[Effects of structured rehabilitation training on shoulder syndrome after cervical lymph neck dissection in patients with oral cancer].

OBJECTIVES

Shoulder dysfunction syndrome is common in patients with oral cancer after neck dissection. Existing rehabilitation programs are mostly based on fixed stage-specific exercises and lack dynamic adjustment mechanisms according to patients' real-time conditions. This study aims to investigate the effects of a structured rehabilitation training program on shoulder dysfunction syndrome in patients after neck dissection for oral cancer and to provide evidence for the development of precise rehabilitation strategies in clinical practice.

METHODS

A total of 98 patients who underwent oral cancer surgery with neck dissection at the Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital of Central South University, between June 2023 and June 2024 were enrolled and randomly assigned to either a structured rehabilitation group or a conventional rehabilitation group. The structured rehabilitation group included 56 patients and received a stage-based rehabilitation program guided by structured assessments, whereas the conventional rehabilitation group included 42 patients and received standard rehabilitation training. The Constant-Murley Score (CMS) and Visual Analogue Scale (VAS) were used to evaluate patients at 2 weeks, 3 months, and 6 months postoperatively. Differences in scores between the 2 groups were compared.

RESULTS

Compared with the conventional rehabilitation group, patients in the structured rehabilitation group showed significantly better CMS at 3 and 6 months after surgery (P<0.001). Moreover, patients undergoing level V neck dissection exhibited earlier improvement in shoulder function scores. At 6 months postoperatively, VAS scores in the structured rehabilitation group were significantly lower than those in the conventional rehabilitation group (P<0.001), with a more pronounced advantage observed in the level V neck dissection subgroup. Multiple regression analysis further confirmed that structured rehabilitation intervention was an independent factor associated with improvements in shoulder function and pain at 3 and 6 months postoperatively (all P<0.001). Subgroup analysis revealed that patients undergoing level III neck dissection did not exhibit significant improvement in CMS and VAS score at 3 months postoperatively, both CMS and VAS scores of III and IV neck dissection at 6 months were significantly better than those in the conventional rehabilitation group (all P<0.001), indicating that the structured rehabilitation program provided long-term benefits regardless of the extent of neck dissection.

CONCLUSIONS

A rehabilitation training program based on structured assessment can significantly improve shoulder joint function, effectively alleviate shoulder dysfunction syndrome, and reduce pain in patients with oral cancer after neck dissection.