Effectiveness of Cervical Rehabilitation Program on Neck Pain, ROM and Disability After Thyroidectomy.
Condition: Thyroiditis, Postpartum
MeSH terms: Postpartum Thyroiditis; Thyroiditis; Neck Pain
Study type: Interventional

Summary: 
      The aim of this research is to determine the Effects of cervical rehabilitation program on
      neck pain, ROM and disability after thyroidectomy. Randomized controlled trials will be done
      at Pakistan ordinance factory (POF) Hospital. The sample size will be 52. The subjects were
      divided in two groups, with 26 subjects in Group A and 26 in Group B. Study duration will be
      of 6 months. Sampling technique applied will be Non probability Convenience Sampling
      technique. Both males and females of aged 30-50 years with thyroidectomy will be included.
      Tools used in the study are Numeric Pain Rating Score (NPRS), goniometer and neck disability
      index (NDI).
    

Detailed description: 
      Thyroidectomy, or surgical removal of the gland, is highly recommended treatment for thyroid
      disorders. The most prevalent of these conditions are symptomatic benign large goiter and
      tumorous condition of the thyroid gland. Both younger females and postmenopausal older women
      are prevalent towards these disorders (nodular goiter, cancer, and hypothyroidism).

      Due to hyperextended position of neck during surgery patient usually complaint about the
      posterior neck pain, movement difficulties of shoulder and neck, occipital headaches,
      shoulder stiffness, motion's cervical range of limitations and some of them experiences the
      discomfort symptoms such as stretching, pressing, or choking feelings in the neck, headache,
      shoulder stiffness, and difficulty in moving the neck or shoulders. These symptoms may
      persist for an extended period following surgery and may even have a negative effect on the
      patient's quality of life. It has been reported that hyperextension can cause bilateral
      hypoglossal palsy, tetraplegia and cervical artery dissection.

      Recently, a variety of treatment modalities have been used to overcome these disturbing
      symptoms, such as intraoperative transcutaneous electrical nerve stimulation (TENS),
      preoperative bilateral greater occipital nerve (GON) block, bilateral superficial cervical
      plexus block combined with bilateral GON block, and postoperative neck stretching exercise.
      Due to surgical position of thyroidectomy patient often develops posture syndrome of thyroid
      surgery (PSTS), symptoms include postoperative nausea, vomiting, dizziness, headache and some
      discomfort associated with neck an occipital radiating pain.

      Position of neck during surgery and static posture of patient after thyroidectomy causes
      tightness of surrounding muscles which leads to posterior neck pain, limited ROM and
      functional disability. Everyone is focused on the incisional pain but not on this disability,
      there is some literature on neck stretching exercises to treat posterior neck pain but no
      other technique is used for treatment of posterior neck pain. The purpose of this study is to
      check the effectiveness of cervical rehabilitation program on neck pain, ROM and disability
      following thyroidectomy.
    

Intervention name(s): cervical rehabilitation program; control group
Intervention type(s): Other; Other
Intervention description(s): (Positional release technique on trapezius muscle): The subject was supine The therapist applied Pressure by pinching the trapezius muscle between the thumb and fingers.
Suboccipital muscle release):
The patient will be in a Supine lying position therapist places both his palms at suboccipital region with upward pressure causing a stretch and distraction for 30 seconds. This technique was performed 3 times in one session with a rest interval of 1 minute after each time.
(Stretching of pectoralis muscle):. once daily Stretching with repetition of five, three times a day for 1week; Relax shoulders and neck sufficiently look down turn face to the right turn face to the left incline head to the right incline head to the left turn shoulders round and round slowly raise hands fully then lower them. patients were asked to perform five repetitions of each stretching exercise, three times per day (morning, afternoon, and evening).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: positional release; suboccipital muscle release