EFFECTS OF CERVICAL MUSCLES STRENGTHENING WITH AND WITHOUT SHOULDER EXERCISES IN POST-MASTECTOMY PATIENTS WITH NECK PAIN
Keywords:
cervical, mastectomy, muscle strength, rehabilitation, exercises, therapeuticAbstract
Background of the Study: To compare the effects of cervical muscles strengthening with and without shoulder exercises on post- mastectomy patients with neck pain.
Methodology: It was a randomized clinical trial, conducted in physical therapy department of a clinical setting through Dynamometer. Sample size of 24 patients were taken. Non-probability convenience sampling technique was used. A written consent form was taken from patients meeting inclusion criteria and were randomly allocated. In one group, patients were treated with cervical Muscles strengthening with shoulder exercises. In other group, patients were treated with cervical Muscles strengthening alone. Treatment was given once a day for three weeks. Muscle strength was examined using dynamometer, Baseline data was taken before treatment on first day after inclusion in study and again on the last day after treatment. SPSS 25 was used to analyze the data.
Results: Wilcoxon signed rank test was used to compare individuals within the group which showed significant results in both groups, p-value 0.000 (i.e. <0.001) for neck strength. Between groups comparison was done using Mann-Whitney U Test and it showed no significant changes for cervical extensors (p- value;0.143) , cervical side bending (right) (p-value; 0.315) and cervical side bending (left) (p-value; 0.853) strength differences, but however cervical flexors strength showed statistically significant results as p-value was 0.003.
Conclusion: It was concluded that Cervical strengthening along with shoulder Rehabilitation can help improve the strength of cervical flexors. However, both the groups have equally resulted in improved cervical extensor, Side bending right and left strength.
References
Chang PJ, Asher A, Smith SR. A Targeted Approach to Post-Mastectomy Pain and Persistent Pain following Breast Cancer Treatment. Cancers 2021;13(20):5191.
Ortiz-Comino L, Fernández-Lao C, Castro-Martín E, Lozano-Lozano M, Cantarero-Villanueva I, Arroyo-Morales M, et al. Myofascial pain, widespread pressure hypersensitivity, and hyperalgesia in the face, neck, and shoulder regions, in survivors of head and neck cancer. Supportive Care in Cancer 2020;28(6):2891-8.
Bender E. Developing world: global warning. Nature 2014;509(7502):S64-S5.
Leitner A, Chang C, editors. Fundamentals of Cancer Pain Management. Springer International Publishing 2021.
Mur‐Gimeno E, Postigo‐Martin P, Cantarero‐Villanueva I, Sebio‐Garcia R. Systematic review of the effect of aquatic therapeutic exercise in breast cancer survivors. European Journal of Cancer Care 2021.
Berrino F, Lutz J, De Angelis R, Rachet B, Gatta G. Cancer survival in five continents: a worldwide population-based study (CONCORD).
Sheppard LA, Ely SJTBJ. Breast cancer and sexuality 2008;14(2):176-81.
Gu J, Groot G, Boden C, Busch A, Holtslander L, Lim HJCbc. Review of factors influencing women's choice of mastectomy versus breast conserving therapy in early stage breast cancer: a systematic review. Clinical breast cancer 2018;18(4):e539-e54.
Yeung WM, McPhail SM, Kuys SS. A systematic review of axillary web syndrome (AWS). Journal of Cancer survivorship: research and practice 2015;9(4):576-98.
da Silva FP, Moreira GM, Zomkowski K, de Noronha MA, Sperandio FF. Manual therapy as treatment for chronic musculoskeletal pain in female breast cancer survivors: a systematic review and meta-analysis. Journal of manipulative and physiological therapeutics 2019;42(7):503-13.
Ezzati K, Laakso E-L, Salari A, Hasannejad A, Fekrazad R, Aris A. The beneficial effects of high-intensity laser therapy and co-interventions on musculoskeletal pain management: a systematic review. Journal of lasers in medical sciences 2020;11(1):81.
Kannan P, Lam HY, Ma TK, Lo CN, Mui TY, Tang WY. Efficacy of physical therapy interventions on quality of life and upper quadrant pain severity in women with post-mastectomy pain syndrome: A systematic review and meta-analysis. Quality of Life Research 2022;31(4):951-73.
Ozyemisci-Taskiran OJPp. Ultrasound-guided block of the suprascapular nerve in breast cancer survivors with limited shoulder motion–case series. 2017;20:E233-E9.
Yang A, Sokolof J, Gulati A. The effect of preoperative exercise on upper extremity recovery following breast cancer surgery: a systematic review. International Journal of Rehabilitation Research. 2018;41(3):189-96.
Haroutiunian S, Nikolajsen L, Finnerup NB, Jensen TS. The neuropathic component in persistent postsurgical pain: a systematic literature review. PAIN® 2013;154(1):95-102.
Bulbule A. Effectiveness of Rhythmic Chopping & Lifting Pattern on Shoulder Range of Motion and Upper Extremity Functional Index in Post: Mastectomy Patients. Indian Journal of Public Health Research & Development 2020;11(2).
Fernández-Lao C, Cantarero-Villanueva I, Fernández-de-las-Peñas C, Del-Moral-Ávila R, Menjón-Beltrán S, Arroyo-Morales M. Widespread mechanical pain hypersensitivity as a sign of central sensitization after breast cancer surgery: comparison between mastectomy and lumpectomy. Pain medicine 2011;12(1):72-8.
la R, Arendt-Nielsen L, Arroyo-Morales M. Myofascial trigger points in neck and shoulder muscles and widespread pressure pain hypersensitivtiy in patients with postmastectomy pain: evidence of peripheral and central sensitization. The Clinical journal of pain 2010;26(9):798-806.
Ge H-Y, Fernández-de-Las-Peñas C, Madeleine P, Arendt-Nielsen L. Topographical mapping and mechanical pain sensitivity of myofascial trigger points in the infraspinatus muscle. European Journal of Pain 2008;12(7):859-65.
Rostkowska E, Bak M, Samborski W. Body posture in women after mastectomy and its changes as a result of rehabilitation. Adv Med Sci 2006;51(1):287-97.
Ebaugh D, Spinelli B, Schmitz KH. Shoulder impairments and their association with symptomatic rotator cuff disease in breast cancer survivors. Medical hypotheses 2011;77(4):481-7.
Giordano S, Kääriäinen M, Alavaikko J, Kaistila T, Kuokkanen H. Latissimus dorsi free flap harvesting may affect the shoulder joint in long run. Scandinavian Journal of Surgery 2011;100(3):202-7.
Eckner JT, Goshtasbi A, Curtis K, Kapshai A, Myyra E, Franco LM, et al. Feasibility and effect of cervical resistance training on head kinematics in youth athletes: a pilot study. American journal of physical medicine & rehabilitation 2018;97(4):292.
Raju AS, Apparao P, Swamy G, Chaturvadi P, Mounika RG. A comparative study on deep cervical flexors training and neck stabilization exercises in subjects with chronic neck pain. Indian Journal of Physiotherapy & Occupational Therapy 2019;13(2).
Lin IH, Chang K-H, Liou T-H, Tsou C-M, Huang Y-C. Progressive shoulder-neck exercise on cervical muscle functions in middle-aged and senior patients with chronic neck pain. European journal of physical and rehabilitation medicine 2017;54(1):13-21.
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Pakistan Journal of Rehabilitation
This work is licensed under a Creative Commons Attribution 4.0 International License.
