nerve. Previous research found that 12 weeks of upper extremity progressive resistance exercise training (PRET) improved shoulder outcomes in survivors of HNC; the purpose of this study was to determine whether benefits persisted over the longer term.

Methods: Survivors of HNC were assigned at random to PRET (n=27) or a standard therapeutic protocol (TP; n=25), with an opportunity for crossover in the TP group after 12 weeks. At 12-month follow-up, participants were mailed a questionnaire that assessed quality of life (QOL), shoulder outcomes, and exercise behaviour.

Results: Of the 52 participants enrolled in the study, 44 were eligible at 12-month follow-up, and 37 (71%) completed the questionnaires. Overall, self-reported outcomes were largely sustained over the follow-up period. After 12 months, regardless of original group allocation, participants who continued resistance exercise training during the follow-up period reported better neck dissection-related functioning (p=0.021) and better QOL (p=0.011) than those who did not.

Conclusions: Benefits of PRET were sustained at 12-month follow-up. Ongoing participation in resistance exercise training may prove valuable as a supportive care intervention for survivors of HNC.

Keywords: exercise therapy; follow-up studies; head and neck neoplasms; quality of life; shoulder pain.

Figures

Figure 1

Flow of study participants through trial and follow-up.

Figure 2

Baseline, post-intervention, and follow-up results for the NDII by resistance exercise behaviour.