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Provision of physiotherapy rehabilitation following neck dissection in the UK

Published online by Cambridge University Press:  13 June 2018

M Robinson
Affiliation:
Department of Otolaryngology, Oxford University Hospitals NHS Foundation Trust, University of Oxford
L Ward
Affiliation:
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford
H Mehanna
Affiliation:
Institute of Head and Neck Studies and Education, University of Birmingham
V Paleri
Affiliation:
Department of Head and Neck Surgery, University of Newcastle, UK
S C Winter*
Affiliation:
Department of Otolaryngology, Oxford University Hospitals NHS Foundation Trust, University of Oxford
*
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: stuart.winter@ouh.nhs.uk

Abstract

Background

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.

Method

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.

Results

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.

Conclusion

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.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

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

References

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, 2010Google Scholar
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;76:6598–606Google Scholar
3Guru, K, Manoor, UK, Supe, SS. A comprehensive review of head and neck cancer rehabilitation: physical therapy perspectives. Indian J Palliat Care 2012;18:8797Google Scholar
4Shone, GR, Yardley, MP. An audit into the incidence of handicap after unilateral radical neck dissection. J Laryngol Otol 1991;105:760–2Google Scholar
5Rogers, SN, Ferlito, A, Pellitteri, PK, Shaha, AR, Rinaldo, A. Quality of life following neck dissections. Acta Otolaryngol 2004;124:231–6Google Scholar
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;43:42–8Google Scholar
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, 2016Google Scholar
8Robson, AK, Paleri, V. Role of dietetics, psychology, dentistry and physiotherapy in head and neck cancer treatment: the evidence. Clin Otolaryngol 2013;38:66–8Google Scholar
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, 2015Google Scholar
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)Google Scholar