The Effect of Myofascial Chain Release Techniques on Shoulder Joint Range of Motion in Breast Cancer Survivors

Istanbul Medeniyet University

Status

Enrolling

Conditions

Breast Cancer Survivors

Treatments

Other: Manual lymphatic drainage

Other: Myofascial relasing

Other: conventional physiotherapy

Study type

Interventional

Funder types

Other

Identifiers

NCT05386628

2022/0132

Details and patient eligibility

About

In breast cancer patients, limitation of shoulder joint movement occurs following mastectomy surgery. Studies have reported that damage to the fascia on the pectoralis major muscle during mastectomy surgery contributes to the development of the limitation. The aim of this study is to investigate the effect of release techniques applied to the fascia on the pectoralis major muscle and the fascial chain on the incerasing of shoulder joint range of motion.

Full description

After mastectomy, complications such as decreased range of motion and muscle strength in the shoulder joint, development of pain and tenderness, and formation of lymphedema are frequently observed. In addition to causing a significant decrease in the patient's daily life quality, shoulder limitation also negatively affects the treatment process by preventing the joint position required for radiotherapy. For this reason, it is a priority to prevent the development of shoulder joint limitations that may occur following surgery and to open the developing limitation immediately. This study was born from the idea that the relaxation techniques to be applied to regain the mobility of the fascial structure, which has been damaged and whose mobility has decreased due to breast surgery, should be performed by covering the entire myofascial chain. In addition, the investigators aim to prevent adhesions that will limit the mobility of soft tissue by minimizing scar tissue formation with early drainage of postoperative edema. The aim of this study is to investigate the effectiveness of myofascial chain relaxation techniques and manual lymphatic drainage applied to improve soft tissue mobility in the prevention and elimination of shoulder limitations after breast cancer surgery.

A total of 48 patients who agreed to participate in the study will be enrolled in the treatment program twice a week for 6 weeks. During the study, the same assessments will be applied to all patients and the cases will be evaluated 3 times (pre-treatment, post treatment, and one month post treatment). During the assessments, the physical evaluations of the patients on the shoulder region will be examined in detail using objective and subjective methods.

Enrollment

48 estimated patients

Sex

Female

Ages

30 to 60 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Women between the ages of 30-60
Having breast surgery within 2 years
Not have received conservative treatment for shoulder rehabilitation in the last 6 months
Having limitation of movement of the shoulder joint due to breast surgery

Exclusion criteria

Not having agreed to participate in the study
Having undergone radical mastectomy surgery
Having connective tissue disease
Presence of brachial plexus paresis/plegia
Presence of radiogenic fibrosis
Presence of additional orthopedic (scoliosis, etc.), neurological (multiple sclerosis, stroke, etc.) and rheumatological diseases (ankylosing spondylitis, rheumatoid arthritis, etc.) that will affect upper extremity functions
Presence of active metastases
Having undergone reconstruction surgery
Continuation of radiotherapy (must have ended at least 3 months ago) or chemotherapy applications
Having had a bilateral mastectomy
To develop lymphedema in the arm-trunk
Use of muscle relaxants
Patients with severe chemotherapy side effects (hyperesthesia, nausea, skin changes, weakness, etc.)

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Double Blind

48 participants in 4 patient groups

control group

Active Comparator group

Description:

Conventional physiotherapy program (joint movement exercises, local relaxation techniques, etc.) will be applied to the participants in this group.

Treatment:

Other: conventional physiotherapy

Manual lymphatic drainage group

Experimental group

Description:

In addition to the conventional physiotherapy program, manual lymphatic drainage (including upper limb extremity and anterior/posterior axillar-axillar anastomoses and axilla-inguinal anastomosis) will be applied to the participants in this group.

Treatment:

Other: conventional physiotherapy

Other: Manual lymphatic drainage

Myofascial relasing group

Experimental group

Description:

In addition to the conventional physiotherapy program, myofascial chain relasing techniques will be applied to the participants in this group.

Treatment:

Other: conventional physiotherapy

Other: Myofascial relasing

Lymphatic drainage and myofascial releasing group

Experimental group