Rehabilitation of shoulder dysfunctions using the Pilates method in patients with head and neck cancer undergoing neck dissection with accessory nerve preservation: a randomized clinical trial.
Keywords:
Head and neck neoplasms, Shoulder dysfunction, Rehabilitation, Physiotherapy, Quality of lifeAbstract
This study evaluated the effectiveness of the Pilates method compared to conventional physiotherapy in the rehabilitation of shoulder dysfunctions—specifically limitations in range of motion in flexion and abduction—in patients with head and neck cancer who underwent cervical lymphadenectomy with accessory nerve preservation. A single-blind randomized clinical trial was conducted with 23 patients divided into two groups: Control (conventional physiotherapy) and Intervention (Pilates). Assessment tools included goniometry, visual analog scale (VAS), manual muscle testing (Oxford MRC), submaximal rowing test with elastic band, SPADI-Brazil questionnaire, and FACT-HN version 4. Results showed no statistically significant difference between groups regarding the number of sessions required to achieve active shoulder range of motion ≥150° (p=0.91). Both groups demonstrated significant improvements in range of motion (p<0.01), muscle strength (p<0.05), pain reduction (p<0.01), and shoulder functionality (p<0.05). Treatment adherence was satisfactory in both groups (>85%), with minimal adverse events. It is concluded that both the Pilates method and conventional physiotherapy are effective interventions for shoulder rehabilitation, contributing to improved quality of life in these patients. The inclusion of these approaches in public health services is recommended, with appropriate professional training.
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Copyright (c) 2025 Rhayssa Espósito Santos Campos, Ludimila Assis Silva Campos, Alice de Andrade Oliveira, Marina Ribeiro Mingorança, Livia Carla Padilha
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