Article

Shoulder pain and dysfunction can occur following neck dissection
surgery for cancer. These conditions often are due to accessory nerve injury.
Such an injury leads to trapezius muscle weakness, which, in turn, alters
scapular biomechanics. The aim of this study was to assess which
strengthening exercises incur the highest dynamic activity of affected trapezius
and accessory scapular muscles in patients with accessory nerve dysfunction
compared with their unaffected side. DESIGN: A comparative design was utilized
for this study. METHODS: The study was conducted in a physical therapy
department. Ten participants who had undergone neck dissection surgery for cancer
and whose operated side demonstrated clinical signs of accessory nerve injury
were recruited. Surface electromyographic activity of the upper trapezius, middle
trapezius, rhomboid major, and serratus anterior muscles on the affected side was
compared dynamically with that of the unaffected side during 7 scapular
strengthening exercises. RESULTS: Electromyographic activity of the upper and
middle trapezius muscles of the affected side was lower than that of the
unaffected side. The neck dissection side affected by surgery demonstrated higher
levels of upper and middle trapezius muscle activity during exercises involving
overhead movement. The rhomboid and serratus anterior muscles of the affected
side demonstrated higher levels of activity compared with the unaffected side.
LIMITATIONS: Exercises were repeated 3 times on one occasion. Muscle activation
under conditions of increased exercise dosage should be inferred with caution.
CONCLUSIONS: Overhead exercises are associated with higher levels of trapezius
muscle activity in patients with accessory nerve injury following neck dissection
surgery. However, pain and correct scapular form must be carefully monitored in
this patient group during exercises. Rhomboid and serratus anterior accessory
muscles may have a compensatory role, and this role should be considered during
rehabilitation.

Langue : ANGLAIS