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Title
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Effectiveness of botulinum toxin a for persistent upper limb pain after breast cancer treatment : a double-blinded randomized controlled trial
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Author
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Abstract
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| Objective: To investigate the effect of a single botulinum toxin A (BTX-A) infiltration in the pectoralis major muscle in addition to a standard physical therapy program for treatment of persistent upper limb pain in breast cancer survivors. Design: Double-blinded (patient and assessor) randomized controlled trial. Setting: A university hospital. Participants: Breast cancer patients (N=50) with pain. Intervention: The intervention group received a single BTX-A infiltration. The control group received a placebo (saline) infiltration. Within 1 week after the infiltration, all patients attended an individual physical therapy program (12 sessions) during the first 3 months and a home exercise program up to 6 months after infiltration. Main Outcome Measures: The primary outcome was change in pain intensity at the upper limb (visual analog scale, 0-100) after 3 months. Secondary outcomes were prevalence rate of pain, pressure hypersensitivity, pain quality, shoulder function, and quality of life. Measures were taken before the intervention and at 1, 3, and 6 months' follow-up. Results: No significant difference in change in pain intensity after 3 months was found (mean difference in change, 3/100; 95% confidence interval [CI], -13 to 19). From baseline up to 6 months, a significantly different change in upper limb pain intensity was found between groups in favor of the intervention group (mean difference in change, 16/100; 95% CI, 1-31). Conclusions: A single BTX-A infiltration in combination with an individual physical therapy program significantly decreased pain intensity at the upper limb in breast cancer survivors up to 6 months. However, the effect size was not clinically relevant, and no other beneficial effects were found. (C) 2018 by the American Congress of Rehabilitation Medicine |
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Language
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English
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Source (journal)
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Archives of physical medicine and rehabilitation. - Chicago, Ill., 1952, currens
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Publication
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Chicago, Ill.
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2018
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ISSN
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0003-9993
[print]
1532-821X
[online]
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DOI
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10.1016/J.APMR.2017.12.032
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Volume/pages
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99
:7
(2018)
, p. 1342-1351
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ISI
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000437552100012
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Pubmed ID
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29409922
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Full text (Publisher's DOI)
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Full text (open access)
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Full text (publisher's version - intranet only)
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