Mastectomy
Conditions
Brief summary
The purpose of the study is to evaluate the therapeutic efficacy of exercise rehabilitation program on upper limb range and forward head posture post unilateral radical mastectomy.
Detailed description
Upper cross syndrome (forward head posture and rounded shoulder) is a major problem facing physical therapist, which causes an increase in pain, limitation of quality of life and delayed rehabilitation process. The lack in knowledge and information in the published studies about effects of exercise program in forward head posture and rounded shoulder in female's management post unilateral mastectomy. This study will be carried out to investigate the effectiveness exercise program in improving the range of motion in shoulder and forward head posture in females post unilateral mastectomy.
Interventions
Patients who have upper cross syndrome post unilateral modified radical mastectomy and who will receive exercise program (strengthening, active range of motion exercise, and strengthening exercises including prone scapular stabilization, shoulders shrug McKenzie exercise for neck, repeated shoulder horizontal adduction, repeated shoulder flexion, repeated shoulder extension, neck flexion McKenzie exercises) and routine medical treatment. Patients will receive 3 sessions per week for 12weeks, time of session is 45 minutes.
DRUGRoutine medical therapy
For pain relief: Acetaminophen: 2 pills two times per day. Ibuprofen 400 mg: 1 pill two times per day. Hormonal therapy: Tamoxifen 20 mg: once daily. Silicone gel creams (Biocorneum): 3 times per day. These medications will be given for all patients throughout the treatment period (12 weeks).
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
45 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* The subject selection will be according to the following criteria: * Age range between 45-65years. * Females only will participate in the study. * All patients have upper cross syndrome post-unilateral modified radical mastectomy * All patients relatives enrolled the study will have their informed consent.
Exclusion criteria
* Age more than 65 years or less than45 years. * Subjects who have hearing problems * Patients have acute viral diseases, acute tuberculosis, mental disorders or those with pacemakers. * Diabetic, cardiac and renal patients. * Genetic disease * Patients who had any other breast cancer operations
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Craniovertebral angle (CVA) | 12 weeks | The Craniovertebral angle (CVA) is measured by creating an angle between a horizontal line passing through the seventh cervical (C7) vertebra and a line connecting C7 to the tragus of the ear. It is commonly used to assess forward head posture, with smaller angles indicating more severe forward head posture. How to Measure the Craniovertebral Angle: • Use software (KINOVEA) to draw a straight horizontal line passing through C7. Draw a second line connecting the C7 mark to the tragus of the ear. Measure the angle formed by these two lines (the acute angle). * Normal value of CVA: more than 50 degree. * Patients selected with CVA ranged between 30-50 degrees. |
| Cobb angle | 12 weeks | To measure the Cobb angle, identify the most tilted vertebrae at the top and bottom of a scoliosis curve on an X-ray (anteroposterior view). Steps to Measure Cobb Angle: 1. Identify End Vertebrae: Select the highest vertebra (upper end vertebra) and lowest vertebra (lower end vertebra) in the curve that are most tilted toward the concavity. 2. Draw Parallel Lines: * Draw a line parallel to the superior (top) endplate of the upper vertebra. * Draw a line parallel to the inferior (bottom) endplate of the lower vertebra. 3. Draw Perpendicular Lines: Draw a line perpendicular (90 degrees) to each of the lines drawn in step 2. 4. Measure the Angle: The angle formed at the intersection of these two perpendicular lines is the Cobb angle. A curve of more than or equal 10 degrees is defined as scoliosis. |
| The Functional Shoulder Score (FSS) | 12 weeks | The FSS is an 11-item patient-reported subjective outcome questionnaire consisting of two major categories - pain (one question) and activities of daily living (ADLs) (10 questions). Subjects will answer each question on a 10-point numeric rating scale, with a lower number always indicating worse pain or greater difficulty in function. The maximum score of 100 represents the total absence of pain and best possible function. The minimum score of 0 represents the worst possible result. Fifty points will be allocated for pain and 50 for ADLs. The final score will be calculated by multiplying the value indicated by the patient's answer to the question about pain by 5 and adding this to the half the sum of the total value recorded for ADLs. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Functional Assessment of Cancer Therapy-Breast Quality-of- Life Instrument: | 12 weeks | The Functional Assessment of Cancer Therapy-Breast (FACT-B) is a widely used 37-item, self-report questionnaire designed to measure the quality of life (QoL) in breast cancer patients. It covers five domains-physical, social/family, emotional, and functional well-being, plus a Breast Cancer Subscale (BCS) addressing specific issues like body image and arm tenderness. It is a 5-point Likert scale (0-4: Not at all to Very much). Scores are summed, with negatively worded items reversed, to calculate subscales (Physical, Social, Emotional, Functional, and Breast Cancer-specific) and a total score (0-148), where higher scores indicate better quality of life. |
Countries
Egypt
Contacts
CONTACTVivian Hana, Master
CONTACTEreny Khalil, Professor
STUDY_DIRECTORGeorge Nashed, Professor
Cairo University
STUDY_CHAIRAmal Abd El-Baky, Professor
Cairo University
Outcome results
None listed