Prieto Gómez V1, Navarro Brazález B1, Yuste Sánchez MJ1, Carazo-Díaz C2, Torres Lcomba M1
1University of Alcalá, Physiotherapy, Alcalá de Henares, Spain, 2University Catholic of Murcia, Medicine, Murcia, Spain
Background: Persistent Pain after Breast Cancer Treatment is a frequent consequence after breast cancer treatment with a reported prevalence of 25% to 60%. In this sense, breast cancer treatment can result not only in neuropathic pain but also in predominantly nociceptive pain as well as pain by central sensitization. In this way, it could be indicated to implant techniques destined to the different tissues involved in pain. In general, the treatment of choice, as in other pathologies of shoulder pain non-related to cancer treatment, is the therapeutic exercise. Recent studies, affirm the need to individualize the exercises and perform scapular-focused exercises.
Purpose: The aim of this study was to determine the effectiveness of shoulder physiotherapy based on deep dry needling (DDN) plus neural tension technique (NNT) plus scapula-focused exercises (SE); vs shoulder physiotherapy based on SE; vs shoulder physiotherapy based on shoulder conventional exercises (SCE) in pain intensity; myofascial pain syndrome (MPS), shoulder pain and dysfunction and shoulder movement pattern; health-related quality of life (HRQoL).
Methods: The single-blinded randomized clinical trial was conducted between April 2016 and May 2018, at Teaching, Care and Research Unit in Physiotherapy of the University of Alcalá by the “Physiotherapy in Women's Health Research Group”. 90 women with peripheral persisting pain following breast cancer treatment were included. These participants were randomly allocated to receive: DDN&NTT&SE (n=30) or SE (n=30) or SCE (control group [n=30]). In addition, therapeutic education about chronic shoulder pain were included in the three groups Six sessions of treatment were applied over 6 weeks with a 6-month follow-up after treatment. Pain intensity, shoulder pain and disability, MPS, HRQoL and shoulder movement pattern were measured at baseline, after finishing the physiotherapy treatment (A1), and at follow-up appointments at 3 and 6 months after A1.
Results: Significant and clinically relevant differences were found in favour DDN&NTT&SE vs SE and SCE in all the outcomes in almost all measurements. In the same way, significant and clinically relevant differences were found in favour SE vs SCE in all the outcomes in almost all assessments.
Conclusion(s): DDN&NTT&SE is more effective than SE and SCE in women with peripheral persistent pain following breast cancer treatment. Although SE denote improvements in all the variables, especially in a long-term, these are insufficients.
Implications: Women with Persistent Pain after Breast Cancer Treatment may benefit from this treatment to reduce their pain substantially. This improvement would induce a marked improvement in their HRQoL, and could prevent the appearance of more notorious disorders related to alterations in the central nervous system. In addition, the health costs of these chronic disorders could be greatly reduced.
Keywords: Persistent pain, Breast cancer, Physical therapy
Funding acknowledgements: This study was supported by the “Physiotherapy in Women's Health Research Group” at Alcalá University, Madrid (Spain).
Purpose: The aim of this study was to determine the effectiveness of shoulder physiotherapy based on deep dry needling (DDN) plus neural tension technique (NNT) plus scapula-focused exercises (SE); vs shoulder physiotherapy based on SE; vs shoulder physiotherapy based on shoulder conventional exercises (SCE) in pain intensity; myofascial pain syndrome (MPS), shoulder pain and dysfunction and shoulder movement pattern; health-related quality of life (HRQoL).
Methods: The single-blinded randomized clinical trial was conducted between April 2016 and May 2018, at Teaching, Care and Research Unit in Physiotherapy of the University of Alcalá by the “Physiotherapy in Women's Health Research Group”. 90 women with peripheral persisting pain following breast cancer treatment were included. These participants were randomly allocated to receive: DDN&NTT&SE (n=30) or SE (n=30) or SCE (control group [n=30]). In addition, therapeutic education about chronic shoulder pain were included in the three groups Six sessions of treatment were applied over 6 weeks with a 6-month follow-up after treatment. Pain intensity, shoulder pain and disability, MPS, HRQoL and shoulder movement pattern were measured at baseline, after finishing the physiotherapy treatment (A1), and at follow-up appointments at 3 and 6 months after A1.
Results: Significant and clinically relevant differences were found in favour DDN&NTT&SE vs SE and SCE in all the outcomes in almost all measurements. In the same way, significant and clinically relevant differences were found in favour SE vs SCE in all the outcomes in almost all assessments.
Conclusion(s): DDN&NTT&SE is more effective than SE and SCE in women with peripheral persistent pain following breast cancer treatment. Although SE denote improvements in all the variables, especially in a long-term, these are insufficients.
Implications: Women with Persistent Pain after Breast Cancer Treatment may benefit from this treatment to reduce their pain substantially. This improvement would induce a marked improvement in their HRQoL, and could prevent the appearance of more notorious disorders related to alterations in the central nervous system. In addition, the health costs of these chronic disorders could be greatly reduced.
Keywords: Persistent pain, Breast cancer, Physical therapy
Funding acknowledgements: This study was supported by the “Physiotherapy in Women's Health Research Group” at Alcalá University, Madrid (Spain).
Topic: Oncology, HIV & palliative care; Pain & pain management
Ethics approval required: Yes
Institution: University of Alcalá
Ethics committee: Human Research Ethics Committee at University of Alcalá
Ethics number: 2013/015/20130624
All authors, affiliations and abstracts have been published as submitted.
