Document Type : Original Article
Authors
1
Hosh Essa, Hosh Essa Hospital, El-Behira, Egypt
2
Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Egypt
3
Oncology Center, Damanhour, El-Behira, Egypt
4
Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Egypt.
10.21608/iptccu.2025.440742
Abstract
Background: Shoulder complaints are frequently observed following neck dissection surgeries (NDS), even in cases where the spinal accessory nerve (SAN) remains intact. Damage to the SAN and the resulting denervation of the trapezius muscle can impair shoulder girdle elevation, leading to scapular dyskinesis. This condition has been linked to shoulder pain and functional limitations as reported by cases. Purpose: Trial conducted to investigate the impact of Maitland mobilization (MM) and scapular stabilization exercises on shoulder dysfunction in cases post-NDS. Methods: Sixty cases (39 females and 21 males) aged between 30 and 50 years, all experiencing shoulder dysfunction after NDS were included. They were randomly assigned into three equal groups. Group A received both MM and scapular stabilization exercises. Group B received only MM, while group C performed only scapular stabilization exercises. Each group also received standard physical therapy. The interventions were administered three times weekly for two months. Shoulder range of motion (ROM) was measured using a digital goniometer, and the Shoulder Pain and Disability Index (SPADI) was used to assess pain and function, both before and after the treatment period. Results: All three groups exhibited significant improvements in shoulder flexion, abduction, and external rotation ROM, along with significant reductions in SPADI scores post-treatment (p < 0.001). Group A demonstrated significantly greater gains in ROM and greater reductions in SPADI scores in comparison with groups B and C (p < 0.001). Furthermore, group B showed superior improvements in shoulder flexion, abduction, and SPADI scores relative to group C (p < 0.001), though no significant difference in external rotation was observed between groups B and C (p > 0.05). Conclusion: The combined use of MM and scapular stabilization exercises proved more effective on shoulder dysfunction post- NDS than either technique applied individually.
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