Progressive functional training in patients who underwent jaw defect reconstruction using vascularized iliac flaps: A randomized controlled trial

Oral Oncol. 2025 Jan 3:161:107150. doi: 10.1016/j.oraloncology.2024.107150. Online ahead of print.

Abstract

Objective: This trial was aimed at investigating the effects of progressive functional training on hip mobility, lower-limb stability, quality of life, and hip complications in patients who have undergone jaw defect reconstruction using vascularized iliac flaps.

Methods: Patients who underwent reconstruction surgery with vascularized iliac flaps were randomly divided into control and training groups. The control group, according to routine nursing practice, only received activity and safety guidance after the operation. The training group received progressive functional training for functional exercise. The primary outcomes were donor area function-Harris hip score and the timed "Up and Go" test. Secondary outcomes were patients' quality of life, the hip visual analog scale, and other complications. Observations and evaluations were performed before the surgery and on postoperative day 7 and at months 1, 3, 6, and 12.

Results: The donor area function and quality of life of the patients in the training group were significantly improved at 1, 3, 6, and 12 months after surgery, and the differences were statistically significant. The load-dependent pain in the training group was significantly reduced compared with that in the control group. The incidence rates of gait disturbance at postoperative months 3, and 6 in the training group were significantly lower than the corresponding rates in the control group (P < 0.05).

Conclusion: Progressive functional training can accelerate the restoration of hip function and stability of lower-limb movement, alleviate gait disorders, relieve pain, and improve patients' quality of life.

Keywords: Donor site function; Donor site morbidity; Functional training; Jaw reconstruction; Vascularized iliac flap.