Scapular Muscle Exercises Following Neck Dissection Surgery for Head and Neck Cancer: A Comparative Electromyographic Study
Shoulder pain and dysfunction can occur following neck dissection surgery for cancer. These conditions often are due to accessory nerve injury. Such an injury leads to trapezius muscle weakness, which, in turn, alters scapular biomechanics. The aim of this study was to assess which strengthening exe...
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| Veröffentlicht in: | Physical therapy 2013-06, Vol.93 (6), p.786-797 |
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| creator | McGarvey, Aoife C Osmotherly, Peter Grant Hoffman, Gary R Chiarelli, Pauline E |
| description | Shoulder pain and dysfunction can occur following neck dissection surgery for cancer. These conditions often are due to accessory nerve injury. Such an injury leads to trapezius muscle weakness, which, in turn, alters scapular biomechanics.
The aim of this study was to assess which strengthening exercises incur the highest dynamic activity of affected trapezius and accessory scapular muscles in patients with accessory nerve dysfunction compared with their unaffected side.
A comparative design was utilized for this study.
The study was conducted in a physical therapy department. Ten participants who had undergone neck dissection surgery for cancer and whose operated side demonstrated clinical signs of accessory nerve injury were recruited. Surface electromyographic activity of the upper trapezius, middle trapezius, rhomboid major, and serratus anterior muscles on the affected side was compared dynamically with that of the unaffected side during 7 scapular strengthening exercises.
Electromyographic activity of the upper and middle trapezius muscles of the affected side was lower than that of the unaffected side. The neck dissection side affected by surgery demonstrated higher levels of upper and middle trapezius muscle activity during exercises involving overhead movement. The rhomboid and serratus anterior muscles of the affected side demonstrated higher levels of activity compared with the unaffected side.
Exercises were repeated 3 times on one occasion. Muscle activation under conditions of increased exercise dosage should be inferred with caution.
Overhead exercises are associated with higher levels of trapezius muscle activity in patients with accessory nerve injury following neck dissection surgery. However, pain and correct scapular form must be carefully monitored in this patient group during exercises. Rhomboid and serratus anterior accessory muscles may have a compensatory role, and this role should be considered during rehabilitation. |
| doi_str_mv | 10.2522/ptj.20120385 |
| format | Article |
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The aim of this study was to assess which strengthening exercises incur the highest dynamic activity of affected trapezius and accessory scapular muscles in patients with accessory nerve dysfunction compared with their unaffected side.
A comparative design was utilized for this study.
The study was conducted in a physical therapy department. Ten participants who had undergone neck dissection surgery for cancer and whose operated side demonstrated clinical signs of accessory nerve injury were recruited. Surface electromyographic activity of the upper trapezius, middle trapezius, rhomboid major, and serratus anterior muscles on the affected side was compared dynamically with that of the unaffected side during 7 scapular strengthening exercises.
Electromyographic activity of the upper and middle trapezius muscles of the affected side was lower than that of the unaffected side. The neck dissection side affected by surgery demonstrated higher levels of upper and middle trapezius muscle activity during exercises involving overhead movement. The rhomboid and serratus anterior muscles of the affected side demonstrated higher levels of activity compared with the unaffected side.
Exercises were repeated 3 times on one occasion. Muscle activation under conditions of increased exercise dosage should be inferred with caution.
Overhead exercises are associated with higher levels of trapezius muscle activity in patients with accessory nerve injury following neck dissection surgery. However, pain and correct scapular form must be carefully monitored in this patient group during exercises. Rhomboid and serratus anterior accessory muscles may have a compensatory role, and this role should be considered during rehabilitation.</description><identifier>ISSN: 0031-9023</identifier><identifier>EISSN: 1538-6724</identifier><identifier>DOI: 10.2522/ptj.20120385</identifier><identifier>PMID: 23431215</identifier><language>eng</language><publisher>United States: American Physical Therapy Association</publisher><subject>Accessory Nerve Injuries - etiology ; Accessory Nerve Injuries - therapy ; Aged ; Care and treatment ; Cervicoplasty ; Complications and side effects ; Electromyography ; Exercise ; Exercise Therapy ; Female ; Head and neck cancer ; Head and Neck Neoplasms - surgery ; Health aspects ; Humans ; Male ; Medical research ; Middle Aged ; Muscle Strength ; Muscle, Skeletal - innervation ; Muscular system ; Neck ; Neck Dissection - adverse effects ; Neck pain ; Patient outcomes ; Physical therapy ; Prevention ; Risk factors ; Shoulder ; Studies ; Surgery ; Upper Extremity - innervation ; Upper Extremity - physiology</subject><ispartof>Physical therapy, 2013-06, Vol.93 (6), p.786-797</ispartof><rights>COPYRIGHT 2013 Oxford University Press</rights><rights>COPYRIGHT 2013 Oxford University Press</rights><rights>Copyright AMERICAN PHYSICAL THERAPY ASSOCIATION Jun 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c807t-f3bdcf4ad7d00b2fece332cb83f7559cc49dbc8ab7e85f3699bcb125e885306b3</citedby><cites>FETCH-LOGICAL-c807t-f3bdcf4ad7d00b2fece332cb83f7559cc49dbc8ab7e85f3699bcb125e885306b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23431215$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McGarvey, Aoife C</creatorcontrib><creatorcontrib>Osmotherly, Peter Grant</creatorcontrib><creatorcontrib>Hoffman, Gary R</creatorcontrib><creatorcontrib>Chiarelli, Pauline E</creatorcontrib><title>Scapular Muscle Exercises Following Neck Dissection Surgery for Head and Neck Cancer: A Comparative Electromyographic Study</title><title>Physical therapy</title><addtitle>Phys Ther</addtitle><description>Shoulder pain and dysfunction can occur following neck dissection surgery for cancer. These conditions often are due to accessory nerve injury. Such an injury leads to trapezius muscle weakness, which, in turn, alters scapular biomechanics.
The aim of this study was to assess which strengthening exercises incur the highest dynamic activity of affected trapezius and accessory scapular muscles in patients with accessory nerve dysfunction compared with their unaffected side.
A comparative design was utilized for this study.
The study was conducted in a physical therapy department. Ten participants who had undergone neck dissection surgery for cancer and whose operated side demonstrated clinical signs of accessory nerve injury were recruited. Surface electromyographic activity of the upper trapezius, middle trapezius, rhomboid major, and serratus anterior muscles on the affected side was compared dynamically with that of the unaffected side during 7 scapular strengthening exercises.
Electromyographic activity of the upper and middle trapezius muscles of the affected side was lower than that of the unaffected side. The neck dissection side affected by surgery demonstrated higher levels of upper and middle trapezius muscle activity during exercises involving overhead movement. The rhomboid and serratus anterior muscles of the affected side demonstrated higher levels of activity compared with the unaffected side.
Exercises were repeated 3 times on one occasion. Muscle activation under conditions of increased exercise dosage should be inferred with caution.
Overhead exercises are associated with higher levels of trapezius muscle activity in patients with accessory nerve injury following neck dissection surgery. However, pain and correct scapular form must be carefully monitored in this patient group during exercises. Rhomboid and serratus anterior accessory muscles may have a compensatory role, and this role should be considered during rehabilitation.</description><subject>Accessory Nerve Injuries - etiology</subject><subject>Accessory Nerve Injuries - therapy</subject><subject>Aged</subject><subject>Care and treatment</subject><subject>Cervicoplasty</subject><subject>Complications and side effects</subject><subject>Electromyography</subject><subject>Exercise</subject><subject>Exercise Therapy</subject><subject>Female</subject><subject>Head and neck cancer</subject><subject>Head and Neck Neoplasms - surgery</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Male</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Muscle Strength</subject><subject>Muscle, Skeletal - innervation</subject><subject>Muscular system</subject><subject>Neck</subject><subject>Neck Dissection - adverse effects</subject><subject>Neck pain</subject><subject>Patient outcomes</subject><subject>Physical therapy</subject><subject>Prevention</subject><subject>Risk factors</subject><subject>Shoulder</subject><subject>Studies</subject><subject>Surgery</subject><subject>Upper Extremity - innervation</subject><subject>Upper Extremity - physiology</subject><issn>0031-9023</issn><issn>1538-6724</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqV0kuP0zAUBeAIgZhhYMcaWWIDghQ_8nDYVWVeUpmRKKwtx7lJXZw42AkzFX8el3ZARRUPeRHJ-u6RnHui6CnBE5pS-qYfVhOKCcWMp_eiY5IyHmc5Te5HxxgzEheYsqPokfcrjDHJk-JhdERZwggl6XH0baFkPxrp0PvRKwPo9Bac0h48OrPG2BvdNegK1Gf0TnsPatC2Q4vRNeDWqLYOXYCskOyqLZrJToF7i6ZoZtteOjnoryHThEFn27VtnOyXWqHFMFbrx9GDWhoPT3bfk-jT2enH2UU8vz6_nE3nseI4H-KalZWqE1nlFcYlrUEBY1SVnNV5mhZKJUVVKi7LHHhas6woSlUSmgLnKcNZyU6iF9vc3tkvI_hBtNorMEZ2YEcvSEIKlmW8YH-nLEtygsNfDPT5b3RlR9eFh2wCKWE8z7JfqpEGhO5qOzipNqFiyliCeZ6kaVDxAdVAB04a20Gtw_Wenxzw4VTQanVw4OXeQDAD3A6NHL0Xl4sP_2Gv_tny8_mfHrmzKtQMGhBh5bPrff9665Wz3juoRe90K91aECw21Reh-uKu-oE_2-1jLFuofuK7rgfwaguWulneaAfCt9KYwH8kbZdXMJGJnGfsOyqNCOo</recordid><startdate>20130601</startdate><enddate>20130601</enddate><creator>McGarvey, Aoife C</creator><creator>Osmotherly, Peter Grant</creator><creator>Hoffman, Gary R</creator><creator>Chiarelli, Pauline E</creator><general>American Physical Therapy Association</general><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8GL</scope><scope>ISN</scope><scope>ISR</scope><scope>3V.</scope><scope>7RQ</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>88I</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20130601</creationdate><title>Scapular Muscle Exercises Following Neck Dissection Surgery for Head and Neck Cancer: A Comparative Electromyographic Study</title><author>McGarvey, Aoife C ; Osmotherly, Peter Grant ; Hoffman, Gary R ; Chiarelli, Pauline E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c807t-f3bdcf4ad7d00b2fece332cb83f7559cc49dbc8ab7e85f3699bcb125e885306b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Accessory Nerve Injuries - etiology</topic><topic>Accessory Nerve Injuries - therapy</topic><topic>Aged</topic><topic>Care and treatment</topic><topic>Cervicoplasty</topic><topic>Complications and side effects</topic><topic>Electromyography</topic><topic>Exercise</topic><topic>Exercise Therapy</topic><topic>Female</topic><topic>Head and neck cancer</topic><topic>Head and Neck Neoplasms - surgery</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Male</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Muscle Strength</topic><topic>Muscle, Skeletal - innervation</topic><topic>Muscular system</topic><topic>Neck</topic><topic>Neck Dissection - adverse effects</topic><topic>Neck pain</topic><topic>Patient outcomes</topic><topic>Physical therapy</topic><topic>Prevention</topic><topic>Risk factors</topic><topic>Shoulder</topic><topic>Studies</topic><topic>Surgery</topic><topic>Upper Extremity - innervation</topic><topic>Upper Extremity - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McGarvey, Aoife C</creatorcontrib><creatorcontrib>Osmotherly, Peter Grant</creatorcontrib><creatorcontrib>Hoffman, Gary R</creatorcontrib><creatorcontrib>Chiarelli, Pauline E</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: High School</collection><collection>Gale In Context: Canada</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Career & Technical Education Database</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Physical therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McGarvey, Aoife C</au><au>Osmotherly, Peter Grant</au><au>Hoffman, Gary R</au><au>Chiarelli, Pauline E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Scapular Muscle Exercises Following Neck Dissection Surgery for Head and Neck Cancer: A Comparative Electromyographic Study</atitle><jtitle>Physical therapy</jtitle><addtitle>Phys Ther</addtitle><date>2013-06-01</date><risdate>2013</risdate><volume>93</volume><issue>6</issue><spage>786</spage><epage>797</epage><pages>786-797</pages><issn>0031-9023</issn><eissn>1538-6724</eissn><abstract>Shoulder pain and dysfunction can occur following neck dissection surgery for cancer. These conditions often are due to accessory nerve injury. Such an injury leads to trapezius muscle weakness, which, in turn, alters scapular biomechanics.
The aim of this study was to assess which strengthening exercises incur the highest dynamic activity of affected trapezius and accessory scapular muscles in patients with accessory nerve dysfunction compared with their unaffected side.
A comparative design was utilized for this study.
The study was conducted in a physical therapy department. Ten participants who had undergone neck dissection surgery for cancer and whose operated side demonstrated clinical signs of accessory nerve injury were recruited. Surface electromyographic activity of the upper trapezius, middle trapezius, rhomboid major, and serratus anterior muscles on the affected side was compared dynamically with that of the unaffected side during 7 scapular strengthening exercises.
Electromyographic activity of the upper and middle trapezius muscles of the affected side was lower than that of the unaffected side. The neck dissection side affected by surgery demonstrated higher levels of upper and middle trapezius muscle activity during exercises involving overhead movement. The rhomboid and serratus anterior muscles of the affected side demonstrated higher levels of activity compared with the unaffected side.
Exercises were repeated 3 times on one occasion. Muscle activation under conditions of increased exercise dosage should be inferred with caution.
Overhead exercises are associated with higher levels of trapezius muscle activity in patients with accessory nerve injury following neck dissection surgery. However, pain and correct scapular form must be carefully monitored in this patient group during exercises. Rhomboid and serratus anterior accessory muscles may have a compensatory role, and this role should be considered during rehabilitation.</abstract><cop>United States</cop><pub>American Physical Therapy Association</pub><pmid>23431215</pmid><doi>10.2522/ptj.20120385</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Physical therapy, 2013-06, Vol.93 (6), p.786-797 |
| issn | 0031-9023 1538-6724 |
| language | eng |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Accessory Nerve Injuries - etiology Accessory Nerve Injuries - therapy Aged Care and treatment Cervicoplasty Complications and side effects Electromyography Exercise Exercise Therapy Female Head and neck cancer Head and Neck Neoplasms - surgery Health aspects Humans Male Medical research Middle Aged Muscle Strength Muscle, Skeletal - innervation Muscular system Neck Neck Dissection - adverse effects Neck pain Patient outcomes Physical therapy Prevention Risk factors Shoulder Studies Surgery Upper Extremity - innervation Upper Extremity - physiology |
| title | Scapular Muscle Exercises Following Neck Dissection Surgery for Head and Neck Cancer: A Comparative Electromyographic Study |
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