Myofascial techniques have no additional beneficial effects to a standard physical therapy programme for upper limb pain after breast cancer surgery : a randomized controlled trial

De Groef, An; Van Kampen, Marijke; Vervloesem, Nele; De Geyter, Sophie; Christiaens, Marie-Rose; Neven, Patrick; Vos, Lore; De Vrieze, Tessa; Geraerts, Inge; Devoogdt, Nele

doi:10.1177/0269215517708605

Title

Myofascial techniques have no additional beneficial effects to a standard physical therapy programme for upper limb pain after breast cancer surgery : a randomized controlled trial

Author

De Groef, An

Van Kampen, Marijke

Vervloesem, Nele

De Geyter, Sophie

Christiaens, Marie-Rose

Neven, Patrick

Vos, Lore

De Vrieze, Tessa

Geraerts, Inge

Devoogdt, Nele

Abstract

Objective: To investigate the effects of myofascial techniques, in addition to a standard physical therapy programme for upper limb pain shortly after breast cancer surgery. Design: Double-blinded (patient and assessor) randomized controlled trial with two groups. Setting: University Hospitals Leuven, Belgium Patients: A total of 147 patients with unilateral axillary clearance for breast cancer. Intervention: All participants received a standard physical therapy programme starting immediately after surgery for four months. The intervention group received additionally eight sessions of myofascial therapy from two up to four months after surgery. The control group received eight sessions of a placebo intervention, including static hand placements at the upper body region. Main measurements: The primary outcome was prevalence rate of upper limb pain. Additionally, pain intensity (Visual Analogue Scale (VAS, 0-100)), pressure hypersensitivity (pressure pain thresholds (PPTs; kg/cm(2))) and pain quality (McGill Pain Questionnaire) were evaluated. All measurements were performed at 2 (=baseline), 4, 9 and 12months post-surgery. Results: At 4, 9 and 12months post-surgery, prevalence rates of pain, pain intensity and pain quality were comparable between the intervention and control group. PPT of the upper trapezius muscle was significantly higher in the intervention group at four months with a difference of -1.2 (-1.9 to -0.4) kg/cm(2), P=0.012). PPT of the supraspinatus muscle was significantly higher in the intervention group at four months (-0.7 (-1.4 to -0.1) kg/cm(2), P=0.021) and at nine months (-0.5 (-1.1 to 0.0), P=0.040). Conclusion: Myofascial therapy has no added beneficial effect as standard physical therapy modality in the postoperative stage.

Language

English

Source (journal)

Clinical rehabilitation. - London

Publication

London : 2017

ISSN

0269-2155

DOI

10.1177/0269215517708605

Volume/pages

31 :12 (2017) , p. 1625-1635