Nervous System Diseases

Symptoms and General Pathology

All Conditions

Neoplasms

Mouth and Tooth Diseases

Rare Diseases

Dyskinesias

Mouth Neoplasms

Head and Neck Neoplasms

Mouth Diseases

Stomatognathic Diseases

Oral Cancer

Lip and Oral Cavity Cancer

scapular-focused exercise

visual feedback

Yueh-Hsia Chen, Master

Patients with head and neck cancer and undergo neck dissection often suffer from spinal accessory nerve dysfunction (e.g. shoulder droop, shoulder pain, and decreased active range of motion (AROM) of the shoulder joint and scapular muscle strength), even the spinal accessory nerve is preserved during surgery. Abnormal muscle activities of scapular muscles, including upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), serratus anterior (SA) and rhomboid were reported in subsequent research articles. Particularly for the trapezius muscle, the decreased amplitudes were observed even after 9 months of neck dissection. It has been reported that conscious correction of scapular orientation during arm movement could increase trapezius muscle activities, and motor control training could change scapular kinematic such as increased posterior tilt and upward rotation during arm movement.

Patients with head and neck cancer and undergo neck dissection often suffer from spinal accessory nerve dysfunction (e.g. shoulder droop, shoulder pain, and decreased active range of motion (AROM) of the shoulder joint and scapular muscle strength), even the spinal accessory nerve is preserved during surgery. Abnormal muscle activities of scapular muscles, including upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), serratus anterior (SA) and rhomboid were reported in subsequent research articles. Particularly for the trapezius muscle, the decreased amplitudes were observed even after 9 months of neck dissection. It has been reported that conscious correction of scapular orientation during arm movement could increase trapezius muscle activities, and motor control training could change scapular kinematic such as increased posterior tilt and upward rotation during arm movement.

The aim of this study is to explore the effects of electromyographic (EMG) visual feedback on scapular muscle activities and strength in oral cancer survivors with spinal accessory nerve dysfunction. Investigators will recruit 60 newly diagnosed oral cancer subjects through the plastic surgeon's referral from January 2020 to February 2021. The participants will be randomized separated into experimental or control group. Each group would receive regular physical therapy for shoulder function (e.g. transcutaneous electrical stimulation, shoulder joint range of motion exercise) and scapular-focused exercise. EMG visual feedback would be combined with scapular-focused exercise.

Effects of Electromyographic Visual Feedback for Spinal Accessory Nerve Dysfunction After Neck Dissection

Effects of Electromyographic Visual Feedback for Spinal Accessory Nerve Dysfunction in Oral Cancer Survivors With Neck Dissection: a Randomized Clinical Trial

Visual Analog Scale, total range=0-10, 0 means no pain and 10 means the obvious pain

abduction measured by goniometer, total range: 0-180

European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30, total range= 0-100. A higher score on the functional scale or global health scale represents a higher level of functioning or quality of life.

The Disabilities of the Arm, Shoulder and Hand (DASH) Score, total range: 0-100. Higher scores indicate greater disability.

EMG activities measure the muscle activities of the upper trapezius, middle trapezius, and lower trapezius

measurement of MVIC of the upper trapezius, middle trapezius, and lower trapezius

measurement of surface EMG activities of the upper trapezius, middle trapezius, and lower trapezius during MVIC

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Effects of Electromyographic Visual Feedback for Spinal Accessory Nerve Dysfunction After Neck Dissection	NCT04476004	Oral Cancer	scapular-focuse... visual feedback	20 Years - 65 Years	Chang Gung Memorial Hospital
Effects of Electromyographic Visual Feedback for Spinal Accessory Nerve Dysfunction After Neck Dissection	NCT04476004	Oral Cancer	scapular-focuse... visual feedback	20 Years - 65 Years	Chang Gung Memorial Hospital
Effects of Electromyographic Visual Feedback for Spinal Accessory Nerve Dysfunction After Neck Dissection	NCT04476004	Oral Cancer	scapular-focuse... visual feedback	20 Years - 65 Years	Chang Gung Memorial Hospital

Spots Global Cancer Trial Database for visual feedback