Robinson M, Ward L, Mehanna H, Paleri V, Winter S C
Department of Otolaryngology,Oxford University Hospitals NHS Foundation Trust,University of Oxford.
Nuffield Department of Orthopaedics,Rheumatology and Musculoskeletal Sciences,University of Oxford.
J Laryngol Otol. 2018 Jul;132(7):624-627. doi: 10.1017/S0022215118000671. Epub 2018 Jun 13.
Neck dissection is associated with post-operative shoulder dysfunction in a substantial number of patients, affecting quality of life and return to work. There is no current UK national practice regarding physiotherapy after neck dissection.
Nine regional centres were surveyed to determine their standard physiotherapy practice pre- and post-neck dissection, and to determine pre-emptive physiotherapy for any patients.
Eighty-nine per cent of centres never arranged any pre-emptive physiotherapy for any patients. Thirty-three per cent of centres offered routine in-patient physiotherapy after surgery. No centres offered out-patient physiotherapy for all patients regardless of symptoms. Seventy-eight per cent offered physiotherapy for patients with any symptoms, with 11 per cent offering physiotherapy for those with severe dysfunction only. Eleven per cent of centres never offered physiotherapy for any dysfunction.
The provision of physiotherapy is most commonly reactive rather than proactive, and usually driven by patient request. There is little evidence of pre-arranged physiotherapy for patients to treat or prevent shoulder dysfunction in the UK.
在相当数量的患者中，颈部清扫术与术后肩部功能障碍相关，这会影响生活质量和重返工作岗位。目前英国尚无关于颈部清扫术后物理治疗的全国性实践。
对九个地区中心进行了调查，以确定其颈部清扫术前和术后的标准物理治疗实践，并确定对任何患者的预防性物理治疗。
89%的中心从未为任何患者安排过预防性物理治疗。33%的中心在术后提供常规住院物理治疗。没有中心为所有患者提供门诊物理治疗，无论其症状如何。78%的中心为有任何症状的患者提供物理治疗，11%的中心仅为功能严重障碍的患者提供物理治疗。11%的中心从未为任何功能障碍提供物理治疗。
物理治疗的提供通常是被动的而非主动的，并且通常由患者要求驱动。在英国，几乎没有证据表明有为患者预先安排物理治疗以治疗或预防肩部功能障碍的情况。
