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Improving screening for physical impairments and access to early physiotherapy after neck dissection surgery: a translational controlled trial

  • Head and Neck
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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Lack of routine screening for a range of physical impairments that can result after neck dissection (ND) may hinder physiotherapy referral and treatment. The purpose of this study was to implement an intervention that targeted both physiotherapists and surgeons to increase their post-operative physical screening of ND patients and in turn improve physiotherapy referral rates.

Methods

The authors undertook a translational controlled pilot study, conducted over a 12-month period that utilised three tertiary hospital sites. The target groups were physiotherapists at one intervention site and surgeons at the other intervention site, with the third hospital acting as a control site and receiving usual care. The intervention included a physiotherapy brochure and a clinical pathway for screening, to promote early identification and prompt referral of patients with a physical impairment. The primary outcome variables were screening and referral rates between sites at the study end-point.

Results

Logistic regression analyses were conducted on n = 174 to assess differences in screening and referral rates between sites. Patients at the intervention site that targeted physiotherapists had four times the odds of being screened for shoulder dysfunction compared to the control site (p = 0.0002), and three times the odds of being referred to physiotherapy (0.0039). There were no statistically significant differences in the odds of patients being screened for shoulder dysfunction or referred to physiotherapy at the intervention site that targeted surgeons.

Conclusion

The translational intervention undertaken by physiotherapists resulted in significantly greater screening and referral rates of post-operative ND patients for physiotherapy.

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Acknowledgements

This research has been financially supported by the Hunter Cancer Research Alliance. The authors would like to acknowledge and thank all of the participating physiotherapists, nurses and surgeons in the John Hunter, Calvary Mater Newcastle, Royal North Shore and Liverpool Hospitals.

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Authors and Affiliations

  1. Emergency Medicine Department, Calvary Mater Newcastle Hospital, Edith St, Waratah, Newcastle, NSW, 2298, Australia

    Aoife C. McGarvey

  2. Physio Living, New Lambton, NSW, Australia

    Aoife C. McGarvey

  3. School of Health Sciences, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia

    Aoife C. McGarvey & Peter G. Osmotherly

  4. School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia

    Gary R. Hoffman & Alix Hall

  5. John Hunter Hospital, New Lambton, NSW, Australia

    Gary R. Hoffman

Authors
  1. Aoife C. McGarvey
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  2. Peter G. Osmotherly
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  3. Gary R. Hoffman
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  4. Alix Hall
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Corresponding author

Correspondence to Aoife C. McGarvey.

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Conflict of interest

There is no financial relationship between the authors and the funding body, Hunter Cancer Research Alliance. I, Aoife McGarvey, have full control of all the primary data and agree to the journal reviewing this data if it is requested.

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McGarvey, A.C., Osmotherly, P.G., Hoffman, G.R. et al. Improving screening for physical impairments and access to early physiotherapy after neck dissection surgery: a translational controlled trial. Eur Arch Otorhinolaryngol 278, 509–516 (2021). https://doi.org/10.1007/s00405-020-06142-0

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  • DOI: https://doi.org/10.1007/s00405-020-06142-0

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