The effect of myofascial and physical therapy on trunk, shoulder, and elbow movement patterns in women with pain and myofascial dysfunctions after breast cancer surgery : secondary analyses of a randomized controlled trial

Abstract: Introduction: Secondary upper limb dysfunctions are common after breast cancer treatment. Myofascial treatment may be a valuable physical therapy modality for this problem. Objective: To investigate the effect of myofascial therapy in addition to physical therapy on shoulder, trunk, and elbow movement patterns in women with pain and myofascial dysfunctions at the upper limb after breast cancer surgery. Design: A double-blinded randomized controlled trial SETTING: Rehabilitation unit of a university hospital. Participants: Forty-eight women with persistent pain after finishing breast cancer treatment. Interventions: Over three months, all participants received a standard physical therapy program. The experimental (n=24) and control group (n=24) received 12 additional sessions of myofascial therapy or placebo therapy, respectively. Main outcome measures: Outcomes of interest were movement patterns of the humerothoracic joint, scapulothoracic joint, trunk and elbow, measured with an optoelectronic measurement system during the performance of a forward flexion and scaption task. Statistical parametric mapping (SPM) analyses were used for assessing the effect of treatment on movement patterns between both groups (group x time interaction effect). Results: A significantly decreased protraction and anterior tilting was found post-experimental treatment. No beneficial effects on movement patterns of the humerothoracic joint, trunk and elbow were found. Conclusion: Myofascial therapy in addition to a 12-week standard physical therapy program can decrease scapular protraction and anterior tilting (scapulothoracic joint) during arm movements. Given the exploratory nature of these secondary analyses, clinical relevance of these results needs to be investigated further