The Use of Mobilization, Muscle Energy Technique, and Soft Tissue Mobilization Following a Modified Radical Neck Dissection of a Patient with Head and Neck Cancer

Background and Purpose: A surgical procedure commonly performed for many patients with head and neck cancer is a modified radical neck dissection. The use of therapeutic intervention postoperatively has been shown to be beneficial; however, documented use of manual therapy techniques (ie, mobilization, muscle energy technique (MET), and soft tissue mobilization) in these cases is limited. The purpose of this case report is to describe and demonstrate the benefits of using manual therapy techniques following a modified radical neck dissection of a patient with head and neck cancer. Case Description: A 49-year-old man completed 3 weeks of physical therapy following a modified radical neck dissection due to head and neck cancer. The patient reported pain, decreased cervical mobility, and function at baseline. Outcomes: The patient experienced a 12 point reduction in the Neck Disability Index at discharge and 30 point reduction at 4 month follow-up. Subjective pain levels improved from 3/10 to 0/10. Cervical mobility increased by 7 degrees-20 degrees in most ranges and strength of scapular muscles improved from 4+/5 to 5/5. The patient was able to return to work without limitation. Discussion: The patient described in this case report experienced less pain and improved physical function and outcome measure scores after intervention and 4 month follow-up. Manual therapy techniques such as joint mobilization, muscle energy technique, and soft tissue mobilization were safely and effectively applied to this patient with head and neck cancer. Randomized controlled clinical trials are needed to evaluate the efficacy of these manual interventions following a modified radical neck dissection of a patient with head and neck cancer.