Effect of Mulligan technique on shoulder dysfunction post neck dissection surgeries

Introduction
Neck dissection surgery (NDS) is frequently used in the management of head and neck malignancies. However, it may result in injury to the spinal accessory nerve, leading to trapezius atrophy, shoulder dysfunction, chronic neck pain, and scapular dyskinesia.

Material and methods
Seventy-six patients, aged between thirty and fifty, experiencing shoulder dysfunction following NDS, were randomly assigned to two equal-sized groups. Group A: 38 patients underwent the Mulligan mobilization technique (MWM) three times a week, along with a conventional physical therapy program, for six weeks; Group B: 38 individuals underwent a conventional physical therapy regimen for six weeks. Shoulder ROM (range of motion) was evaluated by a digital goniometer (flexion, abduction, and external rotation), and upper limb function by the shoulder pain and disability index (SPADI), before and after intervention.

Results
Both groups showed a substantial improvement in shoulder ROM over the course of the intervention (p < 0.001). In Group A, the participants demonstrated an increase of 19.21% in flexion, 28.89% in abduction, and 29.68% in external rotation. In Group B, the improvements were slightly less, with increases of 7.86% in flexion, 8.07% in abduction, and 8.89% in external rotation. Both groups exhibited a substantial decline in SPADI scores post-intervention compared with pre-intervention (p < 0.001). A 58.65% decrease in SPADI score was noted in Group A, and a 22.30% decrease in group B.

Conclusions
MWM is effective in improving shoulder ROM and upper limb function in patients with shoulder dysfunction post-NDS.