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. 2018 Feb 21:6:e4419.
doi: 10.7717/peerj.4419. eCollection 2018.

Functional outcomes and quality of life after a 6-month early intervention program for oral cancer survivors: a single-arm clinical trial

Yueh-Hsia Chen  1 , Wei-An Liang  1 , Chung-Yin Hsu  2 , Siang-Lan Guo  1 , Shwu-Huei Lien  1 , Hsiao-Jung Tseng  3 , Yuan-Hung Chao  2   4   5
Affiliations

Functional outcomes and quality of life after a 6-month early intervention program for oral cancer survivors: a single-arm clinical trial

Yueh-Hsia Chen et al. PeerJ. .

Abstract

Background: Advanced treatment of oral cancer increases survival rates; however, it also increases the risk of developing shoulder dysfunction, dysphagia, oral dysfunction, donor site morbidity and psychological issues. This single-arm preliminary pilot study aims to explore the effects of a six-month early intervention program following reconstructive surgery in oral cancer survivors.

Methods: A total of 65 participants were analyzed following reconstructive surgery. Outcome measurements were taken during the first visit, and at one, three and six months after reconstructive surgery.

Results: Scapular muscle strength and shoulder range of motion progressively improved during the 6-month follow-up. The mean Disability of the Arms, Shoulder and Hand (DASH) score showed significant improvement at 1 month (p < .001). Health related QoL showed significant differences between baseline and 6-months post-surgery scores on global health and on most of the function and symptom scales. The predicted return-to-work rate was 80% at one year after the operation. Return-to-work rate differs in different vocational types, with a higher rate of return in the skilled or semi-skilled (87.5%) and self-employed (86.7%).

Conclusions: We suggest that early integrated intervention program with a follow-up of at least six months following reconstructive surgery may help develop and identify intervention guidelines and goals in the initial six months of treatment following neck dissection in oral cancer survivors.

Keywords: Oral cancer; Quality of life; Return to work; Shoulder dysfunction.

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Conflict of interest statement

The authors declare there are no competing interests.

Figures

Figure 1
Figure 1. Scapula control exercise.
(A–C) Anti-scapular winging exercise: bilateral hands held together and elevated to the top then placed behind the head, pulling the bilateral scapular closer. (D) Wall press exercise. (E) Wall press with scapular elevation exercise. (F) Wall press with arm clock exercise.
Figure 2
Figure 2. Progressive resistance exercise (PRE) training.
(A) Shoulder diagonal flexion with thera-band. (B) Shoulder horizontal abduction and scapulae retraction with thera-band. (C) Shoulder flexion and abduction with free weights.
Figure 3
Figure 3. The CONSORT flow chart.
Figure 4
Figure 4. Curve of the percentage of return-to-work patients at post-operative month in the early and advanced stage groups.
See this image and copyright information in PMC

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