Effectiveness of Cervical Rehabilitation Program on Neck Pain, ROM and Disability After Thyroidectomy.

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).

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.

Eligibility Criteria:
Inclusion Criteria:

* • Both genders (male \& female)

  * Post-thyroidectomy patients
  * Indoor patients

Exclusion Criteria:

* • Any cervical fracture/dislocations

  * Cervical instability
  * Vertebrobasilar insufficiency
  * Cervical Radiculopathy
  * Disc prolapsed at cervical region
  * Any neurological impairment