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Journal of Cancer Survivorship

Published in:

01-10-2018

The relationship between physical impairments, quality of life and disability of the neck and upper limb in patients following neck dissection

Authors: Elise M. Gane, Steven M. McPhail, Anna L. Hatton, Benedict J. Panizza, Shaun P. O’Leary

Published in: Journal of Cancer Survivorship | Issue 5/2018

Abstract

Purpose

The purpose of this study was to examine the relationship between physical impairments, quality of life and disability in patients following neck dissection, with consideration of patient and clinical characteristics.

Methods

Cross-sectional study of patients < 5 years after neck dissection for head and neck cancer. Quality of life and self-reported disability were measured with the Neck Dissection Impairment Index, Quick Disabilities of the Arm, Shoulder and Hand, and Neck Disability Index. Active neck and shoulder range of motion and isometric muscle strength were also assessed. Generalised linear modelling was used to explore relationships between variables.

Results

Eighty-four participants (68% male, median age 61 years) demonstrated reduced quality of life (median (interquartile range) score = 76 (49, 93) from 0 (worst) to 100 (best)), and mild levels of upper limb (14 (2, 32)) and neck disability (14 (6, 28)) (from 0 (best) to 100 (worst)). Bilateral neck dissection was associated with reduced quality of life (coeff (95% CI) = − 12.49 (− 24.69, − 0.29)). Post-operative chemoradiation therapy was associated with reduced quality of life (− 21.46 (− 37.57, − 5.35)) and neck disability (0.71 (0.10, 1.32)). Measures of shoulder flexibility or strength were associated with quality of life and self-reported disability.

Conclusions

Quality of life and musculoskeletal disability after neck dissection are associated with factors from multiple domains including physical motor function and treatment modality.

Implications for Cancer Survivors

Having reduced shoulder flexibility or strength is related to functional deficits and quality of life after neck dissection for head and neck cancer.

National Comphrehensive Cancer Network (2016) Head and neck cancers, version 1.2016. https://www.nccn.org/professionals/physician_gls/PDF/head-and-neck.pdf. Accessed 9 Jan 2017.

Rathod S, Livergant J, Klein J, Witterick I, Ringash J. A systematic review of quality of life in head and neck cancer treated with surgery with or without adjuvant treatment. Oral Oncol. 2015;51(10):888–900. https://doi.org/10.1016/j.oraloncology.2015.07.002. CrossRefPubMed

van Wilgen CP, Dijkstra PU, van der Laan BF, Plukker JT, Roodenburg JL. Shoulder complaints after neck dissection; is the spinal accessory nerve involved? Br J Oral Maxillofac Surg. 2003;41(1):7–11.CrossRefPubMed

Teymoortash A, Hoch S, Eivazi B, Werner JA. Postoperative morbidity after different types of selective neck dissection. Laryngoscope. 2010;120(5):924–9. https://doi.org/10.1002/lary.20894. CrossRefPubMed

Agha-Mir-Salim P, Schulte-Mattler W, Funk U, Lautenschlager C, Bloching M, Berghaus A. Origin of shoulder pain after “neck dissection”. Importance of the cervical plexus. HNO. 2002;50(6):544–52.CrossRefPubMed

Cappiello J, Piazza C, Giudice M, De Maria G, Nicolai P. Shoulder disability after different selective neck dissections (levels II–IV versus levels II–V): a comparative study. Laryngoscope. 2005;115(2):259–63. https://doi.org/10.1097/01.mlg.0000154729.31281.da.CrossRefPubMed

Laverick S, Lowe D, Brown J, Vaughan E, Rogers S. The impact of neck dissection on health-related quality of life. Arch Otolaryngol Head Neck Surg. 2004;130:149–54.CrossRefPubMed

Gallagher K, Sacco A, Lee J, Taylor R, Chanowski E, Bradford C, et al. Association between multimodality neck treatment and work and leisure impairment: a disease-specific measure to assess both impairment and rehabilitation after neck dissection. JAMA Otolaryngol Head Neck Surg. 2015;141(10):888–93.PubMed

van Wilgen CP, Dijkstra PU, van der Laan BFAM, Plukker JTM, Roodenburg JLN. Shoulder complaints after nerve sparing neck dissections. Int J Oral Max Surg. 2004;33(3):253–7.CrossRef

10.

Chepeha D, Taylor R, Chepeha J, Teknos T, Bradford CR, Sharma P, et al. Functional assessment using Constant’s shoulder scale after modified radical and selective neck dissection. Head Neck. 2002;24:432–6.CrossRefPubMed

11.

Robbins KT, Clayman G, Levine PA, Medina JE, Sessions RB, Shaha A, et al. Neck dissection classification update. Arch Otolaryngol Head Neck Surg. 2002;128:751–8.CrossRefPubMed

12.

Robbins KT, Medina JE, Wolfe GT, Levine PA, Sessions RB, Pruet CW. Standardizing neck dissection terminology. Arch Otolaryngol Head Neck Surg. 1991;117:601–5.CrossRefPubMed

13.

Robbins KT, Shaha AR, Medina JE, Califano JA, Wolf GT, Ferlito A, et al. Consensus statement on the classification and terminology of neck dissection. Arch Otolaryngol Head Neck Surg. 2008;134(5):536–8. https://doi.org/10.1001/archotol.134.5.536.CrossRefPubMed

14.

Gane EM, Michaleff ZA, Cottrell MA, McPhail SM, Hatton AL, Panizza BJ, et al. Prevalence, incidence, and risk factors for shoulder and neck dysfunction after neck dissection: a systematic review. Eur J Surg Oncol. 2017;43:1199–218. https://doi.org/10.1016/j.ejso.2016.10.026. CrossRefPubMed

15.

Taylor R, Chepeha J, Teknos T, Bradford C, Sharma P, Terrell J, et al. Development and validation of the neck dissection impairment index: a quality of life measure. Arch Otolaryngol Head Neck Surg. 2002;128(1):44–9.CrossRefPubMed

16.

Stuiver MM, ten Tusscher MR, van Opzeeland A, Brendeke W, Lindeboom R, Dijkstra PU, et al. Psychometric properties of 3 patient-reported outcome measures for the assessment of shoulder disability after neck dissection. Head Neck. 2016;38:102–10.CrossRefPubMed

17.

Beaton D, Wright J, Katz J, Group TUEC. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg. 2005;87-A(5):1038–46.

18.

LeBlanc M, Stineman M, DeMichele A, Stricker C, Mao JJ. Validation of QuickDASH outcome measure in breast cancer survivors for upper extremity disability. Arch Phys Med Rehabil. 2014;95(3):493–8. https://doi.org/10.1016/j.apmr.2013.09.016.CrossRefPubMed

19.

MacDermid JC, Walton DM, Avery S, Blanchard A, Etruw E, McAlpine C, et al. Measurement properties of the neck disability index: a systematic review. J Orthop Sports Phys Ther. 2009;39(5):400–17. https://doi.org/10.2519/jospt.2009.2930. CrossRefPubMed

20.

Vernon H, Mior S. The neck disability index: a study of reliability and validity. J Manip Physiol Ther. 1991;14:409–15.

21.

Vernon H. The neck disability index: state-of-the-art, 1991–2008. J Manip Physiol Ther. 2008;31:491–502.CrossRef

22.

Struyf F, Nijs J, Mottram S, Roussel NA, Cools AMJ, Meeusen R. Clinical assessment of the scapula: a review of the literature. Br J Sports Med. 2014;48:883–90.CrossRefPubMed

23.

Yang J-I, Lin J-J. Reliability of function-related tests in patients with shoulder pathologies. Sports Phys Ther. 2006;36(8):572–6.CrossRef

24.

Hanney WJ, George SZ, Kolber MJ, Young I, Salamh PA, Cleland JA. Inter-rater reliability of select physical examination procedures in patients with neck pain. Physiother Theory Pract, Early Online. 2013(1–8).

25.

Hoving JL, Buchbinder R, Green S, Forbes A, Bellamy N, Brand C, et al. How reliably do rheumatologists measure shoulder movement? Ann Rheum Dis. 2002;61:612–6.CrossRefPubMedPubMedCentral

26.

Kolber MJ, Saltzman SB, Beekhuizen KS, Cheng MS. Reliability and minimal detectable change of inclinometric shoulder mobility measurements. Physiother Theory Pract. 2009;25(8):572–81.CrossRefPubMed

27.

Clarkson HM. Joint motion and function assessment: a research-based practical guide. Philadelphia: Lippincott Williams & Wilkins; 2005.

28.

Van Wyk L, Jull G, Vicenzino B, Greaves M, O'Leary S. A comparison of craniocervical and cervicothoracic muscle strength in healthy individuals. J Appl Biomech. 2010;26(4):400–6.CrossRefPubMed

29.

O'Leary S, Lorass Fagermoen C, Hasegawa H, Slettevold Thorsen A, Van Wyk L. Differential strength and endurance parameters of the craniocervical and cervicothoracic extensors and flexors in healthy individuals—technical note. J Appl Biomech. 2016;33:166–70.CrossRefPubMed

30.

Cadogan A, Laslett M, Hing W, McNair P, Williams M. Reliability of a new hand-held dynamometer in measuring shoulder range of motion and strength. Man Ther. 2011;16:97–101.CrossRefPubMed

31.

Hayes K, Walton JR, Szomor ZL, Murrell GAC. Reliability of 3 methods for assessing shoulder strength. J Shoulder Elb Surg. 2002;11:33–9.CrossRef

32.

Huber PJ. The behaviour of maximum likelihood estimates under nonstandard conditions. Proceedings of the Fifth Berkeley Symposium on Mathematical Statistics and Probability. Berkeley: University of California Press; 1967. p. 221–33.

33.

White H. A heretoskedasticity–consistent covariance matrix estimator and a direct test for heteroskedasticity. Econometrica. 1980;48:817–30.CrossRef

34.

McNeely M, Parliament M, Seikaly H, Jha N, Magee D, Haykowsky M, et al. Effect of exercise on upper extremity pain and dysfunction in head and neck cancer survivors: a randomized controlled trial. Cancer. 2008;133:214–22.CrossRef

35.

McGarvey A, Hoffman G, Osmotherly P, Chiarelli P. Maximizing shoulder function after accessory nerve injury and neck dissection surgery: a multicentre randomized controlled trial. Head Neck. 2015;37:1022–31.CrossRefPubMed

36.

Ward ECD. As-brooks CJv. Head and neck cancer: treatment, rehabilitation, and outcomes. Vol book, whole. San Diego: Plural Publishing; 2014.

37.

Deng J, Ridner SH, Dietrich MS, Wells N, Wallston KA, Sinard RJ, et al. Factors associated with external and internal lymphedema in patients with head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2012;84(3):e319–28. https://doi.org/10.1016/j.ijrobp.2012.04.013.CrossRefPubMed

38.

Dijkstra P, Van Wilgen P, Buijs R, Brendeke W, De Goede C, Kerst A, et al. Incidence of shoulder pain after neck dissection: a clinical explorative study for risk factors. Head Neck. 2001;23(11):947–53.CrossRefPubMed

39.

Erisen L, Basel B, Irdesel J, Zarifoglu M, Coskun H, Basut O, et al. Shoulder function after accessory nerve-sparing neck dissections. Head Neck. 2004;26(11):967–71.CrossRefPubMed

40.

van Wouwe M, de Bree R, Kuik DJ, de Goede CJ, Verdonck-de Leeuw IM, Doornaert P, et al. Shoulder morbidity after non-surgical treatment of the neck. Radiother Oncol. 2009;90(2):196–201. https://doi.org/10.1016/j.radonc.2008.11.003.CrossRefPubMed

41.

Inoue H, Nibu K, Saito M, Otsuki N, Ishida H, Onitsuka T, et al. Quality of life after neck dissection. Arch Otolaryngol. 2006;132(6):662–6.CrossRef

42.

Chaplin J, Morton R. A prospective, longitudinal study of pain in head and neck cancer patients. Head Neck. 1999;21:531–7.CrossRefPubMed

43.

Speksnikder C, van der Bilt A, Slappendel M, de Wijer A, Merkx M, Koole R. Neck and shoulder function in patients treated for oral malignancies: a 1-year prospective cohort study. Head Neck. 2013;35:1303–13.CrossRef

44.

Chepeha D, Taylor R, Chepeha J, Teknos T, Bradford C, Sharma P, et al. Functional assessment using Constant’s shoulder scale after modified radical and selective neck dissection. Head Neck. 2002;24(5):432–6.CrossRefPubMed

45.

Karaman M, Tek A, Uslu C, Akduman D, Bilac O. Effect of functional neck dissection and postoperative radiotherapy on the spinal accessory nerve. Acta Otolaryngol. 2009;129:872–80.CrossRefPubMed

46.

Pignon J-P, Maître AL, Maillard E, Bourhis J. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol. 2009;92(1):4–14. https://doi.org/10.1016/j.radonc.2009.04.014. CrossRefPubMed

47.

Rivelli TG, Mak MP, Martins RE, da Costa sa Silva VT, de Castro G Jr. Cisplatin based chemoradiation late toxicities in head and neck squamous cell carcinoma patients. Discov Med. 2015;20(108):57–66.PubMed

48.

Cisplatin. MacMillan Cancer Support. 2016. http://www.macmillan.org.uk/cancerinformation/cancertreatment/treatmenttypes/chemotherapy/individualdrugs/cisplatin.aspx. Accessed 20 Dec 2016.

49.

Berger A, Abernathy A, A A, B AM, B WS, Cella D, et al. Cancer-related fatigue. J Natl Compr Cancer Netw. 2010;8:904–31.CrossRef

50.

Ghiam MK, Mannion K, Dietrich MS, Stevens KL, Gilbert J, Murphy BA. Assessment of musculoskeletal impairment in head and neck cancer patients. Support Care Cancer. 2017;25:2085–92. https://doi.org/10.1007/s00520-017-3603-1. CrossRefPubMed

51.

Swisher AKPTPCCS, Altaha RMD, Arbaugh JDPT, Barr KDPT, Brooks DDPT, Copeland ADPT, et al. Neck and shoulder impairments and the relationship to quality of life in head and neck cancer survivors. Rehabil Oncol. 2012;30(2):3–7.CrossRef

52.

Ritchie C, Hendrikz J, Kenardy J, Sterling M. Derivation of a clinical prediction rule to identify both chronic moderate/severe disability and full recovery following whiplash injury. Pain. 2013;154(10):2198–206.CrossRefPubMed

53.

Hidalgo-Lozano A, Calderon-Soto C, Domingo-Camara A. Fernandez-de-las-Penas C, Madeleine P, Arroyo-Morales M. Elite swimmers with unilateral shoulder pain demonstrate altered pattern of cervical muscle activation during a functional upper-limb task. J Orthop Sports Phys Ther. 2012;42(6):552–8. https://doi.org/10.2519/jospt.2012.3875. CrossRefPubMed

54.

Zabihhosseinian M, Holmes MW, Howarth S, Ferguson B, Murphy B. Neck muscle fatigue differentially alters scapular and humeral kinematics during humeral elevation in subclinical neck pain participants versus healthy controls. J Electromyogr Kinesiol. 2017;33:73–82. https://doi.org/10.1016/j.jelekin.2017.02.002.CrossRefPubMed

55.

Christensen SW, Hirata RP, Graven-Nielsen T. The effect of experimental neck pain on pressure pain sensitivity and axioscapular motor control. J Pain. 2015;16(4):367–79. https://doi.org/10.1016/j.jpain.2015.01.008.CrossRefPubMed

56.

Hodges PW, Tucker K. Moving differently in pain: a new theory to explain the adaptation to pain. Pain. 2011;152(3 Suppl):S90–8. https://doi.org/10.1016/j.pain.2010.10.020. CrossRefPubMed

57.

Carenfelt C, Eliasson K. Radical neck dissection and permanent sequelae associated with spinal accessory nerve injuries. Acta Otolaryngol. 1981;91(1–2):155–60.CrossRef

58.

Ewing MR, Martin H. Disability following radical neck dissection: an assessment based on the postoperative evaluation of 100 patients. Cancer. 1952;5:873–83.CrossRefPubMed

59.

Merve A, Mitra I, Swindell R, Homer JJ. Shoulder morbidity after pectoralis major flap reconstruction for head and neck cancer. Head Neck. 2009;31(11):1470–6.CrossRefPubMed

60.

Robbins KT, Ferlito A, Shah JP, Hamoir M, Takes RP, Strojan P, et al. The evolving role of selective neck dissection for head and neck squamous cell carcinoma. Eur Archives Oto-rhino-Laryngol. 2013;270(4):1195–202. https://doi.org/10.1007/s00405-012-2153-x. CrossRef

61.

Palmer MJ, Epler ME. Fundamentals of musculoskeletal assessment techniques. 2nd ed. Philadelphia: Lippincott; 1998.

62.

Wang H-L. Shoulder pain after neck dissection among head and neck cancer patients. ProQuest Dissertations Publishing: Indiana University; 2009.

Title: The relationship between physical impairments, quality of life and disability of the neck and upper limb in patients following neck dissection
Authors: Elise M. Gane
Steven M. McPhail
Anna L. Hatton
Benedict J. Panizza
Shaun P. O’Leary
Publication date: 01-10-2018
Publisher: Springer US
Published in: Journal of Cancer Survivorship / Issue 5/2018
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-018-0697-5

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Abstract

Purpose

Methods

Results

Conclusions

Implications for Cancer Survivors

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