The ''Cristo Re'' hospital experience on telerehabilitation for treatment post thyroidectomy neck pain

BackgroundThyroidectomies are one of the most frequently performed endocrine surgical procedures and are mostly consequent to thyroid cancers with about 80% of patients develop neck pain and stiffness. For better management in a public health setting, Cristo Re Hospital in Rome has designed specific physiotherapy based on selective stretching and strengthening of neck muscles combined with breathing.MethodsThe study enrolled 26 patients with a mean age of 51.2 years: 20 were treated with total thyroidectomy and 6 with thyroid lobectomy. Follow-up was performed at 1 day, 1 week and 1 month after surgery. We used for assessment: Visual Analog Scale (VAS), Neck Pain and Disability Scale-I (NPDS-I), Short Form-12 (SF12), Disability of the Arm, Shoulder and Hand (DASH), Neck Disability Index Questionnaire (NDI). The patients performed 10 therapeutic sessions: the first in the hospital on the first post-surgery day, the others in telerehabilitation 3 times a week (40 min. each) for 3 weeks. A nonparametric Friedmann test was analyzed the differences between the scale averages at T0/T1 and T2. Using case-control analysis the effects of treatment duration (90 min.) were assessed with the U-Mann-Whitney test.ResultsA statistically significant improvement was shown in the Physical Component Summary- SF12 at 1 week and 1 month after treatment (+3 pts at T1, +13.2 at T2 p < 0.001), while no significant changes in the Mental Component Summary. The averages of NPDS-I, NDI and DASH also decreased at T1 and T2 demonstrating the effectiveness of the protocol (-37.7 median points,-18.3 mp,-34.5 mp,-35 mp, respectively p < 0.001). No significant change in VAS scale at T1 and T2 and in patients treated for more or less than 90 minutes.ConclusionsThis protocol is useful for reducing neck pain and improving quality of life and can be recommended as a therapy after thyroidectomy with a strong reduction in cost and morbidity, being able to treat patients even in telerehabilitation.