Effect of Graded Motor Imagery on Shoulder Dysfunction Post Mastectomy

Cairo University (CU)

Status: Active, not recruiting

Conditions: Shoulder Dysfunction

Treatments: Other: Graded Motor Imagery (GMI); Other: Physical therapy program

Study type: Interventional

Funder types: Other

Identifiers

NCT07240129

P.T.REC/012/005749

Details and patient eligibility

About

One of the most common complications after breast cancer surgery is a functional limitation of the upper body. Up to 67% of breast cancer patients experience arm or shoulder impairment, including pain, numbness, loss of strength, and reduced ROM, after surgery.

Graded motor imagery is effective in reducing pain interference with function using a graded sequence of strategies including left/right judgements (implicit motor imagery), imagined movements (explicit motor imagery) and mirror therapy.

Full description

54 female patients who have shoulder dysfunction post-mastectomy will participate in this study. Their ages will be ranged 35 to 55 years.

In this study the patients will be randomly assigned into two equal groups (27 patients for each group):

1. Group A (study group):

   This group includes 27 patients who will receive graded motor imagery (GMI) along with the conventional physiotherapy (It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises). GMI is consists of a three-step process. Each step of will be carried out for two weeks, for 30 minutes on two separate days, for total 6 weeks.

2. Group B (control group):

This group includes 27 patients who will receive conventional physiotherapy treatment for improving ROM and decreasing pain. It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises, 2 times / week for 6 weeks.

Enrollment: 54 estimated patients

Sex: Female

Ages: 35 to 55 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age range of 35 to 55 years.
• All patients are post-mastectomized unilaterally.
• Female patients only.
• Patients have shoulder ROM restriction.
• Patients have shoulder pain more than 3 months (chronic).
• After 3 months post-surgery.

Exclusion criteria

• Having double mastectomy.
• Psychopathological disorders.
• Having other orthopedic problems (e.g. tendinitis, dislocation, osteoarthritis, referred pain to shoulder).
• Motor problems (e.g. tremor, dyskinesia).
• Metastasis.
• Visual impairment such that they could not read unaided or with their reading glasses.
• Having previously received GMI treatment.
• Diabetes mellitus.
• Having neurological problems as hemiplegia.
• Patients with lymphedema

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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54 participants in 2 patient groups, including a placebo group

Group A (study group)

Active Comparator group

Description:

This group includes 27 patients who will receive graded motor imagery (GMI) along with the conventional physiotherapy (It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises). GMI is consists of a three-step process. Each step of will be carried out for two weeks, for 30 minutes on two separate days, for total 6 weeks

Treatment:

Other: Physical therapy program

Other: Graded Motor Imagery (GMI)

Group B (control group)

Placebo Comparator group

Description:

This group includes 27 patients who will receive conventional physiotherapy treatment for improving ROM and decreasing pain. It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises, 2 times / week for 6 weeks

Treatment:

Other: Physical therapy program