Open AccessThe Impact of Post‐Thyroidectomy Neck Stretching Exercises on Neck Discomfort, Pressure Symptoms, Voice and Quality of Life: A Randomized Controlled Trial
Author(s) -
Thorsen Rikke Taudal,
Døssing Helle,
Bonnema Steen Joop,
Brix Thomas Heiberg,
Godballe Christian,
Sorensen Jesper Roed
Publication year - 2022
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-022-06610-0
Subject(s) - medicine , randomized controlled trial , quality of life (healthcare) , physical therapy , dysphagia , swallowing , thyroidectomy , surgery , cardiothoracic surgery , thyroid , nursing
Background Following surgery for benign nodular goiter, patients may experience neck and shoulder pain, neck pressure and tightness, choking sensation, altered voice function, and dysphagia leading to decreased short‐term quality of life (QoL). This single‐blinded randomized controlled trial investigated the effect of post‐thyroidectomy rehabilitative neck stretching and movement exercises on these variables including QoL. Methods Patients undergoing thyroid lobectomy or total thyroidectomy were randomized to perform neck stretching and movement exercises three times daily in four weeks following surgery (intervention group) or conventional follow‐up without exercises (control group). Outcome measures were scores in the following questionnaires: Disease‐specific Thyroid‐Related Patient‐Reported Outcome (ThyPRO‐39) involving symptoms of “sense of fullness in the neck,” “pressure in the throat,” and “discomfort swallowing” combined in the multi‐item Goiter Symptom Scale, the Voice Handicap‐Index‐10 (VHI‐10), neck and shoulder pain measurement by a numeric rating scale (NRS), and General measure of health (EQ‐5D‐5L). All scores were assessed prior to surgery and one, two, four weeks, and three months after surgery. Data were analyzed using a linear mixed model. Results Eighty‐nine patients were included and randomized to the control ( n = 45) or the intervention group ( n = 44). At three months after surgery, both the control and the intervention group experienced large to moderate improvements in the Goiter symptom and Hyperthyroid symptom scale of the ThyPRO questionnaire ( p < 0.004). No significant between‐group differences were found in any of the other applied scales. Conclusions This study confirms that patients experience profound improvements in QoL after surgery for benign nodular goiter. However, early post‐thyroidectomy neck stretching and movement exercises did not result in further QoL improvement, reduction in pain or less impacted subjective voice function for patients primarily undergoing thyroid lobectomy. Trial Registration Number NCT04645056 ( https://clinicaltrials.gov )