Effects of Electromyographic Visual Feedback for Spinal Accessory Nerve Dysfunction After Neck Dissection
Condition: Oral Cancer
MeSH terms: Mouth Neoplasms
Study type: Interventional

Summary: 
      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.
    

Detailed description: 
      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.
    

Intervention name(s): scapular-focused exercise; visual feedback
Intervention type(s): Other; Other
Intervention description(s): scapular-focused exercise; EMG visual feedback
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Scapular-focused exercise; Scapular Dyskinesis; Spinal accessory nerve; Physical therapy; Electromyography; Visual feedback