Factors influencing neck and shoulder function after oral oncology treatment: a five-year prospective cohort study in 113 patients

Background: The aim of this study was to identify factors influencing shoulder and/or neck function in patients up to five years after treatment. Materials and methods: Lateral flexion of the neck, ipsilateral forward flexion, and abduction of the shoulder were measured. Potential factors were entered into a linear mixed model analysis to create a multivariate model for describing the results. Results: Predicted neck and shoulder function was negatively influenced by higher age before intervention. Contralateral flexion of the neck was lower for patients undergoing surgery and radiotherapy compared to surgery. Ipsilateral flexion of the neck is influenced by a higher age at baseline. Ipsilateral shoulder abduction is lower for female gender, bone graft/flap reconstruction, and more extensive neck dissection. Ipsilateral forward flexion of the shoulder is lower for bone graft/flap reconstruction and better for patients with a T2 tumor in comparison to T3 and T4 tumors, as predicted. Conclusion: By our five-year follow-up outcomes of this study, neck and/or shoulder impairments can be found for high-risk patients by physiotherapists.