Skip to main content Accessibility help

Provision of physiotherapy rehabilitation following neck dissection in the UK

  • M Robinson (a1), L Ward (a2), H Mehanna (a3), V Paleri (a4) and S C Winter (a1)...



Neck dissection is associated with post-operative shoulder dysfunction in a substantial number of patients, affecting quality of life and return to work. There is no current UK national practice regarding physiotherapy after neck dissection.


Nine regional centres were surveyed to determine their standard physiotherapy practice pre- and post-neck dissection, and to determine pre-emptive physiotherapy for any patients.


Eighty-nine per cent of centres never arranged any pre-emptive physiotherapy for any patients. Thirty-three per cent of centres offered routine in-patient physiotherapy after surgery. No centres offered out-patient physiotherapy for all patients regardless of symptoms. Seventy-eight per cent offered physiotherapy for patients with any symptoms, with 11 per cent offering physiotherapy for those with severe dysfunction only. Eleven per cent of centres never offered physiotherapy for any dysfunction.


The provision of physiotherapy is most commonly reactive rather than proactive, and usually driven by patient request. There is little evidence of pre-arranged physiotherapy for patients to treat or prevent shoulder dysfunction in the UK.


Corresponding author

Address for correspondence: Mr Stuart Winter, Department of Head and Neck Surgery, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Headington, Oxford, UK E-mail:


Hide All

Mr S Winter takes responsibility for the integrity of the content of the paper



Hide All
1Oxford Cancer Intelligence Unit & National Cancer Intelligence Network. Profile of Head and Neck Cancers in England: Incidence, Mortality and Survival. Oxford: Oxford Cancer Intelligence Unit, 2010
2Schache, AG, Powell, NG, Cuschieri, KS, Robinson, M, Leary, S, Mehanna, H et al. HPV-related oropharynx cancer in the United Kingdom: an evolution in the understanding of disease etiology. Cancer Res 2016;76:6598–606
3Guru, K, Manoor, UK, Supe, SS. A comprehensive review of head and neck cancer rehabilitation: physical therapy perspectives. Indian J Palliat Care 2012;18:8797
4Shone, GR, Yardley, MP. An audit into the incidence of handicap after unilateral radical neck dissection. J Laryngol Otol 1991;105:760–2
5Rogers, SN, Ferlito, A, Pellitteri, PK, Shaha, AR, Rinaldo, A. Quality of life following neck dissections. Acta Otolaryngol 2004;124:231–6
6Rieke, K, Boilesen, E, Lydiatt, W, Schmid, KK, Houfek, J, Watanabe-Galloway, S. Population-based retrospective study to investigate preexisting and new depression diagnosis among head and neck cancer patients. Cancer Epidemiol 2016;43:42–8
7National Collaborating Centre for Cancer. Cancer of the Upper Aerodigestive Tract: Assessment and Management in People Aged 16 and Over. NICE Guideline 36. London: National Institute for Health and Care Excellence, 2016
8Robson, AK, Paleri, V. Role of dietetics, psychology, dentistry and physiotherapy in head and neck cancer treatment: the evidence. Clin Otolaryngol 2013;38:66–8
9Health and Social Care Information Centre, National Head and Neck Cancer Audit. National Head and Neck Cancer Audit: Tenth Annual Report (DAHNO). Leeds: Health and Social Care Information Centre, 2015
10National Institute for Health and Care Excellence. Guidance on Cancer Services. Improving Outcomes in Head and Neck Cancers: The Manual. Cancer Service Guideline 6. London: National Institute for Health and Care Excellence, 2004 (reviewed 2015)



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed