| De Groef et al.1212 De Groef A, Meeus M, De Vrieze T, Vos L, Van Kampen M, Christiaens MR, et al. Pain characteristics as important contributing factors to upper limb dysfunctions in breast cancer survivors at long term. Musculoskelet Sci Pract. 2017;29:52-9.
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147 women in CG 53±9 years old and IG 54±7 years old. |
A question regarding the prevalence point of pain, shoulder and neck region, arm, armpit, trunk side, and breast region (yes/no).
VAS and McGill pain.
DASH upper limb (UL) functionality.
QoL SF-36. |
Randomized clinical trial divided into 2 groups.
CG (n=74). IG (n=69).
All patients were assessed before surgery and at 2, 4, 9, and 12 months after surgery. |
All participants (n=147) four months before randomization received physical therapy.
CG received physical therapy and placebo treatment
IG received physical therapy and myofascial therapy. |
There were no significant differences in pain prevalence rate and intensity between IG and CG. No significant differences in shoulder function and QoL in both short- and long-term groups. |
| Ibrahim et al.88 Ibrahim M, Muanza T, Smirnow N, Sateren W, Fournier B, Kavan P, et al. A pilot randomized controlled trial on the effects of a progressive exercise program on the range of motion and upper extremity grip strength in young adults with breast cancer. Clin Breast Cancer. 2018;18(1):e55-e64.
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59 women aged 39.2 ±5.0 years old. |
General information ROM was used the goniometer for flexion, abduction, adduction, ER and IR movements.
Presence of pain (yes/no) during isolated movements.
Wrist strength was measured using a hand dynamometer. |
Prospective randomized study.
6 assessments (T1) after surgery and before radiotherapy, (T2) after radiotherapy completion, (T3) 3 months, (T4) 6 months, (T5) 12 months and (T6) 18 months after radiotherapy. |
CG (n=30) received standard care (general information and encouragement of a healthy lifestyle with physical exercise).
IG (n=29) 12-week exercise program that began in the first three to four weeks after radiotherapy. |
T1-T2 postoperative pain levels were lower in IG for ER, flexion, and abduction movements.
T3-T4 IG improved ROM in ER and abduction movements; the same movements were decreased in CG. Pain levels were decreased in IG for flexion, abduction, and ER movements and increased incidence of pain in the same movements in CG.
T5-T6 12 months after radiotherapy IG did not report pain in all movements except for ER. Recurrence of IG pain at 18 months after radiotherapy was present in all shoulder movements. In contrast, CG at 12 months after radiation reported pain in all movements and persisted at 18 months after radiotherapy in flexion and ER movements. |
| House et al.1313 House G, Burdea G, Grampurohit N, Polistico K, Roll D, Damiani F, et al. A feasibility study to determine the benefits of upper extremity virtual rehabilitation therapy for coping with chronic pain post-cancer surgery. Br J Pain. 2016;10(4):186-97.
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6 women aged 57±8 years old. |
Pain assessed by NRS.
UL, FMA, and CAHAI-9 function.
JHFT hand function.
BDI
Dynamometer hand strength.
Wrist weights strength. |
Pilot study |
Twice a week training for eight weeks with robotic rehabilitation, each session lasted 20 to 50 minutes. |
The pain was measured at the beginning and end of each session, with a 20% decrease in reported severity.
UL movements improved (p=0.02).
The BDI scale results were statistically significant after training (p=0.01). |
| Cho et al.1414 Cho Y, Do J, Jung S, Kwon O, Jeon JY. Effects of a physical therapy program combined with manual lymphatic drainage on shoulder function, quality of life, lymphedema incidence, and pain in breast cancer patients with axillary web syndrome following axillary dissection. Support Care Cancer. 2016;24(5):2047-57.
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48 women aged 50±7 years old in the physical therapy group (PT) and 46±6 years old in the physical therapy combined with manual lymphatic drainage (PTMLD) group. |
Assessment of perimetry lymphedema.
Manual dynamometer force.
Digital inclinometer shoulder ROM.
QL EORT QLQ-C30.
DASH functionality.
Visible and palpable presence of the axillary cord. |
Randomized |
Two groups, one PT (n=24) and another PTMLD group (n=24).
Three times a week for four weeks. |
In both groups, there was a significant improvement in physical, emotional, and social role, fatigue, and pain (p<0.05). Arm volume increased significantly over time in the PT group (p<0.05). The PTMLD group significantly decreased the NRS score compared to the PT group (p<0.05). The same occurred based on the EORT QLQ-C30. The pain was also significantly decreased in the PTMLD group compared to the PT group (p<0.05). Significant decrease in arm volume was observed in the PTMLD group (p<0.05). |
| Zengin Alpozgen et al.99 Zengin Alpozgen A, Razak Ozdincler A, Karanlik H, Yaman Agaoglu F, Narin AN. Effectiveness of Pilates-based exercises on upper extremity disorders related with breast cancer treatment. Eur J Cancer Care. 2017;26(6):1-8.
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57 women aged 46.22±11.19 years old in the Pilates group (PE), 51.94±8.05 in the exercise group (CE) and 51.53±13.81 in the home-exercise group (HE). |
Pain assessed by VAS.
Digital goniometer shoulder ROM.
Force digital dynamometer.
UL DASH and Constant-Murley Functionality. |
Randomized |
Three groups: PE (n=18), Stretching, strengthening, and shoulder range of motion (CE) exercise group (n=18) and the home exercise (HE) group (n=19). PE and EC groups were supervised by a physical therapist three times a week for eight weeks. |
Pain on movement decreased significantly in all groups (p<0.001). Resting pain also improved significantly in all PE (p=0.004), CE (p=0.002), and HE (p=0.005) groups.
Muscle strength increased in the PE and CE groups.
In ROM, the CE group had an improvement in all shoulder movements (p<0.001), in the PE group only in shoulder flexion (p=0.001) and shoulder abduction movements (p=0.002) and in the HE group only. In shoulder abduction movement (p=0.002).
There was a significant improvement in UL functionality for PE and CE groups (p<0.001). |
| Angooti Oshnari et al.1515 Angooti Oshnari L, Hosseini SA, Haghighat S, Hossein Zadeh S. The effect of complete decongestive therapy on edema volume reduction and pain in women with post breast surgery lymph edema. Iran J Cancer Prev. 2016;9(2):e4209.
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36 women aged 53±10.28 years old |
Arm volume was calculated as arm percentage volume reduction (PVR) VAS pain |
Quasi-experimental study. |
1st phase - six times a week for two weeks, it was performed by manual lymphatic drainage (MLD) physical therapist.
2nd phase - maintenance, for two weeks included daily lymphatic drainage performed by the patient (SLD) with monitoring of the physical therapist twice a week |
Lymphatic drainage was effective in reducing lymphatic edema and pain in women after breast cancer surgery. |
| Rett et al.1616 Rett MT, Mesquita PJ, Mendonça AR, Moura PD, DeSantana JM. A cinesioterapia reduz a dor no membro superior de mulheres submetidas à mastectomia ou quadrantectomia. Rev Dor. 2012;13(3):201-7.
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39 women aged 50.6±10.8 years old |
ROM by Goniometry.
VAS - intensity of pain.
McGill (Br-MPQ) pain characterization. |
Descriptive and longitudinal analytical study. |
There were 20 physical therapy sessions, 3 times a week, lasting 60 minutes. The exercises were cervical stretching and active-free exercises of flexion, extension, abduction, adduction, IR, and ER. |
VAS pain decreased from 3.8±1.7 to 3.0±1.9 when compared from the 1st session to the 10th session. From the 1st session to the 20th session, there was no decrease in pain (p=0.09), and from the 10th session to the 20th session (p=0.79).
In the Br-MPQ scale from the 1st session (p=0.0021) and the 10th session (p=0.0159) and from the 1st (p=0.0001) session to the 20th (p=0.0003).
ROM improved in all movements, and no association was found between ROM and pain intensity. |
| Keays et al.1010 Keays KS, Harris SR, Lucyshyn JM, MacIntyre DL. Effects of Pilates exercises on shoulder range of motion, pain, moos, and upper-extremity function in women living with breast cancer: a pilot study. Phys Ther. 2008;88(4):494-510.
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4 women |
ROM by Goniometry.
UL functionality self-reported 12-item questionnaire.
Pain - BPI
Humor - (POMS) Lymphedema - Perimetry |
Not shown |
Pilates specific exercises for 12 weeks, three times a week. |
All women improved shoulder flexion and ER, and 2 women improved abduction and RI.
3 women had zero pain score.
3 women showed improved mood.
In the analysis of UL functionality, 2 women reported improvement, and only 1 woman kept UL functionality stable. |
