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Effect of Progressive Resistive Exercise Training (PRET) on Shoulder Joint Abduction Range of Motion, Pain and Disability in Post Operative Oral Cancer Patients Undergoing Radiation Therapy: A Randomized Controlled Trial A Randomized Controlled Trial

In Indian Journal of Physiotherapy and Occupational Therapy - An International Journal
By: Chatterjee M.
Contributor(s): Vedang M [Corresponding author] | Nikam S | Kannan S | Gupta T | Ghosh Laskar S | Agarwal JP.
Material type: materialTypeLabelArticlePublisher: 2017Description: .Subject(s): Oral Cancer | PRET | Shoulder Dysfunction | Radiotherapy In: Indian Journal of Physiotherapy and Occupational Therapy - An International Journal Vol. 11, no. 1, p.57-63Summary: Background Significant shoulder dysfunction comprising of restricted shoulder abduction and pain persists in a majority of the post surgery oral cancer patients even on performing active shoulder exercises and Radiotherapy (RT) worsens the symptoms. Progressive Resistive Exercise Training (PRET) involves gradual and incremental increase in resistance for improved rehabilitation. This trial was done to evaluate effects of PRET with active exercises in treating shoulder dysfunction in post surgery patients undergoing RT. Method Ninety four post surgery oral cancer patients undergoing radiotherapy were recruited in this trial. Patients in the control group (n=47) performed active shoulder exercises only. Patients in the trial group (n=47) performed both resistive and active exercises. Resistance was gradually progressed under supervision over 6 weeks according to the tolerance of patients in trial group. Active shoulder Range of Motion (AROM) was measured at week 0, 2, 4 and 6. Shoulder Pain and Disability Index (SPADI) was also measured in both groups at the base line and at 6th week. Result Greater improvement was found in shoulder abduction active range of motion in the trial group (mean =59.2°) than in control group (mean=22.3°), p<0.001. The SPADI score also indicated significant improvement in trial group at 6 weeks when compared to control group. Conclusion PRET in combination with active exercises provided more benefits to the patients compared to active exercises only and should be considered the standard of care.
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Address for correspondence: vedangmurthy@gmail.com

Background

Significant shoulder dysfunction comprising of restricted shoulder abduction and pain persists in a majority of the post surgery oral cancer patients even on performing active shoulder exercises and Radiotherapy (RT) worsens the symptoms. Progressive Resistive Exercise Training (PRET) involves gradual and incremental increase in resistance for improved rehabilitation. This trial was done to evaluate effects of PRET with active exercises in treating shoulder dysfunction in post surgery patients undergoing RT.

Method

Ninety four post surgery oral cancer patients undergoing radiotherapy were recruited in this trial. Patients in the control group (n=47) performed active shoulder exercises only. Patients in the trial group (n=47) performed both resistive and active exercises. Resistance was gradually progressed under supervision over 6 weeks according to the tolerance of patients in trial group. Active shoulder Range of Motion (AROM) was measured at week 0, 2, 4 and 6. Shoulder Pain and Disability Index (SPADI) was also measured in both groups at the base line and at 6th week.

Result

Greater improvement was found in shoulder abduction active range of motion in the trial group (mean =59.2°) than in control group (mean=22.3°), p<0.001. The SPADI score also indicated significant improvement in trial group at 6 weeks when compared to control group.

Conclusion

PRET in combination with active exercises provided more benefits to the patients compared to active exercises only and should be considered the standard of care.

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