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T. Fretta1, L. Boing2, A. Guimarães2
1Ribeirão Preto Medical School – University of São Paulo, Physioterapist, RibeiraoI Preto, Brazil, 2Santa Catarina State University, Science Center of Health Sciences and Sports, Florianopolis, Brazil
Background: Changes in postural alignment are found in women with breast cancer caused by removal of the breast (JEONG et al., 2017; PERES et al., 2017). The interventions involving the mat Pilates method and the variables of postural alignment are extremely important for physiotherapist.
Purpose: Relate the effect of a protocol of the Pilates method on postural alignment in the intention-to-treat group (ITT) of participants during a period of adjuvant clinical treatment for breast cancer in hormone therapy.
Methods: Two-arm randomized controlled clinical trial of participants during a period of adjuvant clinical treatment for breast cancer in hormone therapy (n = 34) at the Oncological Research Center (CEPON) Brazil.
PG (n=18) performed 16 weeks of mat Pilates exercises three times a week. The evolution of upper limb movements respected the limits of each participant according to their will, the intervention was performed by a physiotherapist. The detailed intervention is provided in the protocol study (Boing et al., 2020).
CG (n=16) maintained their daily routine activities and participated in three lectures during the 16-week period.
Both groups, an explanatory booklet on the benefits of practicing physical activity after the breast cancer diagnosis, as well as instructions on the prevention of lymphedema.
The postural assessment was performed using the Postural Assessment Software.
In order to verify the clinical characteristics, we chose to use simple frequency. In order to estimate the correlation between variables, gross and adjusted with their respective IC 95%, we used simple linear regression and multiple regression with robust variance. Followed by Cohen's effect size calculation ¦2.
Registered in Clinical Trials - NCT03194997
PG (n=18) performed 16 weeks of mat Pilates exercises three times a week. The evolution of upper limb movements respected the limits of each participant according to their will, the intervention was performed by a physiotherapist. The detailed intervention is provided in the protocol study (Boing et al., 2020).
CG (n=16) maintained their daily routine activities and participated in three lectures during the 16-week period.
Both groups, an explanatory booklet on the benefits of practicing physical activity after the breast cancer diagnosis, as well as instructions on the prevention of lymphedema.
The postural assessment was performed using the Postural Assessment Software.
In order to verify the clinical characteristics, we chose to use simple frequency. In order to estimate the correlation between variables, gross and adjusted with their respective IC 95%, we used simple linear regression and multiple regression with robust variance. Followed by Cohen's effect size calculation ¦2.
Registered in Clinical Trials - NCT03194997
Results: The mean age of 55.29±10.93 years. There was a prevalence of 58.8% in conservative surgery, 59% of the surgery was performed on the left side, 61,8% underwent axillary lymphadenectomy and 70.6% did not undergo breast reconstruction.
Performed a simple linear regression in the postural alignment and found a statistical veracity in the horizontal alignment of the antero-superior iliac spine of the PG (β=-2.41; p=0.039) and in the vertical alignment of the acromion head (β=5.86; p=0.016).
When multiple linear regression adjusted by the surgery side was performed, the participants who underwent surgery on the right side showed an improvement in the horizontal alignment of the C7 head to the right side (β=-5.37; p=0.049). The participants who underwent total mastectomy revealed an improvement in the anterior displacement of the head in the lateral view right (β=7.03; p=0.046), as well as, in the lateral view left the participants who underwent conservative mastectomy exhibited an improvement in vertical alignment trunk (β=-2.12; p=0.019). The PG had a statistical veracity in the horizontal alignment of the C7 head in the left side view (β=-4.94; p=0.043). The calculation of the Cohen effect size efeito ¦2 did not show any difference.
Performed a simple linear regression in the postural alignment and found a statistical veracity in the horizontal alignment of the antero-superior iliac spine of the PG (β=-2.41; p=0.039) and in the vertical alignment of the acromion head (β=5.86; p=0.016).
When multiple linear regression adjusted by the surgery side was performed, the participants who underwent surgery on the right side showed an improvement in the horizontal alignment of the C7 head to the right side (β=-5.37; p=0.049). The participants who underwent total mastectomy revealed an improvement in the anterior displacement of the head in the lateral view right (β=7.03; p=0.046), as well as, in the lateral view left the participants who underwent conservative mastectomy exhibited an improvement in vertical alignment trunk (β=-2.12; p=0.019). The PG had a statistical veracity in the horizontal alignment of the C7 head in the left side view (β=-4.94; p=0.043). The calculation of the Cohen effect size efeito ¦2 did not show any difference.
Conclusion(s): The protocol improved the improved the postural alignment of the study participants.
Implications: Removing the breast causes changes in postural alignment and there is an urgent need for more research on the topic, including RCTS investigating the effectiveness of physiotherapy interventions in postural alignment.
Funding, acknowledgements: Not applicable
Keywords: Breast Neoplasms, Clinical Trial, Posture
Topic: Oncology, HIV & palliative care
Did this work require ethics approval? Yes
Institution: Santa Catarina State University (UDESC) and Oncological Research Center (CEPON)
Committee: UDESC and Cepon
Ethics number: UDESC protocol nº 2.252.288 and CEPON protocol nº 2.319.138
All authors, affiliations and abstracts have been published as submitted.
