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treatment process due to extra losses such as with drains, fistulas, vomiting and diarrhoea (IKNL-a 2012, Vogel, Beijer et al. 2012). In order to complete the treatment, especially with chemoradiation, preventing dehydration is of major importance.\u000D5.4.2 Screening for malnutrition and dehydration\u000DDue to the higher risk of malnutrition and the negative effects of a poor nutritional status on the oncological treatment, adequate screening in the diagnostic process and in the period during and after treatment is vital (IKNL-a 2012). In order to monitor physical status and nutritional status before, during and after treatment validated screening tools should be used (IKNL-a 2012, IKNL-b 2012, Vogel, Beijer et al. 2012).\u000DThe diagnosis of dehydration is primarily made on the basis of medical history taking and physical examination. In some cases (especially with suspected electrolyte disorders) laboratory testing may offer a meaningful addition to the diagnostics (IKNL-d 2010).\u000D5.4.2.1 Nutrition screening tools\u000DScreening for malnutrition aims for the timely detection of (the risk of) malnutrition (Vogel, Beijer et al. 2012). Screening for malnutrition can be performed by a nurse or physician, who may then refer the patient to a nutritionist. Since 2008, screening for and treatment of malnutrition have been included in the basic set of quality indicators of the Health Care Inspectorate (Vogel, Beijer et al. 2012). A number of screening tools meet the validity criteria and the quick and easy criterion: easy to apply and non-invasive. The screening tool used at the Antoni van Leeuwenhoek is the SNAQ (Short Nutritional Assessment Questionnaire). The SNAQ includes indicators for acute and chronic malnutrition (Neelemaat, Kruizenga et al. 2008, Leistra, Neelemaat et al. 2009, Vogel, Beijer et al. 2012). A disadvantage of using the SNAQ for the cancer patient population is that it does not detect an unfavourable body composition (such as loss of muscle mass with a steady weight) (Vogel, Beijer et al. 2012). Regardless, the use of the SNAQ is recommended in the literature, as well as other screening tools for further diagnostics (IKNL-a 2012, Vogel, Beijer et al. 2012).\u000DAn example of another screening tool for further diagnostics is bioelectrical impedance analysis (BIA). BIA is an indirect method of measuring body composition, and is based on the flow of an electric current through the body, or the resistance to that flow. Within the Head and Neck population research to investigate the validity and effectiveness of the BIA is scarce. A pilot study of Wladysiuk et al. concluded that BIA is a useful diagnostic tool for the assessment of nutrition status in healthy and for example patients with Head and Neck cancer (Wladysiuk, Mlak et al. 2016) . Nevertheless, they also concluded that further research is needed.\u000D5.5 Physical therapy\u000D5.5.1 Shoulder disabilities resulting from head and neck cancer treatment\u000DCommon complaints after neck dissections are shoulder disabilities, consisting of pain in the shoulder region and reduced range of motion. The prevalence of shoulder pain and impairment after radical neck dissection varies between 20% after selective dissection and 77% after radical neck dissection (Shone and Yardley 1991, Van Wilgen, Dijkstra et al. 2004, Goldstein, Ringash et al. 2014). In a cohort study (n=112) it was found that shoulder pain after neck dissection can be subscribed to neurotmesis or neurapraxia of the spinal accessory nerve in only 51% of cases (Van Wilgen, Dijkstra et al. 2004). Loss of function in the spinal accessory nerve leads to loss of function in the upper portion of the\u000D120\u000D