Muscle Energy Technique and Mulligan's Mobilization in Breast Cancer Surgery Patients (MWMMET)

Cairo University (CU)

Status: Enrolling

Conditions: Breast Cancer; Kinematics; Postural; Defect; Mobility Limitation; Muscle Relaxation

Treatments: Other: combination of mobilization with movement and muscle energy techniques; Other: mobilization with movement; Other: muscle energy techniques Interventions:

Study type: Interventional

Funder types: Other

Identifiers

NCT05911867

F.P.T2207005

Details and patient eligibility

About

A recent study aimed to examine the combined effect of Mulligan and muscle energy techniques on postural changes and shoulder kinematics among women who had undergone breast cancer surgery with axillary dissection.

Full description

90 female patients who had undergone breast cancer surgery with axillary dissection were recruited and randomly assigned to three groups. Group A received Mulligan and muscle energy technique, group B received Mulligan technique only, and group C received muscle energy technique. The study measured shoulder kinematics and postural changes using a digital inclinometer for range of motion, PAS/SAPO for cervical angle, and the horizontal alignment of acromions and quick DASH for upper extremity activities. Outcome measurements were taken at three different time points: baseline, six weeks post-intervention, and eight weeks after the intervention during a follow-up assessment.

Enrollment: 108 estimated patients

Sex: Female

Ages: 50 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• female
• between 50 and 65 years
• limited shoulder range of motion

Exclusion criteria

• having metastases
• lymphedema
• traumatic or musculoskeletal disorders affecting the arm
• not taking anticoagulants
• not having undergone bilateral breast cancer surgery
• not having a locoregional recurrence
• not having vascular disorders in the affected arm

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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108 participants in 3 patient groups

combination of mobilization with movement and muscle energy techniques

Experimental group

Description:

Mulligan technique (MWM) involves the therapist using a belt around the humeral head to guide appropriate gliding while the patient moves their shoulder actively through the range. The therapist applies pressure to the scapula in a counter direction. Regarding the cervical spine, the second technique, Cervical Self-Natural Apophyseal Glides (SNAG), involves the therapist standing behind the patient and applying force to the spinous process of each vertebra using a thumb-over-thumb technique. The examiner passively abducts the arm in the horizontal plane until the first barrier to motion by applying pressure to the distal humerus. This passive stretch will be held for three seconds.

Treatment:

Other: combination of mobilization with movement and muscle energy techniques

mobilization with movement

Active Comparator group

Description:

Regarding the shoulder joint, the Mulligan technique (MWM) involves the therapist using a belt around the humeral head to guide appropriate gliding while the patient moves their shoulder actively through the range. The therapist applies pressure to the scapula in a counter direction. This technique is usually performed for five sets of five repetitions with one minute of rest between sets in a sitting position. Regarding the cervical spine, the second technique, Cervical Self-Natural Apophyseal Glides (SNAG), involves the therapist standing behind the patient and applying force to the spinous process of each vertebra using a thumb-over-thumb technique. The patient actively performs repeated flexion or extension of their neck, returning back to the neutral position.

Treatment:

Other: mobilization with movement

muscle energy techniques

Active Comparator group

Description:

The examiner passively abduct the arm in the horizontal plane until the first barrier to motion by applying pressure to the distal humerus. This passive stretch will be held for three seconds. The examiner then instruct the participant to attempt to horizontally adduct the test arm at 25% of their maximal effort while the examiner applies manual resistance at the distal humerus to create an isometric contraction lasting five seconds. The participant then actively abduct the arm in the horizontal plane for a three-second active-assisted stretch.

Treatment:

Other: muscle energy techniques Interventions: