Effect of Exercise on Upper Extremity Pain and Dysfunction in Head and Neck Cancer Survivors
Bibliographic record
Abstract
Head and neck cancers (HNC) account for only 4% to 5% of all malignant tumors. The etiology of most HNC is related to lifestyle factors such as smoking tobacco and heavy alcohol consumption. Survivors of HNC often have considerable post treatment morbidity affecting eating, speaking, function and cosmesis that heighten the impact of the disease. Shoulder pain is a well-recognized complication resulting from surgery for HNC and is associated with poorer quality of life and increased risk for longterm disability. As a result of their demographic and disease profile, HNC survivors represent a unique and challenging cancer group in terms of exercise rehabilitation. PURPOSE: This study was designed to examine the effects of progressive resistance exercise training (PRET) as an adjunct to standard physical therapy (SPT) on upper extremity pain and dysfunction in post-surgical head and neck cancer survivors. METHODS: Fifty-two head and neck cancer survivors were randomly assigned to PRET (n = 27) or SPT (n =25) for 12 weeks. The primary endpoint was change in patient-rated shoulder pain and disability from baseline to post-intervention. Secondary endpoints were upper extremity strength and endurance, shoulder range of motion, fatigue and quality of life. RESULTS: Follow-up assessment for the primary outcome was 92% and adherence to the supervised PRET and SPT programs were 95% and 87%, respectively. Based on intention-to-treat analyses, PRET was superior to SPT for improving shoulder pain and disability [−10.0; 95% CI: −15.8 to −4.2; p = .001], upper extremity strength [+10.8 kg; 95% CI: 5.4 to 16.2; p < .001], and upper extremity endurance [+189 repetitions × kg; 95% CI: 5 to 374; p =.045]. Changes in neck dissection impairment, fatigue, and quality of life favored the PRET group but did not reach statistical significance. CONCLUSIONS: The PRET program significantly reduced shoulder pain and disability and improved upper extremity muscular strength and endurance in cancer survivors with shoulder dysfunction due to spinal accessory nerve damage. Clinicians may consider PRET as an adjunct to SPT in the rehabilitation of post-surgical head and neck cancer survivors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".