Shoulder Dysfunction
Conditions
Keywords
Graded Motor Imagery, Post Mastectomy
Brief summary
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.
Detailed 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. 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.
Interventions
1. Left/right judgements: It includes left/right judgments of photographs that depict the affected area. 2. Imagined movements: Movement visualizations will be performed. 3. Mirror therapy: It includes observation of the movements of unaffected body part in the mirror, 2 times / week for 6 weeks.
OTHERPhysical therapy program
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.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
Double blind study design. Randomization and masking were performed by an independent investigator who was not engaged in either the treatment administration or the outcome assessment
Intervention model description
Design of the study: In this study the patients will be randomly assigned into two equal groups (27 patients for each group)
Eligibility
Sex/Gender
FEMALE
Age
35 Years to 55 Years
Healthy volunteers
No
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).
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual analog scale | From baseline to 6 weeks | A validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between 0 means "no pain" and 10 means "worst pain." |
| Smartphone clinometer application | From baseline to 6 weeks | The smartphone clinometer application has excellent agreement with a goniometer-based gold standard for measurement of shoulder ROM in both healthy subjects and symptomatic patients. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Shoulder Pain and Disability Index | From baseline to 6 weeks | Is a self-administered questionnaire that aims to measure pain and disability associated with shoulder disease with lower scores indicate little pain or disability and higher scores indicate higher pain and disability |
| Handheld dynamometer | From baseline to 6 weeks | A valid tool for measuring isometric muscle strength in kilograms/newton that provides an objective overview of shoulder flexor and abductor muscles strength |
Countries
Egypt
Contacts
PRINCIPAL_INVESTIGATORAsmaa Abdallah, PhD
Teaching assistant of physical therapy for surgery, cairo university, egypt
Outcome results
None listed