Abstract: PURPOSE: To evaluate the improvement of shoulder and neck function in postoperative oral cancer patients using an "Internet +" remote rehabilitation model based on a four-dimensional innovation model. METHODS: A total of 61 patients who underwent oral cancer surgery in Hospital of Stomatology, China Medical University from July to October 2024 were selected and divided into control group (n=31) and experimental group (n=30) by random number table method. The control group received standard postoperative rehabilitation, including instructional manuals and exercise videos, to ensure proper rehabilitation training and precautions after discharge. Rehabilitation physicians assessed outcomes and provided guidance during follow-up visits. The experimental group adopted the "Internet +" remote rehabilitation model based on a four-dimensional innovation framework. The patients were instructed to download a rehabilitation follow-up app, which provided daily exercise reminders. Patients logged their completed exercises and periodically recorded rehabilitation videos. Rehabilitation physicians remotely evaluated and guided patients based on the submitted videos. Shoulder and neck function were assessed using the Constant-Murley Shoulder Score, Shoulder Pain and Disability Index (SPADI), and Neck Dissection Impairment Index(NDII) at preoperative, 10-day, 1-month, and 3-month postoperative intervals. RESULTS: There was no significant differences in baseline characteristics between the two groups(P>0.05). Generalized estimating equation analysis showed that there was significant difference in neck function between the two groups in the NDII scale (P<0.05). The score of the experimental group was significantly higher than that of the control group at 3 months after surgery(P<0.05), but there was no significant difference between the two groups at 10 days and 1 month after surgery. For SPADI, between-group differences were observed in shoulder dysfunction (P<0.05), with the experimental group showing higher scores at 1 month (P<0.05), but no significant differences at 10 days or 3 months. Pain scores did not differ between groups or across time points (P>0.05). Additionally, Constant-Murley Score demonstrated that the experimental group had higher total scores, daily activity function, range of motion, and strength (P<0.05), with all subscales significantly higher at 1 month (P<0.05), but no differences at 10 days or 3 months. Similarly, pain scores in this scale showed no significant differences(P>0.05). CONCLUSIONS: Compared with traditional rehabilitation methods, the application of "Internet +" remote rehabilitation based on the four-dimensional innovative model can significantly improve the shoulder function of patients after selective neck dissection for oral cancer 1 month after operation, and neck function 3 months after operation. At the same time, it can accelerate the rehabilitation efficiency of patients and improve their quality of life.

Key words: Oral cancer, Internet +, Remote rehabilitation, Shoulder and neck function training, Four-dimensional innovation model