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Phys. Ther. Korea 2020; 27(3): 220-226

Published online August 20, 2020

https://doi.org/10.12674/ptk.2020.27.3.220

© Korean Research Society of Physical Therapy

Physical Therapy for Esophageal Cancer Patient With Long Thoracic Neuropathy After Esophagectomy: A Case Report

Junghwa Do1 , PhD, DPT, One-bin Lim2 , PhD, PT, Ja-young Kim1 , MD, Jae Yong Jeon1 , PhD, MD, Young-ki Cho1 , PhD, PT

1Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 2Department of Physical Therapy, College of Health Science, Yonsei University, Wonju, Korea

Correspondence to: Jae Yong Jeon
E-mail: jyjeon71@gmail.com
https://orcid.org/0000-0003-1534-7931

Received: July 3, 2020; Revised: July 22, 2020; Accepted: July 31, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0)which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Esophageal cancer is a representative cancer that occur physical deterioration but, physical problems after surgery were not well reported. The purpose of this study is to report on the long thoracic neuropathy after surgery, and to identify the symptoms and effects of physical therapy after esophageal cancer surgery. This is a case of a 61-year-old man who showed winging of the scapula with long thoracic nerve injury on the results of electromyography after an esophageal cancer surgery. Physical therapy programs were implemented 8 sessions during hospitalization. The quality of life, fatigue, shoulder range of motion (ROM), numeric rating scale (NRS), 6-minute walk test, and 30-second chair stand test were assessed. The quality of life, fatigue, shoulder ROM, NRS (pain), 6-minute walk test, and 30-second chair stand test were improved. However, the esophageal-specific symptom was not different after physical therapy program. As esophageal cancer suffers from physical difficulties after surgery, physical therapy programs are thought to be helpful.

Keywords: Esophageal neoplasms, Exercise, Pain, Quality of life

Article

ARTICLE

Phys. Ther. Korea 2020; 27(3): 220-226

Published online August 20, 2020 https://doi.org/10.12674/ptk.2020.27.3.220

Copyright © Korean Research Society of Physical Therapy.

Physical Therapy for Esophageal Cancer Patient With Long Thoracic Neuropathy After Esophagectomy: A Case Report

Junghwa Do1 , PhD, DPT, One-bin Lim2 , PhD, PT, Ja-young Kim1 , MD, Jae Yong Jeon1 , PhD, MD, Young-ki Cho1 , PhD, PT

1Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 2Department of Physical Therapy, College of Health Science, Yonsei University, Wonju, Korea

Correspondence to:Jae Yong Jeon
E-mail: jyjeon71@gmail.com
https://orcid.org/0000-0003-1534-7931

Received: July 3, 2020; Revised: July 22, 2020; Accepted: July 31, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0)which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Esophageal cancer is a representative cancer that occur physical deterioration but, physical problems after surgery were not well reported. The purpose of this study is to report on the long thoracic neuropathy after surgery, and to identify the symptoms and effects of physical therapy after esophageal cancer surgery. This is a case of a 61-year-old man who showed winging of the scapula with long thoracic nerve injury on the results of electromyography after an esophageal cancer surgery. Physical therapy programs were implemented 8 sessions during hospitalization. The quality of life, fatigue, shoulder range of motion (ROM), numeric rating scale (NRS), 6-minute walk test, and 30-second chair stand test were assessed. The quality of life, fatigue, shoulder ROM, NRS (pain), 6-minute walk test, and 30-second chair stand test were improved. However, the esophageal-specific symptom was not different after physical therapy program. As esophageal cancer suffers from physical difficulties after surgery, physical therapy programs are thought to be helpful.

Keywords: Esophageal neoplasms, Exercise, Pain, Quality of life

Fig 1.

Figure 1.Winging scapula after esophagogectomy.
Physical Therapy Korea 2020; 27: 220-226https://doi.org/10.12674/ptk.2020.27.3.220

Table 1 . Comparison of values obtained for EORTC QLQ-C30, EORTC-OES18 between the baseline and after the physical therapy program.

AssessmentCase

PrePost
EORTC QLQ-C30
Global health status/QoL5058.3
Functional scales
Physical functioning46.653.3
Role functioning33.350
Emotional functioning7583.3
Cognitive functioning100100
Social functioning100100
Symptom scales
Fatigue33.344.4
Insomnia10033.3
Nausea and vomiting33.333.3
Pain66.650
Dyspnea10033.3
EORTC QLQ-OES18
Dysphagia55.555.5
Eating trouble66.666.6
Reflex66.666.6
Pain41.68.3
Dry mouth66.666.6
Taste trouble16.616.6
Coughing trouble26.626.6
Speaking trouble26.626.6
Trouble swallowing saliva66.666.6
Choking66.666.6

EORTC QLQ-C30, The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire; version 3; EORTC QLQ-OES18, The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Esophageal 18.


Table 2 . Comparison of values obtained for FACIT-fatigue, NRS, and the 30-second chair stand test between the baseline and after the physical therapy program.

AssessmentCase

PrePost
FACIT-fatigue (socres)1512
NRS (scores)63
The 30-second chair stand test (times)1014
6-minute walk test (m)360400
Shoulder AROM (degrees)
Flexion125180
Abduction110180

FACIT-fatigue, Functional Assessment of Chronic Illness Therapy-Fatigue; NRS, numeric rating scale; AROM, active range of motion exercise.