PII S0360-3016(02)02898-5 CLINICAL INVESTIGATION Head and Neck PILOT STUDY OF IMPEDANCE-CONTROLLED MICROCURRENT THERAPY FOR MANAGING RADIATION-INDUCED FIBROSIS IN HEAD-AND-NECK CANCER PATIENTS

Purpose: To evaluate the effectiveness of impedance-controlled microcurrent therapy for managing treatment sequelae in head-and-neck cancer patients. Methods and Materials: Between January 1998 and June 1999, 26 patients who were experiencing late effects of radiotherapy were treated b.i.d. with impedance-controlled microcurrent therapy for 1 week. Objective rangeof-motion measurements were made for cervical rotation, extension/flexion, and lateral flexion before therapy, at the end of each treatment day, and monthly for 3 months. In addition, each patient’s subjective complaints were tabulated before treatment and reevaluated at the last follow-up visit. No additional physical therapy or electrical stimulation was permitted during the follow-up period. Results: At the end of the course of microcurrent therapy, 92% of the 26 patients exhibited improved cervical rotation, 85% had improved cervical extension/flexion, and 81% had improved cervical lateral flexion. Twentytwo patients returned for the 3-month follow-up visit. Of these, 91% had maintained a cervical rotation range of motion greater than their pretherapy measurements. Eighty-two percent maintained improved cervical extension/flexion and 77% maintained improved lateral flexion. When the range-of-motion measurements were stratified by pretreatment severity (severe, moderate, mild, or asymptomatic), the degree of improvement directly correlated with the severity. Thus, patients who had more severe initial symptoms experienced a higher percentage of improvement than did those with milder symptoms. For these patients, the cervical rotation range of motion changed from a baseline of 59° 12° to 83° 14° at 3 months; flexion/extension improved from 47° 10° to 73° 13°; and lateral flexion went from 31° 7° to 48° 9°. Some patients also reported symptom improvement for tongue mobility, facial asymmetry, xerostomia, cervical/facial muscle spasms, trismus, and soft tissue tenderness. No adverse effects were observed. Conclusion: Impedance-controlled microcurrent therapy shows promise for remediation of range-of-motion limitations arising as late effects of radiotherapy for head-and-neck cancer. Additional studies are needed to validate these preliminary results and to optimize the microcurrent treatment protocol, particularly with respect to treatment schedules and combining microcurrent therapy with physical and/or drug therapy. © 2002 Elsevier Science Inc.