Supportive Care in Cancer

, Volume 25, Issue 7, pp 2085–2092 | Cite as

Assessment of musculoskeletal impairment in head and neck cancer patients

  • Michael K. Ghiam
  • Kyle Mannion
  • Mary S. Dietrich
  • Kristen L. Stevens
  • Jill Gilbert
  • Barbara A. Murphy
Original Article



This study aims to describe the types of musculoskeletal impairment in head and neck cancer survivors and to evaluate objective and subjective measures of musculoskeletal impairment and identify areas of need in future studies.


This is a cross-sectional pilot study of 29 head and neck cancer patients who were treated with resection and reconstruction. Subjective measures of musculoskeletal impairment (Neck Disability Index, Shoulder Pain and Disability Index, Vanderbilt Head and Neck Symptom Survey, General Symptom Survey) were collected and compared to objective measures (Cervical Range of Motion Device, Inter-incisal Distance). Digital photography was used to assess the severity of postural abnormalities. Findings were summarized using descriptive statistical and graphical methods.


The majority of patients in this cohort suffered from neck disability (69%). Thirty-five percent of patients had shoulder pain and disability. Cervical range of motion deficits were observed in all directions. Inter-incisal distance averaged 33.4 mm and inversely correlated with self-reported jaw and trismus symptoms. Digital photography identified shoulder misalignment in 93% of subjects, head tilt in 89% of subjects, and postural deviation in 68% of subjects.


Musculoskeletal impairment is a significant side effect in head and neck cancer survivors that results in chronic neck pain, shoulder disability, trismus, and postural deficits. Tools to describe postural deficits are needed.


Musculoskeletal impairment Shoulder dysfunction Cervical range of motion Trismus Posture Head and neck cancer 


Compliance with ethical standards

Financial support or funding

This is study is supported by Pain and Symptom Management Ingram Foundation Funds.

Conflict of interest

All authors on this manuscript have no conflicts of interest to declare. We have access to all primary research data to share with reviewers if requested.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Michael K. Ghiam
    • 1
  • Kyle Mannion
    • 2
  • Mary S. Dietrich
    • 3
  • Kristen L. Stevens
    • 4
  • Jill Gilbert
    • 5
  • Barbara A. Murphy
    • 5
  1. 1.Vanderbilt University School of MedicineNashvilleUSA
  2. 2.Department of OtolaryngologyVanderbilt University Medical CenterNashvilleUSA
  3. 3.Center for Quantitative SciencesVanderbilt University School of MedicineNashvilleUSA
  4. 4.Department of Otolaryngology–Head and Neck SurgeryUniversity of MinnesotaMinneapolisUSA
  5. 5.Division of Hematology Oncology, Department of MedicineVanderbilt University Medical CenterNashvilleUSA

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