Breast Cancer, Kinematics, Mobility Limitation, Muscle Relaxation, Postural; Defect
Conditions
Brief summary
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.
Detailed 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.
Interventions
OTHERcombination of mobilization with movement and muscle energy techniques
The examiner passively abducts the arm in the horizontal plane until the first barrier to motion by applying pressure to the distal humerus. The participant then actively abduct the arm in the horizontal plane for a three-second active-assisted stretch. 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. The passive gliding is maintained in the anterosuperior direction along the facet joint line while flexing or extending the neck throughout the range.
OTHERmuscle energy techniques Interventions:
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 applied 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.
OTHERmobilization with movement
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. The passive gliding is maintained in the anterosuperior direction along the facet joint line while flexing or extending the neck throughout the range.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
both participants and outcome assessors are blind for groups allocation and treatment modalities
Intervention model description
controlled, single-blinded, and randomized clinical trial
Eligibility
Sex/Gender
FEMALE
Age
50 Years to 65 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| digital inclinometer | 6 weeks | ). This tool is recognized as valid and reliable for this purpose and requires the patient to move their affected shoulder in various directions while keeping their feet fixed in place |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postural Assessment Software (PAS/SAPO) | 6 weeks | The women participants were positioned in a comfortable stance, and anatomical markers will be attached to specific points such as the tragus and both acromions. Their photographs will be captured and later analyzed using the PAS/SAPO software to record the cervical angle and horizontal alignment of the acromions. A forward head position was identified by an angle less than 50°. This method has been demonstrated to be reliable and valid for identifying forward head positions |
Other
| Measure | Time frame | Description |
|---|---|---|
| Quick DASH scale | 6 weeks | The Arabic version of the Quick-DASH questionnaire includes 11 items, which inquire about the patient's difficulty in performing physical activities related to the upper extremity, the severity of pain and tingling, and the impact of the problem on social activities, work, and sleep. Each item includes five response options, ranging from no difficulty to being unable to perform the activity. If at least 10 items are answered, their responses are added to create a raw score, which is then transformed to a 0-100 scale. |
Countries
Egypt
Contacts
Primary ContactHany M Elgohary, Ph.D
Backup ContactAlaa M Khedr
Outcome results
None listed