Interventions on neck and shoulder function dysfunction of postoperative patients with head and neck cancer:a network Meta-analysis

SUN Shiyan; YU Xiurong; SHAO Fangfei; LI Cheng; WANG Shanshan; ZHOU Minmin; TANG Xiuru

doi:10.12102/j.issn.2095-8668.2024.19.006

Abstract：Objective:To evaluate the effects of seven different interventions on neck and shoulder function dysfunction of postoperative patients with head and neck cancer using network Meta-analysis.Methods:A computerized search of randomized controlled trials on the effects of different interventions on neck and shoulder function and daily living ability of postoperative patients with head and neck cancer was performed in PubMed,the Cochrane Library,Web of Science,EMbase,CBM,VIP,CNKI and WanFang Database.The retrieval time was from the inception to May 23,2024.Literature screening and data extraction were performed independently by two researchers.RevMan 5.4 was used to evaluate the quality of the included literature for risk of bias,and ADDIS 1.16.8 and Stata 15.0 were used for network Meta-analysis and graphing.Results:A total of 19 studies with 1 386 patients involving 7 interventions were included.The results of the network Meta-analysis showed that acupuncture had the better efficacy in improving functional evaluation indexes of the shoulder joint(SMD=49.97,95％CI 42.77-57.28,P＜0.05)and NDII(SMD=19.16,95％CI 1.84-36.35,P＜0.05);and neck and shoulder aerobics had the best efficacy in improving lateral neck flexion(SMD=9.61,95％CI 5.73-12.88,P＜0.05),and neck rotation(SMD=12.82,95％CI 5.54-34.31,P＜0.05).Conclusion:Current evidence suggests that acupuncture is the most preferred recommended intervention to reduce postoperative shoulder pain and improve the ability of daily living in patients with head and neck cancer;and neck and shoulder aerobics are advantageous in improving neck mobility(neck lateral flexion,and neck rotation),but more high-quality studies are needed to further validate this conclusion.