title: A pilot study of a randomized controlled trial to evaluate the effects of progressive resistance exercise training on shoulder dysfunction caused by spinal accessory neurapraxia/neurectomy in head and neck cancer survivors.
abstract: BACKGROUND
  Shoulder dysfunction remains a frequent complication after neck dissection procedures for head and neck cancer.
  
  
  METHODS
  We conducted a pilot study to evaluate the effects of progressive resistance exercise training (PRET) on shoulder dysfunction caused by spinal accessory neurapraxia/neurectomy in patients with head and neck cancer. Twenty patients (mean age, 61 +/- 7.7 years) were randomly assigned to PRET or standard care intervention. Subjects assigned to the PRET group exercised three times per week for 12 weeks. The goal of the exercise program was to enhance scapular stability and strength of the upper extremity. The resistance-training program was progressive in terms of number of sets and repetitions performed, as well as the amount of weight lifted, depending on performance status.
  
  
  RESULTS
  The completion rate for the trial was 85% (17 of 20). The exercise group completed 93% of scheduled exercise sessions. Significant improvements were found in favor of the PRET group in active shoulder external rotation (p =.001), shoulder pain (p =.038), and overall score for shoulder pain and disability (p =.045).
  
  
  CONCLUSIONS
  The study results demonstrate a high rate of completion and adherence with our PRET program among patients with head and neck cancer. The preliminary findings, although limited, also suggest a potential therapeutic role for resistance exercise as an adjunct to standard physical therapy treatment.
authors.affiliation: Physical Therapy, Rehabilitation Medicine Department, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta T6G 1Z2 Canada. margiem@cancerboard.ab.ca
authors.forename: Margaret L
authors.initials: ML
authors.lastname: McNeely
authors.forename: Matthew
authors.initials: M
authors.lastname: Parliament
authors.forename: Kerry S
authors.initials: KS
authors.lastname: Courneya
authors.forename: Hadi
authors.initials: H
authors.lastname: Seikaly
authors.forename: Naresh
authors.initials: N
authors.lastname: Jha
authors.forename: Rufus
authors.initials: R
authors.lastname: Scrimger
authors.forename: John
authors.initials: J
authors.lastname: Hanson
mesh_terms: D000055:Accessory Nerve / Q000601:surgery*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects*; D010865:Pilot Projects; D011446:Prospective Studies; D012399:Rotation; D012782:Shoulder / Q000294:innervation / Q000503:physiopathology*; D020069:Shoulder Pain / Q000503:physiopathology / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D017741:Survivors; D016896:Treatment Outcome