Post-thyroidectomy rehabilitation exercise improves swallowing QoL but increases early pain in single-center RCT

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Thyroid : official journal of the American Thyroid Association Published April 4, 2026 Medically reviewed May 26, 2026 Study authors: Huang Jiayong, Chen Wanna, Zhang Jing, Xu Heyang, Li Yongxue, Liu Yihao, Lin Bo, Li Ruixia, Liang Mi… PubMed ↗ DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Consider standardized rehabilitation for swallowing QoL post-thyroidectomy but note early pain increase.

This single-center, open-label randomized controlled trial enrolled 356 post-thyroidectomy patients without definite laryngeal nerve injury. The intervention group received standardized postoperative neck and orofacial rehabilitation exercises (including neck extension, swallowing, and voice training) for 3 months, while the control group received general advice to move their necks freely. The primary outcome was swallowing-related quality of life measured by the MD Anderson Dysphagia Inventory (MDADI) at 1 month after surgery, with additional follow-up at 1 week, 3 months, and 6 months.

The rehabilitation exercise group showed significantly better swallowing-related quality of life at both 1 month (MDADI total score: 97.4 [80.3, 100] vs. 88.9 [75.8, 99.7] in controls, p = 0.004) and 6 months (100 [96.8, 100] vs. 98.9 [85.5, 100], p = 0.020). However, the exercise group reported higher pain levels at 1 week postoperatively (p = 0.013), though specific pain scores were not reported. No statistically significant differences were observed in other secondary outcomes including thyroid cancer-specific quality of life and scar assessment.

Regarding safety, no severe adverse events occurred during the rehabilitation exercises, though the higher early pain in the intervention group warrants consideration. Key limitations include the single-center, open-label design and lack of reporting on effect sizes, discontinuation rates, and funding sources. The findings suggest that standardized postoperative rehabilitation may accelerate swallowing-related quality of life recovery in this population, but clinicians should weigh the potential early pain increase against the QoL benefits.

Study Details

Study typeRct

Sample sizen = 374

EvidenceLevel 2

Follow-up3.0 mo

PublishedApr 2026

PMID41778443

View Original Abstract ↓

BACKGROUND: Approximately 80% of post-thyroidectomy patients suffer from swallowing disorders even in the absence of definite laryngeal nerve injury. This study aimed to evaluate the efficacy of a standardized postoperative neck and orofacial rehabilitation exercise in enhancing quality of life (QoL), particular swallowing-related QoL, among post-thyroidectomy patients without definite laryngeal nerve injury during surgery. METHODS: This was a single-center, open-label randomized controlled trial. The trial was registered at the Chinese Clinical Trial Registry (ChiCTR2500097960). Participants were randomized 1:1 to rehabilitation exercise group (RE group) and control group. The RE group performed a standardized postoperative neck and orofacial rehabilitation exercise, which included neck extension, swallowing, and voice training, while the control group received only general advice to move their necks freely. The rehabilitation exercise program duration is 3 months. The QoL of participants was evaluated at 1 week, 1 month, 3 months, and 6 months postoperatively. The primary outcome was swallowing-related QoL evaluated by the MD Anderson Dysphagia Inventory (MDADI) at 1 month after surgery. Secondary outcomes included swallowing-related QoL at other follow-up time points, the thyroid cancer-specific QoL, scar assessment, and safety endpoints defined by postoperative drainage, pain scores, and adverse events. RESULTS: A total of 374 patients were recruited, and 356 participants were included in final analysis, including 176 in RE group and 180 in control group. The swallowing-related QoL in the RE group was significantly better than that in the control group at 1 month (MDADI total score 97.4 [80.3, 100] vs. 88.9 [75.8, 99.7], = 0.004) and 6 months (MDADI total score 100 [96.8, 100] vs. 98.9 [85.5, 100], = 0.020) postoperatively. The RE group reported higher pain levels at 1 week after surgery ( = 0.013) but no significant differences at subsequent time points. No statistically significant differences between groups were observed in other outcomes. No severe adverse event occurred during rehabilitation exercise. CONCLUSIONS: The standardized postoperative neck and orofacial rehabilitation exercise was an effective and safe approach for accelerating the recovery of the swallowing-related QoL in post-thyroidectomy patients without definite laryngeal nerve injury during surgery.