Upper body motor function and swallowing impairments and its association in survivors of head and neck cancer: A cross-sectional study

PLoS One. 2020 Jun 19;15(6):e0234467. doi: 10.1371/journal.pone.0234467. eCollection 2020.

Abstract

Background: Upper body motor function and swallowing may be affected after curative treatment for head and neck cancer. The aims of this study are to compare maximum mouth opening (MMO), temporomandibular dysfunction (TMD), cervical and shoulder active range of motion (AROM) and strength, and swallowing difficulty between survivors of head and neck cancer (sHNC) and healthy matched controls (HMC) and to examine the correlations between these outcomes in sHNC.

Methods: Thirty-two sHNC and 32 HMC participated on the study. MMO, TMD, cervical and shoulder AROM, cervical and shoulder strength, the SPADI shoulder pain and disability indices, the Eating Assessment Tool (EAT-10) score, swallowing difficulty as determined using a visual analogue scale (VAS), and the location of disturbances in swallowing, were recorded.

Results: MMO and cervical and shoulder AROM and strength were significantly lower in sHNC, whereas FAI, SPADI score, EAT-10 and VAS were higher. The MMO, TMD, cervical and shoulder AROM, and cervical shoulder strength values showed significant correlations (some direct, others inverse) with one another. Swallowing difficulty was inversely associated with the MMO, cervical AROM and shoulder strength.

Conclusion: Compared with controls, sHNC present smaller MMO, lower cervical and shoulder AROM, lower cervical and shoulder strength and higher perception of TMD, shoulder pain and disability and swallowing difficulty. sHNC suffer impaired swallowing related to lower MMO, presence of TMD, cervical AROM and shoulder strength values. Improving these variables via physiotherapy may reduce the difficulty in swallowing experienced by some sHNC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cancer Survivors
  • Cervical Vertebrae / physiopathology
  • Cross-Sectional Studies
  • Deglutition Disorders / etiology*
  • Female
  • Head and Neck Neoplasms / complications*
  • Humans
  • Male
  • Middle Aged
  • Range of Motion, Articular*
  • Shoulder / physiopathology
  • Shoulder Pain / etiology*
  • Temporomandibular Joint Dysfunction Syndrome / etiology*

Grants and funding

This research was supported by the Fondos Estructurales de la Unión Europea (FEDER) and Unit of Excellence on Exercise and Health (UCEES), University of Granada. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.