The effect of improving cervical extension function on quality of life in patients with dropped head syndrome.

Abstract

This study examined the effect of improvements in cervical extension function on quality of life (QOL) in patients with dropped head syndrome (DHS) using patient-reported quality of life (PRQOL). A total of 116 DHS patients were divided into three groups according to cervical extension function at the end of outpatient physical therapy: Non-improvement group (unable to sphinx prone position), Improvement group (able to sphinx prone position), and Marked-improvement group (able to sphinx prone position and all-fours position). Disease-specific QOL (DHS-QOL scale) and health-related QOL (EQ-5D-3L) were assessed both before and after physical therapy, and the PRQOL results were compared among groups. The Non-improvement group showed no significant changes in either scale. In contrast, the Improvement group demonstrated moderate gains in both DHS-QOL and EQ-5D-3L, while the Marked-improvement group showed the greatest improvements, with large effect sizes across both measures. These findings indicate that enhancement of cervical extension function was strongly associated with PRQOL improvement. Cervical extensor improvement in DHS patients contributes not only to physical function but also to patient-perceived QOL. Acquisition of cervical extension in the all-fours position may serve as a clinically meaningful goal for improving QOL in DHS patients.