Optimising Survivorship in Oral Cavity Cancer: A Scoping Review of Functional Impairments and Early Rehabilitation Interventions

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Arockia Pramila. C¹, T. Senthil Kumar^2,*, Lakshmi Narasiman³, P. Senthil⁴, Shanmugasundaram Gouthaman⁵

¹faculty of physiotherapy, Sri Ramachandra Institute of Higher Education and Research (DU), Porur, Chennai. India; ²Department of Cardiopulmonary Physiotherapy, Faculty of Physiotherapy, Sri Ramachandra Institute of Higher Education and Research (DU), Porur, Chennai. India; ³Department of Surgical Oncology, Sri Ramachandra Institute Of Higher Education and Research (DU), Porur, Chennai. India; ⁴Vels School of Physiotherapy, Periyapalayam Campus - Vistas, Manjankaranai Village, Uthukkottai Taluk, Tiruvallur District, Tamil Nadu – 601102; ⁵Department of Surgical Oncology, Apollo Hospital, Vanagaram, India

Abstract: Background: Oral mucosal cancer poses a major global health concern, with South Asia, particularly India, experiencing the highest incidence and mortality rates. Advances in surgical, chemotherapeutic, and radiotherapeutic management have improved survival, but these treatments often lead to functional impairments such as trismus, neck–shoulder disabilities and swallowing dysfunction, which markedly reduce quality of life. Prehabilitation and early rehabilitation interventions have emerged as promising approaches to address post-surgical or radiation complications. This scoping review is intended to synthesise evidence on functional impairments following oral cavity cancer treatment.

Materials and Methods: The review was started with registration in open access (Doi: 0.17605/osf.io/krmdw), and in accordance with PRISMA-SCR guidelines. A systematic search of Medline (PubMed), Scopus, and Web of Science was conducted up to April 2024 without lower date limits. Eleven studies were included after screening 80 records.

Results: Across the included studies, patients constantly experienced postoperative impairments such as reduced mouth opening (trismus), swallowing dysfunction, cervical stiffness, and shoulder mobility limitations. Neck dissections and reconstructive procedures were strongly related to long-term musculoskeletal impairments, while radiation intensified swallowing difficulties. The intervention included rehabilitation with oral exercises, range of motion programs, and a structured physiotherapy protocol that improved swallowing, neck-shoulder function, and quality of life, while early and prehabilitation programs showed feasibility, compliance, and potential to reduce treatmentrelated complications.

Conclusion: Functional impairments present after post-oral cavity cancer treatment force the need for proactive multidisciplinary rehabilitation strategies involving oncologists, surgeons, and specialists. Integrating prehabilitation, including early preoperative exercises along with other therapy, can optimise survivorship care, enhancing recovery, preserving function, and improving quality of life.

Keywords: Oral cavity cancer, Functional impairments, Prehabilitation, Oral health,Early rehabilitation.