ORIGINAL PAPER
Scapular and shoulder exercises for improving shoulder function and preventing secondary lymphedema following breast cancer surgery – a randomised clinical trial protocol
1
Annamalai Univerisity, Annamalai Nagar, India
2
Government Hospital, Madukkarai, Coimbatore, India
3
SRM College of Physiotherapy, Faculty of Medicine and Health sciences, SRM Institute of Science and Technology (SRMIST), Kattankulathur, Tamil Nadu, India
4
PSG Institute of Medical Sciences and Research, Coimbatore, India
5
Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
6
Neuromusculoskeletal Rehabilitation Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
7
Sustainable Engineering Asset Management Research Group, Research Institute of Sciences and Engineering, University of Sharjah, Sharjah, United Arab Emirates
8
Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
9
Department of Physiotherapy, Government Cuddalore Medical College and Hospital, Annamalai Nagar, India
10
GEM Cancer Center, Coimbatore, India
Submission date: 2024-02-29
Acceptance date: 2024-08-15
Online publication date: 2025-08-14
Corresponding author
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The most prevalent cancer among women worldwide is breast cancer. Those diagnosed with breast cancer usually undergo modified radical mastectomy (MRM) or breast-conserving therapy (BCT). The excision of lymph nodes is likely to result in secondary lymphedema. As there are not many indian studies on preventing secondary lymphedema through upper limb exercises after breast cancer surgery, the present study investigated the effect of scapular and shoulder muscle strengthening exercises in preventing the development of upper limb lymphedema following breast cancer surgery.
Subjects and Methods:
In this single-blinded, randomised clinical trial, 58 participants will be randomised to receive conventional physiotherapy or conventional physiotherapy along with shoulder and scapular muscle strengthening exercises (four sessions per day) for 24 weeks following MRM or BCT surgery. The primary outcome variables include shoulder and scapular muscle strength, shoulder range of motion, upper limb circumference, volumetry, shoulder pain, and disability. The secondary outcome variable is quality of life assessment.
Results:
Outcome variables will be evaluated by a blinded assessor at baseline (second postoperative day) and three, six, 12, 16, and 24 weeks after surgery. A mixed model analysis of variance (ANoVA) will be used to analyse the data for all outcomes. Furthermore, an intention-to-treat analysis will be used, and missing data will be handled with multiple imputations.
Conclusions:
Strengthening exercises following breast cancer surgery, if found effective, can be used in breast cancer rehabilitation protocols to improve shoulder function and prevent secondary lymphedema.
The most prevalent cancer among women worldwide is breast cancer. Those diagnosed with breast cancer usually undergo modified radical mastectomy (MRM) or breast-conserving therapy (BCT). The excision of lymph nodes is likely to result in secondary lymphedema. As there are not many indian studies on preventing secondary lymphedema through upper limb exercises after breast cancer surgery, the present study investigated the effect of scapular and shoulder muscle strengthening exercises in preventing the development of upper limb lymphedema following breast cancer surgery.
Subjects and Methods:
In this single-blinded, randomised clinical trial, 58 participants will be randomised to receive conventional physiotherapy or conventional physiotherapy along with shoulder and scapular muscle strengthening exercises (four sessions per day) for 24 weeks following MRM or BCT surgery. The primary outcome variables include shoulder and scapular muscle strength, shoulder range of motion, upper limb circumference, volumetry, shoulder pain, and disability. The secondary outcome variable is quality of life assessment.
Results:
Outcome variables will be evaluated by a blinded assessor at baseline (second postoperative day) and three, six, 12, 16, and 24 weeks after surgery. A mixed model analysis of variance (ANoVA) will be used to analyse the data for all outcomes. Furthermore, an intention-to-treat analysis will be used, and missing data will be handled with multiple imputations.
Conclusions:
Strengthening exercises following breast cancer surgery, if found effective, can be used in breast cancer rehabilitation protocols to improve shoulder function and prevent secondary lymphedema.
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| eISSN: | 2544-4395 |
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