{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:32:48Z","timestamp":1777465968169,"version":"3.51.4"},"reference-count":45,"publisher":"SAGE Publications","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMR"],"published-print":{"date-parts":[[2023,3,15]]},"abstract":"<jats:p>BACKGROUND: Shoulder disability is a common problem following neck dissection. Even if nerve structures are preserved, this may occur after the surgery. OBJECTIVE: The primary aim was to research changes in rotator cuff and scapular muscles strength, and scapular muscle endurance after neck dissection in patients with head and neck cancer. The secondary aim was to investigate the relationship between these changes and postoperative shoulder function. METHODS: This cross-sectional and prospective follow-up study included 14\u00a0patients who underwent neck dissection (9\u00a0unilateral and 5\u00a0bilateral). Evaluations were performed preoperatively and at 3\u00a0months postoperatively. Muscle strength measurements, including trapezius, serratus anterior, and rotator cuff muscles, were obtained using a handheld dynamometer. The scapular muscle endurance test was used for muscle endurance assessment. Postoperative shoulder function was evaluated using Constant-Murley shoulder score. RESULTS: A decrease in muscle strength and the scapular muscle endurance test was found at 3\u00a0months postoperatively, except for the subscapularis muscle strength (p&lt; 0.05). There were moderate to strong correlations between Constant-Murley shoulder score and percentage changes in muscle strength and the scapular muscle endurance test, except for the upper trapezius muscle strength (p&lt; 0.05). CONCLUSIONS: Muscle strength and scapular muscle endurance may reduce following neck dissection. These reductions are associated with postoperative shoulder function. Thus, muscle strength and endurance training may be beneficial for early postoperative rehabilitation in patients with head and neck cancer.<\/jats:p>","DOI":"10.3233\/bmr-210270","type":"journal-article","created":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T11:26:04Z","timestamp":1666092364000},"page":"347-355","source":"Crossref","is-referenced-by-count":4,"title":["Decreased muscle strength and scapular muscle endurance associated with shoulder function after neck dissection"],"prefix":"10.1177","volume":"36","author":[{"given":"Seher","family":"\u00d6zy\u00fcrek","sequence":"first","affiliation":[{"name":"Faculty of Physical Therapy and Rehabilitation, Dokuz Eyl\u00fcl University, Izmir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayb\u00fcke","family":"Cansu Kalkan","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, Dokuz Eyl\u00fcl University, Izmir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ersoy","family":"Do\u011fan","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Dokuz Eyl\u00fcl University, Izmir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hande","family":"Melike B\u00fclb\u00fcl","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, Dokuz Eyl\u00fcl University, Izmir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"Akif Kamar","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, Dokuz Eyl\u00fcl University, Izmir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Balci","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, Dokuz Eyl\u00fcl University, Izmir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmet","family":"\u00d6mer \u0130kiz","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Dokuz Eyl\u00fcl University, Izmir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pembe","family":"Keskino\u011flu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics, Faculty of Medicine, Dokuz Eyl\u00fcl University, Izmir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arzu","family":"Gen\u00e7","sequence":"additional","affiliation":[{"name":"Faculty of Physical Therapy and Rehabilitation, Dokuz Eyl\u00fcl University, Izmir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"issue":"9625","key":"10.3233\/BMR-210270_ref1","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1016\/S0140-6736(08)60728-X","article-title":"Head and neck cancer","volume":"371","author":"Argiris","year":"2008","journal-title":"Lancet."},{"issue":"5","key":"10.3233\/BMR-210270_ref2","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.oraloncology.2014.01.016","article-title":"International trends in head and neck cancer incidence rates: Differences by country, sex and anatomic site","volume":"50","author":"Simard","year":"2014","journal-title":"Oral Oncol."},{"key":"10.3233\/BMR-210270_ref3","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.oraloncology.2016.12.006","article-title":"Competing causes of death in the head and neck cancer population","volume":"65","author":"Massa","year":"2017","journal-title":"Oral Oncol."},{"issue":"3","key":"10.3233\/BMR-210270_ref4","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1002\/1097-0142(195105)4:3<441::AID-CNCR2820040303>3.0.CO;2-O","article-title":"Neck dissection","volume":"4","author":"Martin","year":"1951","journal-title":"Cancer"},{"issue":"3","key":"10.3233\/BMR-210270_ref5","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1001\/archotol.124.3.348","article-title":"Selective Neck Dissection of anatomically appropriate levels is as efficacious as modified radical neck dissection for elective treatment of the clinically negative neck in patients with squamous cell carcinoma of the upper respiratory and digestive tract","volume":"124","author":"Clayman","year":"1998","journal-title":"Arch Otolaryngol \u2013 Head Neck Surg."},{"issue":"1","key":"10.3233\/BMR-210270_ref6","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1590\/S1808-86942011000100011","article-title":"Neck dissection complications","volume":"77","author":"Dedivitis","year":"2011","journal-title":"Braz J Otorhinolaryngol."},{"issue":"4","key":"10.3233\/BMR-210270_ref7","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/0002-9610(83)90246-5","article-title":"Functional evaluation of the spinal accessory nerve after neck dissection","volume":"146","author":"Leipzig","year":"1983","journal-title":"Am J Surg."},{"issue":"4","key":"10.3233\/BMR-210270_ref8","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1001\/archotol.1961.00740030433011","article-title":"A syndrome resulting from radical neck dissection","volume":"74","author":"Nahum","year":"1961","journal-title":"Arch Otolaryngol."},{"issue":"7","key":"10.3233\/BMR-210270_ref9","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/j.ejso.2016.10.026","article-title":"Prevalence, incidence, and risk factors for shoulder and neck dysfunction after neck dissection: A systematic review","volume":"43","author":"Gane","year":"2017","journal-title":"Eur J Surg Oncol."},{"issue":"1","key":"10.3233\/BMR-210270_ref10","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1002\/lio2.702","article-title":"Head and Neck Cancer Survivorship Consensus Statement from the American Head and Neck Society","volume":"7","author":"Goyal","year":"2022","journal-title":"Laryngoscope Investig Otolaryngol."},{"issue":"1","key":"10.3233\/BMR-210270_ref11","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.bjoms.2006.09.007","article-title":"An evaluation of the shoulder domain of the University of Washington Quality of Life Scale","volume":"45","author":"Rogers","year":"2007","journal-title":"Br J Oral Maxillofac Surg."},{"issue":"6","key":"10.3233\/BMR-210270_ref12","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1002\/hed.2880120607","article-title":"Innervation of the trapezius Muscle: A study in patients undergoing neck dissections","volume":"12","author":"Soo","year":"1990","journal-title":"Head Neck."},{"issue":"2","key":"10.3233\/BMR-210270_ref13","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1177\/0194599814531021","article-title":"Spinal accessory nerve monitoring and clinical outcome results of Nerve-Sparing neck dissections","volume":"151","author":"Birinci","year":"2014","journal-title":"Otolaryngol \u2013 Head Neck Surg."},{"issue":"10","key":"10.3233\/BMR-210270_ref14","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.1016\/j.jbiomech.2006.10.016","article-title":"Shoulder function: The perfect compromise between mobility and stability","volume":"40","author":"Veeger","year":"2007","journal-title":"J Biomech."},{"issue":"1","key":"10.3233\/BMR-210270_ref15","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.otohns.2008.03.019","article-title":"Impact of Shoulder Complaints after Neck Dissection on Shoulder Disability and Quality of Life","volume":"139","author":"Stuiver","year":"2008","journal-title":"Otolaryngol \u2013 Head Neck Surg."},{"issue":"2","key":"10.3233\/BMR-210270_ref16","doi-asserted-by":"crossref","first-page":"78","DOI":"10.2519\/jospt.2008.2454","article-title":"Spinal accessory nerve palsy: Associated signs and symptoms","volume":"38","author":"Kelley","year":"2008","journal-title":"J Orthop Sports Phys Ther."},{"issue":"4","key":"10.3233\/BMR-210270_ref17","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1002\/hed.2890080408","article-title":"A Prospective Study of Shoulder Disability Resulting from Radical and Modified Neck Dissections","volume":"8","author":"Remmler","year":"1986","journal-title":"Head Neck Surg."},{"issue":"11","key":"10.3233\/BMR-210270_ref18","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1002\/hed.21112","article-title":"Accessory nerve function after level 2b \u2013 preserving selective neck dissection","volume":"31","author":"Celik","year":"2009","journal-title":"Head Neck J Sci Spec Head Neck."},{"issue":"6","key":"10.3233\/BMR-210270_ref19","doi-asserted-by":"crossref","first-page":"786","DOI":"10.2522\/ptj.20120385","article-title":"Scapular muscle exercises following neck dissection surgery for head and neck cancer: A comparative electromyographic study","volume":"93","author":"McGarvey","year":"2013","journal-title":"Phys Ther."},{"key":"10.3233\/BMR-210270_ref20","doi-asserted-by":"crossref","unstructured":"Di Giacomo G, Pouliart N, Costantini A, De Vita A. Atlas of functional shoulder anatomy. 2008.","DOI":"10.1007\/978-88-470-0759-8"},{"issue":"8I","key":"10.3233\/BMR-210270_ref21","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1177\/000348940010900811","article-title":"Objective comparison of shoulder dysfunction after three neck dissection techniques","volume":"109","author":"Cheng","year":"2000","journal-title":"Ann Otol Rhinol Laryngol."},{"key":"10.3233\/BMR-210270_ref22","unstructured":"Ehsan M. A longitudinal study to investigate changes in functional ability and concerns in head neck cancer patients undergoing neck dissection. Dissertation. 2016."},{"issue":"1","key":"10.3233\/BMR-210270_ref23","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.anl.2020.06.013","article-title":"Shoulder function after neck dissection: Assessment via a Shoulder-Specific Quality-of-Life questionnaire and active shoulder abduction","volume":"48","author":"Imai","year":"2021","journal-title":"Auris Nasus Larynx."},{"issue":"1","key":"10.3233\/BMR-210270_ref24","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/00005537-200001000-00014","article-title":"Accessory nerve function after modified radical and lateral neck dissections","volume":"110","author":"K\u00f6ybasioglu","year":"2000","journal-title":"Laryngoscope."},{"issue":"1","key":"10.3233\/BMR-210270_ref25","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1017\/S0022215106002052","article-title":"Spinal Accessory Nerve Function after Neck Dissections","volume":"121","author":"Orhan","year":"2007","journal-title":"J Laryngol Otol."},{"issue":"4","key":"10.3233\/BMR-210270_ref26","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.anl.2005.05.007","article-title":"Assessment of shoulder impairment after functional neck dissection: Long term results","volume":"32","author":"G\u00fcldiken","year":"2005","journal-title":"Auris Nasus Larynx."},{"issue":"11","key":"10.3233\/BMR-210270_ref27","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1002\/gps.2252","article-title":"Reliability and validity of revised turkish version of mini mental state examination (RMMSE-T) in communitydwelling educated and uneducated elderly","volume":"24","author":"Keskinoglu","year":"2009","journal-title":"Int J Geriatr Psychiatry."},{"issue":"3","key":"10.3233\/BMR-210270_ref28","first-page":"390","article-title":"Strength profiles in healthy individuals with and without scapular dyskinesis","volume":"12","author":"Hannah","year":"2017","journal-title":"Int J Sports Phys Ther."},{"issue":"4","key":"10.3233\/BMR-210270_ref29","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/j.jelekin.2004.09.006","article-title":"Normalization procedures using maximum voluntary isometric contractions for the serratus anterior and trapezius muscles during surface EMG analysis","volume":"15","author":"Ekstrom","year":"2005","journal-title":"J Electromyogr Kinesiol."},{"issue":"4","key":"10.3233\/BMR-210270_ref30","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.jsams.2008.09.005","article-title":"The \u201cempty Can\u201d and \u201cFull Can\u201d tests do not selectively activate supraspinatus","volume":"12","author":"Boettcher","year":"2009","journal-title":"J Sci Med Sport."},{"issue":"6","key":"10.3233\/BMR-210270_ref31","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1016\/j.jse.2019.07.028","article-title":"Can handheld dynamometry predict rotator cuff tear size? A Study in 2100 consecutive patients","volume":"29","author":"Klironomos","year":"2020","journal-title":"J Shoulder Elb Surg."},{"issue":"5","key":"10.3233\/BMR-210270_ref32","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.jmpt.2008.04.010","article-title":"Reliability of isometric muscle endurance tests in subjects with postural neck pain","volume":"31","author":"Edmondston","year":"2008","journal-title":"J Manipulative Physiol Ther."},{"key":"10.3233\/BMR-210270_ref33","first-page":"160","article-title":"A clinical method for functional assessment of the shoulder","author":"Constant","year":"1987","journal-title":"Clin Orthop Relat Res."},{"key":"10.3233\/BMR-210270_ref34","unstructured":"Evans JD. Straightforward statistics for the behavioral sciences. Thomson Brooks\/Cole Publishing Co. 1996."},{"issue":"1","key":"10.3233\/BMR-210270_ref35","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1111\/j.1365-2354.2009.01149.x","article-title":"An exploratory trial of preventative rehabilitation on shoulder disability and quality of life in patients following neck dissection surgery","volume":"20","author":"Lauchlan","year":"2011","journal-title":"Eur J Cancer Care (Engl)."},{"issue":"11","key":"10.3233\/BMR-210270_ref36","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1002\/hed.20095","article-title":"Shoulder function after accessory Nerve-Sparing neck dissections","volume":"26","author":"Erisen","year":"2004","journal-title":"Head Neck."},{"issue":"6","key":"10.3233\/BMR-210270_ref37","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1177\/0194599818821885","article-title":"Neck and shoulder motor function following neck dissection: A comparison with healthy control subjects","volume":"160","author":"Gane","year":"2019","journal-title":"Otolaryngol \u2013 Head Neck Surg."},{"issue":"3","key":"10.3233\/BMR-210270_ref38","first-page":"364","article-title":"The role of the scapula in the rehabilitation of shoulder injuries","volume":"35","author":"Voight","year":"2000","journal-title":"J Athl Train."},{"issue":"4","key":"10.3233\/BMR-210270_ref39","first-page":"505","article-title":"Determining normative values for scapular muscle endurance in College-Aged individuals","volume":"71","author":"Ozyurek","year":"2018","journal-title":"Med Dello Sport."},{"issue":"1","key":"10.3233\/BMR-210270_ref40","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1002\/cncr.23536","article-title":"Effect of exercise on upper extremity pain and dysfunction in head and neck cancer survivors: A randomized controlled trial","volume":"113","author":"McNeely","year":"2008","journal-title":"Cancer."},{"issue":"6","key":"10.3233\/BMR-210270_ref41","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/S1010-5182(05)80112-X","article-title":"Reinnervation of the trapezius muscle after radical neck dissection","volume":"22","author":"Krause","year":"1994","journal-title":"J Cranio-Maxillofacial Surg."},{"issue":"7","key":"10.3233\/BMR-210270_ref42","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1002\/cncr.32681","article-title":"2b or Not 2b? Shoulder function after level 2b neck dissection: A Double-Blind randomized controlled clinical trial","volume":"126","author":"Dziegielewski","year":"2020","journal-title":"Cancer."},{"issue":"2","key":"10.3233\/BMR-210270_ref43","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1002\/hed.21366","article-title":"Physiotherapy for accessory nerve shoulder dysfunction following neck dissection surgery: A literature review","volume":"33","author":"McGarvey","year":"2011","journal-title":"Head Neck."},{"key":"10.3233\/BMR-210270_ref44","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.oraloncology.2018.06.019","article-title":"Comparison of hospital based and home based exercise on quality of life, and neck and shoulder function in patients with spinal accessary nerve injury after head and neck cancer surgery","volume":"86","author":"Do","year":"2018","journal-title":"Oral Oncol."},{"key":"10.3233\/BMR-210270_ref45","first-page":"2019","article-title":"The sonography and physical findings on shoulder after selective neck dissection in patients with head and neck cancer: A pilot study","author":"Huang","year":"2019","journal-title":"Biomed Res Int."}],"container-title":["Journal of Back and Musculoskeletal Rehabilitation"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/BMR-210270","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:27:15Z","timestamp":1777382835000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.3233\/BMR-210270"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,15]]},"references-count":45,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3233\/bmr-210270","relation":{},"ISSN":["1878-6324","1053-8127"],"issn-type":[{"value":"1878-6324","type":"electronic"},{"value":"1053-8127","type":"print"}],"subject":[],"published":{"date-parts":[[2023,3,15]]}}}