Vol. 6, Issue 1, Part A (2024)

Objective: one of the complications of neck dissection in patients with oral cancer surgery is post-surgical neck and shoulder - pain and stiffness, limitation in ROM, which interfere with normal muscle firing around periscapular and shoulder musculature; this long term misfiring pattern may lead to scapular dyskinesia; it affect ADL activities and QOL in these patients. This study aims to focus on to compare effectiveness of manual therapy v/s conscious control of scapula along with conventional physiotherapy to correct scapular dyskinesia in postsurgical cancer patients. 
Methods: A randomized controlled trial was performed, Forty patients were randomly allocated with oral cancer surgery into the two groups, Group A -Manual therapy along with conventional physiotherapy; Group B - Scapular-focused exercises along with conventional physiotherapy was performed on both groups after neck dissection surgery for 3 months. Shoulder pain intensity, active range of motion (AROM) of shoulder abduction, scapular muscle strength and activity under maximal voluntary isometric contraction (MVIC), scapular muscle activity and QoL were measured while performing scapular movements 3 months after at the end of intervention.
Results: Both groups showed a significant improvement in outcome measure; however Group A (Manual therapy + conventional physiotherapy) showed significant improvement in shoulder AROM, pain, QOL, improvement in strength of lower trapezius and serratus anterior compared with Group B (conventional physiotherapy + scapular focused exercise).
Conclusion: Post-surgical cancer patients with scapular dyskinesia manual therapy along with conventional physiotherapy have promising effect. Manual therapy with conventional physiotherapy showed a significant improvement in shoulder AROM, pain, QOL, improvement in strength and muscle activation pattern of lower trapezius and serratus anterior muscle.