Authors (including presenting author) :
Liu YWS(1), Lo X(1), Chow CMT(1), Lai SM(1), Cheung CTL(2), Chan PYE(2), Fong SL(1), Chiu LS(3), Chan KC(1), Wong WC(1), Yuen KH(1), Wong HY(2), Lai WCW(2)
Affiliation :
(1)Department of Surgery, Alice Ho Miu Ling Nethersole Hospital, (2)Department of Physiotherapy, Alice Ho Miu Ling Nethersole Hospital, (3)Department of Mixed Ward, Alice Ho Miu Ling Nethersole Hospital
Introduction :
Patients commonly experience neck pain, stiffness, and pressure symptoms after thyroidectomy, affecting their mobility, rehabilitation, and quality of life (QoL). Studies indicate that neck stretching exercises can significantly reduce these issues and the need for postoperative analgesics. Therefore, a pilot study was conducted at the AHNH Thyroid Centre to evaluate the effectiveness of neck stretching exercises on post-thyroidectomy patients and their impact on QoL.
Objectives :
1. Assess the effectiveness of neck stretching exercises in reducing post-thyroidectomy neck pain, stiffness and discomfort.
2. Improve the QoL for post-thyroidectomy patients.
Methodology :
In this randomized controlled trial, adults (> 18 years old) undergoing elective hemithyroidectomy, completion/ total thyroidectomy were eligible, while patients with spinal and nerve injury were not. The intervention group received neck exercise training from a physiotherapist on POD0 and performed exercises twice daily for four weeks. The control group received conventional follow-up without exercises. Educational materials, including instruction sheets and videos were provided to intervention group patients.
Outcome Measures:
Primary outcome: neck symptoms and mobilization assessed by the Numeric Global Rating Scale of Change (NGRSC) and neck Range of Motion (ROM).
Secondary outcome: neck pain score assessed by the Numeric Pain Rating Scale (NPRS) and the consumption of oral analgesics.
Tertiary outcome: Patient satisfaction assessed by the Short Assessment of Patient Satisfaction (SAPS) survey.
Data were collected on Pre-op Day, POD0, 1, 7, and 4 weeks through face-to-face interviews and phone follow-ups.
Result & Outcome :
Total 28 patients were recruited and divided into control (n=16) and intervention (n=12) groups. The NGRSC (mean) for intervention group increased from 5.67 (POD7) to 8.58 (4 weeks) vs control group increased from 5.56 (POD7) to 7 (4 weeks). 75% (intervention group) vs 50% (control group) regained full ROM in 4 weeks. The NPRS scores (mean) on comparing intervention and control groups were 1.92 vs 1.94 on POD0, 1.17 vs 0.75 on POD1, 0 vs 0.44 on POD7. The oral analgesic consumptions within first 4 weeks on comparing intervention and control groups were total 27 vs 38 tablets. 100% (intervention group) vs 87.5% (control group) satisfied with the post-operative nursing care in the SAPS survey. In conclusion, this study confirmed that neck exercise training reduced neck pain and discomfort, improved neck ROM and enhanced QoL after surgery.
