Department of Physical Therapy, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Rd. Niaosong Dist, Kaohsiung City 83301, Taiwan, ROC.
Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Rd. Niaosong Dist, Kaohsiung City 83301, Taiwan, ROC.
Oral Oncol. 2017 Nov;74:130-134. doi: 10.1016/j.oraloncology.2017.10.002. Epub 2017 Oct 9.
Physical therapy improves outcomes for patients with head and neck cancer (HNC) but home-based program (HBP) has not yet been investigated thoroughly. This study compared a HBP with outpatient physical therapy (OPT).
This trial categorized patients with primary HNC into OPT and HBP groups. The patients in the HBP group received home-based therapy once a day for 5 days per week. By contrast, the OPT group received various physical therapies, including aerobic, anaerobic, and stretching therapies, twice per week, plus a thrice-weekly home-based therapy that similarly consisted of aerobic, anaerobic, and stretching exercises. The major outcome was the Functional Assessment of Cancer Therapy-Head and Neck (FACT H&N), and secondary outcomes were the visual analog scale (VAS) of shoulder pain, 6-min walking test (6MWT), and shoulder range of motion (ROM), all of which were evaluated before, during, and after interventions.
Significant improvements were found after 12 weeks of the HBP or OPT. The HBP was not inferior to OPT regarding FACT H&N (p=.074), VAS of shoulder pain (p=.677), 6MWT (p = .677), and shoulder ROM (p=.145 for flexion; p=.383 for abduction).
Both the HBP and OPT can improve shoulder abduction, shoulder flexion and functional capacity.
物理疗法可改善头颈部癌症（HNC）患者的预后，但尚未对头颈部癌症患者的家庭为基础的治疗计划（HBP）进行深入研究。本研究比较了 HBP 与门诊物理治疗（OPT）。
本试验将原发性头颈部癌症患者分为 OPT 和 HBP 组。HBP 组患者每周接受 5 天，每天 1 次的家庭治疗。相比之下，OPT 组患者每周接受 2 次包括有氧运动、无氧运动和伸展运动治疗，以及每周 3 次的类似有氧运动、无氧运动和伸展运动的家庭治疗。主要结局是癌症治疗功能评估-头颈部（FACT H&N），次要结局是肩部疼痛的视觉模拟量表（VAS）、6 分钟步行试验（6MWT）和肩部活动范围（ROM），所有这些都在干预前、干预中和干预后进行评估。
HBP 或 OPT 治疗 12 周后均有显著改善。在 FACT H&N（p=.074）、肩部疼痛的 VAS（p=.677）、6MWT（p =.677）和肩部 ROM（p =.145 为前屈；p =.383 为外展）方面，HBP 并不逊于 OPT。
HBP 和 OPT 都可以改善肩部外展、肩部前屈和功能能力。
