Clinical results of rehabilitation for accessory nerve palsy after radical neck dissection

Conclusions. Occupational therapy significantly improves shoulder range of motion in patients with accessory nerve palsy after radical neck dissection, but it has limited effects on the associated pain. Objective. To evaluate the outcome of occupational therapy rehabilitation for patients with accessory nerve palsy. Patients and methods. The occupational therapy group involved 35 shoulders of 29 patients with accessory nerve palsy after radical neck dissection; the control group included 10 shoulders of 9 patients who did not receive occupational therapy. All patients had a malignant tumor in the head or neck that necessitated radical neck dissection. We collected data pertaining to resting pain, motion pain, and the active and passive range of motion during shoulder flexion and abduction. Results. Occupational therapy did not adequately relieve resting or motion pain, but all patients achieved independence in activities of daily living and housekeeping activities. Although occupational therapy significantly improved shoulder elevation for all movements, shoulder elevation was significantly better for flexion than for active and passive abduction.