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Effect of myofascial techniques for treatment of upper limb dysfunctions in breast cancer survivors: randomized controlled trial

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Abstract

Purpose

Besides pain, myofascial dysfunctions may contribute to the presence of upper limb impairments such as impaired range of motion, decreased strength, lymphedema, and altered postures and kinematics. Therefore, the aim of this study was to investigate the effect of myofascial therapy in addition to a standard physical therapy program for treatment of upper limb dysfunctions in breast cancer survivors.

Methods

Fifty women treated for a unilateral breast cancer with pain and myofascial dysfunctions at the upper limb region. The intervention group received 12 sessions of myofascial therapy consisting of release techniques on myofascial trigger points and adhesions in addition to a standard physical therapy program for 3 months. The control group received 12 sessions of a placebo intervention in addition to the same standard physical therapy program during the 3 months. Outcome parameters are active shoulder range of motion (inclinometer); arm lymphedema (perimeter); upper limb strength (handheld dynamometer); scapular statics and dynamics (acromion-table and pectoralis minor index, inclinometer); shoulder function (Disability of Shoulder, Arm and Hand questionnaire); and quality of life (Short Form 36). Measures were taken before and after the intervention at 6 and 12 months follow-up.

Results

No differences between groups were found for all outcome parameters over the course of 1 year. However, overall beneficial effects of the standard physical therapy program for active shoulder range of motion and shoulder function were found in both groups up to 1 year follow-up.

Conclusion

Myofascial therapy has no additional beneficial effect for improvement of upper limb function in breast cancer survivors.

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References

  1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A (2015) Global cancer statistics, 2012. CA Cancer J Clin 65(2):87–108

    Article  PubMed  Google Scholar 

  2. Stubblefield MD, Keole N (2013) Upper body pain and functional disorders in patients with breast cancer. PM & R: the journal of injury, function, and rehabilitation 6(2):170–183

    Article  Google Scholar 

  3. De Groef A, Van Kampen M, Dieltjens E, et al. (2015) Effectiveness of postoperative physical therapy for upper-limb impairments after breast cancer treatment: a systematic review. Archives of Physical Medicine and Rehabilitation

  4. Hidding JT, Beurskens CH, van der Wees PJ, van Laarhoven HW, Nijhuis-van der Sanden MW (2014) Treatment related impairments in arm and shoulder in patients with breast cancer: a systematic review. PLoS One 9(5):e96748

    Article  PubMed  PubMed Central  Google Scholar 

  5. Torres Lacomba M, Mayoral del Moral O, Coperias Zazo JL, Gerwin RD, Goni AZ (2010) Incidence of myofascial pain syndrome in breast cancer surgery: a prospective study. Clin J Pain 26(4):320–325

    Article  PubMed  Google Scholar 

  6. De Groef A, Van Kampen, M., Vervloesem, N., Dieltjens, E., Christiaens, MR., Neven, P., Geraerts, I, Devoogdt, N (2016) Effect of myofascial techniques for treatment of persistent upper limb pain after breast cancer treatment: randomized controlled trial. Submitted

  7. Shamley D, Srinaganathan R, Oskrochi R, Lascurain-Aguirrebena I, Sugden E (2009) Three-dimensional scapulothoracic motion following treatment for breast cancer. Breast Cancer Res Treat 118(2):315–322

    Article  PubMed  Google Scholar 

  8. Crosbie J, Kilbreath SL, Dylke E et al (2010) Effects of mastectomy on shoulder and spinal kinematics during bilateral upper-limb movement. Phys Ther 90(5):679–692

    Article  PubMed  Google Scholar 

  9. Cheville AL, Tchou J (2007) Barriers to rehabilitation following surgery for primary breast cancer. J Surg Oncol 95(5):409–418

    Article  PubMed  Google Scholar 

  10. Bron C, de Gast A, Dommerholt J, Stegenga B, Wensing M, Oostendorp RA (2011) Treatment of myofascial trigger points in patients with chronic shoulder pain: a randomized, controlled trial. BMC Med 9:8

    Article  PubMed  PubMed Central  Google Scholar 

  11. Grieve R, Clark J, Pearson E, Bullock S, Boyer C, Jarrett A (2011) The immediate effect of soleus trigger point pressure release on restricted ankle joint dorsiflexion: a pilot randomised controlled trial. J Bodyw Mov Ther 15(1):42–49

    Article  PubMed  Google Scholar 

  12. Hains G, Descarreaux M, Hains F (2010) Chronic shoulder pain of myofascial origin: a randomized clinical trial using ischemic compression therapy. J Manip Physiol Ther 33(5):362–369

    Article  Google Scholar 

  13. Valentine RE, Lewis JS (2006) Intraobserver reliability of 4 physiologic movements of the shoulder in subjects with and without symptoms. Arch Phys Med Rehabil 87(9):1242–1249

    Article  PubMed  Google Scholar 

  14. Tengrup I, Tennvall-Nittby L, Christiansson I, Laurin M (2000) Arm morbidity after breast-conserving therapy for breast cancer. Acta Oncol 39(3):393–397

    Article  CAS  PubMed  Google Scholar 

  15. Devoogdt N, Lemkens H, Geraerts I et al (2010) A new device to measure upper limb circumferences: validity and reliability. International angiology: a journal of the International Union of Angiology 29(5):401–407

    CAS  Google Scholar 

  16. Kim JK, Park MG, Shin SJ (2014) What is the minimum clinically important difference in grip strength? Clin Orthop Relat Res 472(8):2536–2541

    Article  PubMed  PubMed Central  Google Scholar 

  17. De Groef A, Van Kampen M, Vervloesem N, et al. (2016) Inter-rater reliability of shoulder measurements in middle-aged women. Physiotherapy

  18. Angst F, Schwyzer HK, Aeschlimann A, Simmen BR, Goldhahn J (2011) Measures of adult shoulder function: disabilities of the arm, shoulder, and hand questionnaire (DASH) and its short version (QuickDASH), shoulder pain and disability index (SPADI), American shoulder and elbow surgeons (ASES) society standardized shoulder assessment form, constant (Murley) score (CS), simple shoulder test (SST), Oxford shoulder score (OSS), shoulder disability questionnaire (SDQ), and western Ontario shoulder instability index (WOSI). Arthritis Care Res (Hoboken) 63(Suppl 11):S174–S188

    Article  Google Scholar 

  19. Treanor C, Donnelly M (2015) A methodological review of the short form health survey 36 (SF-36) and its derivatives among breast cancer survivors. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation 24(2):339–362

    Article  Google Scholar 

  20. Ebaugh D, Spinelli B, Schmitz KH (2011) Shoulder impairments and their association with symptomatic rotator cuff disease in breast cancer survivors. Med Hypotheses 77(4):481–487

    Article  PubMed  Google Scholar 

  21. Borstad JD, Ludewig PM (2005) The effect of long versus short pectoralis minor resting length on scapular kinematics in healthy individuals. The Journal of orthopaedic and sports physical therapy 35(4):227–238

    Article  PubMed  Google Scholar 

  22. Lee SA, Kang JY, Kim YD et al (2010) Effects of a scapula-oriented shoulder exercise programme on upper limb dysfunction in breast cancer survivors: a randomized controlled pilot trial. Clin Rehabil 24(7):600–613

    Article  PubMed  Google Scholar 

  23. Struyf F, Nijs J, Mottram S, Roussel NA, Cools AM, Meeusen R (2014) Clinical assessment of the scapula: a review of the literature. Br J Sports Med 48(11):883–890

    Article  PubMed  Google Scholar 

  24. Ratcliffe E, Pickering S, McLean S, Lewis J (2014) Is there a relationship between subacromial impingement syndrome and scapular orientation? A systematic review. Br J Sports Med 48(16):1251–1256

    Article  PubMed  Google Scholar 

  25. Nesvold IL, Reinertsen KV, Fossa SD, Dahl AA (2011) The relation between arm/shoulder problems and quality of life in breast cancer survivors: a cross-sectional and longitudinal study. Journal of cancer survivorship: research and practice 5(1):62–72

    Article  Google Scholar 

  26. Mols F, Vingerhoets AJ, Coebergh JW, van de Poll-Franse LV (2005) Quality of life among long-term breast cancer survivors: a systematic review. European journal of cancer (Oxford, England: 1990) 41(17):2613–2619

    Article  Google Scholar 

  27. De Groef A, Van Kampen M, Dieltjens E et al (2015) Effectiveness of postoperative physical therapy for upper-limb impairments after breast cancer treatment: a systematic review. Arch Phys Med Rehabil 96(6):1140–1153

    Article  PubMed  Google Scholar 

  28. Muir SW, Corea CL, Beaupre L (2010) Evaluating change in clinical status: reliability and measures of agreement for the assessment of glenohumeral range of motion. North American journal of sports physical therapy: NAJSPT 5(3):98–110

    PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We thank Elies Clabau and Roxane Van Hemelrijck for measuring the patients. We thank Nele Vervloesem, Sophie De Geyter, and Evi Dieltjens for treating the patients. We are grateful to the nurses of the department of surgical oncology and medical staff of the multidisciplinary breast clinic to motivate the patients to participate in our study. Finally, we thank all patients who took part in this study.

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Authors and Affiliations

  1. Department of Rehabilitation Sciences; Department of Physical Medicine and Rehabilitation , University Hospitals Leuven, KU Leuven – University of Leuven, Herestraat 49, 3000, Leuven, Belgium

    An De Groef, Marijke Van Kampen, Nele Verlvoesem, Evi Dieltjens, Lore Vos, Tessa De Vrieze, Inge Geraerts & Nele Devoogdt

  2. Multidisciplinary Breast Center, University Hospitals Leuven, Leuven, Belgium

    Marie-Rose Christiaens & Patrick Neven

  3. Department of Surgical Oncology, KU Leuven – University of Leuven, Leuven, Belgium

    Marie-Rose Christiaens

  4. Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium

    Patrick Neven

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  1. An De Groef
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  2. Marijke Van Kampen
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  3. Nele Verlvoesem
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  9. Inge Geraerts
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  10. Nele Devoogdt
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Corresponding author

Correspondence to An De Groef.

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Conflict of interest

This study was funded by the agency for Innovation by Science and Technology (Applied Biomedical Research) (IWT 110703). The funding source had no role in study design, data collection, data analysis, data interpretation, or writing of the report. No support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work. We have full control of all primary data and we agree to allow the journal to review the data if requested. The authors have no further conflicts of interest.

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De Groef, A., Van Kampen, M., Verlvoesem, N. et al. Effect of myofascial techniques for treatment of upper limb dysfunctions in breast cancer survivors: randomized controlled trial. Support Care Cancer 25, 2119–2127 (2017). https://doi.org/10.1007/s00520-017-3616-9

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  • DOI: https://doi.org/10.1007/s00520-017-3616-9

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