Head and Neck Cancer Clinical Trial
Official title:
Rehabilitation Outcomes in Head and Neck Survivors
Head and neck cancer is prevalent in Taiwan, and oral cancer is the most common location.
Patients with advanced stage of the disease need extensive tumor excision with neck
dissection. Secondary reconstructive surgeries using free flap could improve the
postoperative function or appearance of cancer survivors. Advanced treatments make survival
rates increased. Effects of treatment for oral cancer develop shoulder dysfunction, speech,
mastication, donor site morbidity and psychological issues. Physical therapy may have
benefits for temporomandibular joint function, shoulder pain relief, muscle performance, and
oral structures coordination. Return to work in the number of cancer survivors is a realistic
outcome. Rehabilitation effects on functional restorations and quality of life for head and
neck survivors are needed for further studied.
The purpose of this project is to explore the rehabilitation effects following head and neck
reconstructive survivors. The investigators measure temporomandibular joint function,
shoulder function, pain monthly. Physical functions, self-reported quality of life, and the
status of return to work are measured 3 and 6 months after surgery. This prospective study
could help to predict the rehabilitation outcomes and benefits.
Head and neck cancer is prevalent in Taiwan, and oral cancer is the most common location.
Patients with advanced stage of the disease need extensive tumor excision with neck
dissection. Secondary reconstructive surgeries using free flap could improve the
postoperative function or appearance of cancer survivors. Oral functions include respiration,
speech, mastication, deglutition, and cosmetics. Advanced treatments make survival rates
increased, but might develop shoulder dysfunction, speech, mastication, donor site morbidity
and psychological issues. The purpose of this project is to explore the effects of
rehabilitation following reconstructive surgery in oral cancer survivors.
This study design is an interrupted time-series design. The investigators will recruit 50
subjects one week following reconstructive surgery. The measurements include manual muscle
strength, joint range of motion, maximal mouth opening, pain status, hand-to-neck test,
hand-to-scapula test, hand-to-opposite-scapula test, 6-minute walking test, timed up & go
test, European Organization for Research and Treatment of Cancer (EORTC) quality of life
questionnaire (QLQ)-C30, European Organization for Research and Treatment of Cancer (EORTC)
quality of life questionnaire (QLQ)-H&N35 and return-to-work. These tests were done at the
first visit (0 week post-operation), three months and six months after reconstructive surgery
respectively. The intervention programs consist of edema control, scar management, pain
management, respiration training, oral function training, neck and shoulder function
training, donor site mobility training. Continuous variables were analyzed by descriptive
statistics. One-way ANOVA was used to compare the difference between measurements. Binary
logistic regression was used to predict the factors of return-to-work.
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