{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:41:51Z","timestamp":1790289711292,"version":"4.1.0"},"reference-count":49,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2014,5,28]],"date-time":"2014-05-28T00:00:00Z","timestamp":1401235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA78940"],"award-info":[{"award-number":["R01CA78940"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01 CA78940"],"award-info":[{"award-number":["R01 CA78940"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the association of neck dissection and radiation treatment for head and neck cancer (HNC) with subsequent shoulder range of motion (ROM) and quality of life (QOL) in 5\u2010year survivors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A cross\u2010sectional convenience sample.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Otolaryngology clinics at tertiary care hospital and Veterans Affairs medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Five\u2010year, disease\u2010free survivors of HNC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Demographic and cancer treatment information was collected, including type of neck dissection (none, spinal accessory \u201cnerve sparing,\u201d and \u201cnerve sacrificing\u201d) and radiation. QOL questionnaires were administered, and shoulder ROM was measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measurements<\/jats:title><jats:p>University of Washington Quality of Life (UWQOL), Functional Assessment of Cancer Therapy (FACT) Head and Neck, and Performance Status Scale for Head and Neck. Shoulder ROM measurements included abduction, adduction, flexion, extension, internal and external rotation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and five survivors completed QOL surveys; 85 survivors underwent additional shoulder ROM evaluations. The nerve sacrifice group exhibited significantly poorer scores for UWQOL measures of disfigurement, level of activity, recreation and\/or entertainment, speech and shoulder disability, and willingness to eat in public, FACT functional well\u2010being, and FACT Head and Neck (<jats:italic>P<\/jats:italic> &lt; .05). Shoulder ROM for flexion and abduction was poorest in the nerve sacrifice group (<jats:italic>P<\/jats:italic> &lt; .05). Radiation was associated with significantly worse UWQOL swallowing (<jats:italic>P<\/jats:italic> &lt; .05), but no other differences were found for QOL or ROM measurements. Decreased QOL scores were associated with decreased shoulder flexion and abduction (<jats:italic>P<\/jats:italic> &lt; .05). Survivors with decreased shoulder abduction had significantly (<jats:italic>P<\/jats:italic> &lt; .05) worse scores in disfigurement, recreation and\/or entertainment, employment, shoulder disability, and FACT emotional well\u2010being.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sparing the spinal accessory nerve during neck dissection is associated with significantly less long\u2010term shoulder disability in 5\u2010year survivors of HNC. QOL measures demonstrated the highest level of function in the no dissection group, an intermediate level of functioning with nerve sparing, and poorest function when the nerve is sacrificed. Decreased shoulder flexion and abduction is associated with reduced QOL in long\u2010term survivors of HNC.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.pmrj.2014.05.015","type":"journal-article","created":{"date-parts":[[2014,5,28]],"date-time":"2014-05-28T08:31:17Z","timestamp":1401265877000},"page":"1073-1080","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Quality of Life, Shoulder Range of Motion, and Spinal Accessory Nerve Status in 5\u2010Year Survivors of Head and Neck Cancer"],"prefix":"10.1002","volume":"6","author":[{"given":"Sarah M.","family":"Eickmeyer","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Medical College of Wisconsin Milwaukee WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine K.","family":"Walczak","sequence":"additional","affiliation":[{"name":"Rehabilitation Services, Froedtert Hospital Milwaukee WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine B.","family":"Myers","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Sciences Medical College of Wisconsin Milwaukee WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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