Effect of extracorporeal shock wave therapy on intercostobrachial neuralgia post mastectomy: A randomized controlled trial

Rehab Mohamed Ismail, Mohamed Mahmoud Abd El Khalek Khalaf, Hossam Abd El Kader El Fol, Noha M. Kamel

Rehab Mohamed Ismail, Mohamed Mahmoud Abd El Khalek Khalaf, Hossam Abd El Kader El Fol, Noha M. Kamel – Effect of extracorporeal shock wave therapy on intercostobrachial neuralgia post mastectomy: A randomized controlled trial –  Fizjoterapia Polska 2025; 25(1); 282-288

DOI: https://doi.org/10.56984/8ZG007DPNQ0

Abstract
Background. Intercostobrachial neuralgia is a neuropathic and chronic pain condition that may develop as a consequence of surgical treatment for breast cancer. It adversely affects physical functioning and the patient’s quality of life. However, treating neuropathic pain with extracorporeal shock wave therapy (ESWT) helps minimize these problems.
Purpose. This study aims to investigate the effect of ESWT in cases diagnosed with intercostobrachial neuralgia after mastectomy.
Subjects and methods. A prospective, single-blind, randomized controlled trial registered with the clinical trials registry (NCT06452615) included 52 female patients aged 40 to 65 years suffering from intercostobrachial neuralgia post-modified radical mastectomy. Patients were randomly assigned to the study group (ESWT group), which received two sessions of ESWT per week in addition to routine medical treatment, and the control group, which received only routine medical treatment. The treatment lasted for eight weeks. The visual analog scale (VAS), Douleur Neuropathique 4 questionnaire (DN4), and goniometer were used to measure pain intensity, neuropathic pain (primary outcome), and shoulder range of motion (ROM) (secondary outcome) at baseline (pre-treatment), and at the 4th and 8th weeks post-treatment in both groups.
Results. Both groups demonstrated a substantial reduction in VAS and DN4 scores, while flexion and abduction ROM showed significant improvement (p < 0.001) at post-I and II stages compared to pre-treatment. The between-group comparison revealed that VAS and DN4 scores were significantly reduced (p < 0.05), whereas flexion and abduction ROM were significantly improved (p < 0.01) in the ESWT group compared to the control group at post-I and II treatments.
Conclusion. ESWT can effectively improve intercostobrachial neuralgia post mastectomy.
Key words
extracorporeal shock wave therapy, intercostobrachial neuralgia, mastectomy
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Effect of complete decongestive therapy on carpal tunnel syndrome post upper limb lymphedema

Sara Abd Elmohsen Ali El-Sayed, Haidy Nady Ashem, Yasser Mohammed Ahmed Abdelgwad, Mona Selim Mohamed Faggal, Khadra Mohamed Ali

Sara Abd Elmohsen Ali El-Sayed, Haidy Nady Ashem, Yasser Mohammed Ahmed Abdelgwad, Mona Selim Mohamed Faggal, Khadra Mohamed Ali – Effect of complete decongestive therapy on carpal tunnel syndrome post upper limb lymphedema –  Fizjoterapia Polska 2024; 24(3); 256-262

DOI: https://doi.org/10.56984/8ZG020AG0O

Abstract:
Purpose. To evaluate the therapeutic effects of CDT on carpal tunnel syndrome post upper limb lymphedema.
Methods. A randomized controlled trial involving 60 female patients aged 40‑60 years with CTS post upper limb lymphedema was conducted. Patients were randomly assigned to two groups: Group A received CDT along with standard medical treatment, and Group B received medical treatment and bandaging. Outcomes measured included pain (Visual Analogue Scale), upper limb volume, grip strength, and nerve conduction studies.
Results. Both groups showed significant improvement post-treatment in all measured outcomes. However, Group A (CDT) exhibited significantly greater improvements in pain reduction, decrease in upper limb volume, increase in grip strength, and nerve conduction compared to Group B (medical treatment and bandaging).
Conclusion. CDT significantly enhances outcomes in patients with CTS post upper limb lymphedema compared to medical treatment and bandaging. Implementing CDT in standard care for these patients is recommended to improve quality of life and functional outcomes.

Keywords:
lymphedema, mastectomy, carpal tunnel syndrome (CTS)

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Kinematic disorders of the scapula in a group of women after mastectomy – a systematic review

Maciej Śliwiński, Paulina Ostrowska, Rita Hansdorfer-Korzon


Maciej Śliwiński, Paulina Ostrowska, Rita Hansdorfer-Korzon – Kinematic disorders of the scapula in a group of women after mastectomy – a systematic review. Fizjoterapia Polska 2022; 22(2); 150-167

Abstract
Background. Breast cancer is the most common neoplastic disease in the group of women. In terms of negative consequences of oncological treatment, disorders of the kinematics of the shoulder complex and coexisting disorders of motor control are also distinguished. Aim of the study. The aim of the study is to systematize information on motor disorders in terms of scapula kinematics in the area of the shoulder complex during upper limb elevation movements in the group of women after mastectomy. Methods. The systematic review is based on the search results of Science Direct, Ebsco, and PubMed. The systematic review was performed on the basis of PRISMA guidelines. Results. The analysis of the works showed the existence of disorders in the kinematics of the scapula in the group of women after mastectomy. In this group of patients, the scope of upwards rotation of the scapula during the elevation of the upper limb, its lowering, and functional movements was limited. Conclusions: The analysed articles indicate the existence of disorders of the scapula kinematics in the group of women after mastectomy. The obtained results indicate the necessity of implementing routine evaluation and motor re-education in the field of scapula kinematics disorders in the process of comprehensive rehabilitation in this group of patients.
Key words:
mastectomy, motor control, breast cancer
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The effectiveness of conservative methods of rehabilitation (PT) in treatment of lymphoedema after mastectomy operation

Dorota Hanasz-Sokołowska, Urszula Kaźmierczak, Wojciech Hagner, Magdalena Kaźmierczak

Dorota Hanasz-Sokołowska, Urszula Kaźmierczak, Wojciech Hagner, Magdalena Kaźmierczak – The effectiveness of conservative methods of rehabilitation (PT) in treatment of lymphoedema after mastectomy operation. Fizjoterapia Polska 2006; 6(1); 67-72

Abstract

Background. The aim of our research was to evaluate the effectivness of two methods of treatment of the lymphoedema after mastectomy operation. Method number 1 – classic method in treatment of lymphoedema after mastectomy operation. Treatment by using: lymphatic drainage, pneumatic massage, exercises in series 10/ 3 times a week. Method number 2 – complex methods that helps in restoration of patency: lymphatic drainage, pneumatic massage, exercises, bandaimy the upper limb, where lymphoedema appeared in series 10, 5 times a week. The examination aim was to evaluate subside of pain druing process of decreasing of lymphoedema. Material and methods. In our research we examinated patients with lymphoedema of upper limb after mastectomy operation, who were treated in Wojewódzkie Centrum Onkologii in Gdansk. Patients were devided into two groups of 15 patients each. In first group patients were treated in serie of 10, 3 times a week by classic method used: lymphatic drainage, pneumatic massage, exercises. In second group patients were treated by complex method of treatment, in series of 10, 5 times a week, by using classic treatment and adding the bandainy of upper limb, were lymphoedema appeared after operation. Results. Treatment of lymphoedema by using two methods had influence on our final results. Lymphoedema in group number 1, who were treated by classic method was located on level of forearm and elbow point. Lymphoedema in group number 2, who were treated by complex method was located over decvanon of vinov bone. Conclusions. Our research shows that conservative methods of rehabilitation had influence in process of decreasing lymphoedema, also helped to relieve pain in upper limb. The complex method is very effective treatment in lymphotic restor patency process.

Key words:
mastectomy, lymphoedema, rehabilitation
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The influence of kinesiotaping applications on lymphoedema of an upper limb in women after mastectomy

Anna Lipińska, Zbigniew Śliwiński, Wojciech Kiebzak, Tomasz Senderek, Janusz Kirenko

Anna Lipińska, Zbigniew Śliwiński, Wojciech Kiebzak, Tomasz Senderek, Janusz Kirenko – The influence of kinesiotaping applications on lymphoedema of an upper limb in women after mastectomy. Fizjoterapia Polska 2007; 7(3); 258-269

Abstract
Background. Doctor Kenzo Kase is a creator of the method Kinesio Taping. In the course of years-lasting experiences he worked out a plaster called Kinesio Tex, which applied during therapy in the form of application affects a patient not only during a visit, but also after its finishing supporting autotherapy of an organism. The usage of the method of kinesiotaping at women after mastectomy influences on the decrease of oedema lymphatic and normalization of muscular tension. Material and methods. Researches were conducted in Rehabilitation Ward of Swiętokrzyskie Oncology Centre in the period from November 2006 to February 2007. The group consisted of 25 women at the age of 40 to 70 years old (the average of their age 55,16 years) treated because of breast cancer with oedema lymphatic. Every woman taking part in the experiment was subjected to kinesiotaping therapy. The research of measurement of oedema lymphatic, the muscular strength of indicated muscular structures as well as the range of movement in a humeral joint, elbow joint, wristradial joint were carried out in four series: before the first application (research I), before every next (research II, III) and after the last application (research IV). In the break between researches a patient was obliged to follow rules referring to behaviour after mastectomy. Results. Assessment of the efficiency of an upper limb at women after mastectomy shows that a 20 – day cycle of improving with the use of lymphatic applications of the kinesiotaping method considerably reduced oedema lymphatic which 24%, increases range of motion 20 % and normalization of muscular tension brings satisfactory therapeutic effects. Conclusions. Lymphatic applications accelerate lymphatic and venous microcirculation, reduces the stasis of lymph in intercellular spaces. Decrease of oedema contributes to the improvement of movement range in all joints of an upper limb and normalization of muscular tension con-tributing to the increase of muscular strengt.
Key words:
Kinesio Taping Method, lymphatic applications, mastectomy, lymphoedema
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Assessment of quality of life of post-mastectomy women from ‘Amazons’ Post-Mastectomy Women’s Club

Waldemar Andrzejewski, Krzysztof Kassolik, Monika Ochrymowicz, Katarzyna Pawłowska

Waldemar Andrzejewski, Krzysztof Kassolik, Monika Ochrymowicz, Katarzyna Pawłowska – Assessment of quality of life of post-mastectomy women from ‘Amazons’ Post-Mastectomy Women’s Club. Fizjoterapia Polska 2008; 8(1); 51-64

Abstract
Background. Post-mastectomy women are pessimistic about their life owing to a number of adverse changes in the upper limb and shoulder girdle on the operated side and the possibility of mental disturbances caused by a fear of disability, cancer relapse or death. Following a radical mastectomy, women indeed lead a stressful life. The stress may by caused by uncertainty about the efficacy of the treatment, cancer relapse anxiety, physical disability (limitation of motor function, lymphedema, decrease in musclepower), breast loss (half-woman complex), personal, family =, professional, and postoperative sequelae-related problems. All the above-mentioned situations have a deleterious effect on the women’s psyche, which is dominated by fear of disability and death, anxiety, about their future life in society and family, meticulous analysis of their own medical case, distrust of medical staff, exaggerated sensitivity and reactions to the behaviour of those around them and everyday problems. The aim of this study was to assess the quality of life of post-mastectomy women.Material and method. The study group consisted of thirty women after mastectomy from the ‘Amazons’ Post-Mastectomy Women’s Club in Wroclaw. The patients filled in a sixty-question inquiry form. Conclusions. According to subjective evaluation, breast amputation was followed by different degrees of deterioration of the quality of life for the majority of the patients (82% of the study group). Mastectomy forced the women to give up active ways of spending their free time, which were replaced by passive pursuits, and to completely abandon some of their housework.
Key words:
mastectomy, quality of life, Post-Mastectomy Women’s Club – ‘Amazons’
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The influence of systematic physiotherapy on upper limb function in post-mastectomy women

Ewa Puszczałowska-Lizis, Paweł Lizis

Ewa Puszczałowska-Lizis, Paweł Lizis – The influence of systematic physiotherapy on upper limb function in post-mastectomy women. Fizjoterapia Polska 2011; 11(1); 41-48

Abstract
The aim of this paper was to evaluate the effect of physiotherapy on upper limb function in post-mastectomy women. Thirty-three women attending the Amazons Post-Mastectomy Women’s Club at the Holy Cross Cancer Centre in Kielce were examined on two occasions at three months’ interval. The participants were divided into Group I of 15 patients regularly attending rehabilitation and Group II of 18 patients practicing rehabilitation occasionally. Bilateral measurement of the angular range of motion in the shoulder was the basic method of assessment. A shoulder range of motion of the upper limb on the operated side smaller by more than 10° in relation to the opposite limb was regarded as ROM limitation. Upper limb circumferences were also measured at 10 cm above and below the lateral humeral epicondyle and in the central metacarpus excluding the thumb to an accuracy of 1 mm. Circumferences of the upper limb on the operated side greater by more than 2 cm compared to the opposite limb were regarded as lymphoedema. Our evaluation of statistical significance of correlations between qualitative parameters (influence of rehabilitation on limitation of the shoulder range of motion and incidence of lymphoedema) relied on the non-parametric Chi-square test (χ²).There was a statistically significant correlation between regular rehabilitation practice and the shoulder range of motion and persistence of upper limb lymphoedema on the mastectomy side.Physiotherapy improves ROM and effectively prevents deterioration of upper limb lymphoedema in post-mastectomy women.
Key words:
breast cancer, mastectomy, shoulder joint, range of motion, lymphoedema
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Effect of Scapular Stabilization Exercises versus Mulligan Technique on Shoulder Kinematics and Postural Changes Post Mastectomy

Ahmed Abdallah Sary, Adel Abdel Hamid Nossier, Yasser Elkerm, Hany Mohamed Elgohary

Ahmed Abdallah Sary, Adel Abdel Hamid Nossier, Yasser Elkerm, Hany Mohamed Elgohary
– Effect of Scapular Stabilization Exercises versus Mulligan Technique on Shoulder Kinematics and Postural Changes Post Mastectomy. Fizjoterapia Polska 2021; 21(2); 198-203

Abstract
Objective. To evaluate the effects of scapular stabilization exercises versus Mulligan technique when compared with traditional physical therapy on post-mastectomy shoulder kinematics and body posture. Design. Randomized controlled trial. Participants. Female patients who were suffering from limitation in shoulder joint motion (abduction and flexion less than 120°), forward head posture and shoulders height asymmetry post mastectomy. Interventions: The participants were assigned randomly in 3 different groups: 1- Group (A) scapular stabilization exercises group includes 20 patients received strengthening, scapular stabilization and postural exercises plus a traditional rehabilitation program, 2- Group (B) Mulligan technique group includes 20 patients received Mulligan mobilization with movement for shoulder joint and cervical sustained natural apophyseal glides plus a traditional rehabilitation program. 3- Group (C) Control group includes 20 patients received traditional physical therapy only. Main Outcome Measures. Shoulder range of motion (ROM) procedures included measurement of flexion, and abduction active range of motion and posture assessment procedure of cervical angle and acromions’ horizontal alignment. They were evaluated at the beginning and after 6 weeks of training. Results. All groups showed significant difference in shoulder range of motion (flexion and abduction), there was high percent of clinical improvement in favor of group B compared to the other groups. There was significant increase of cervical angle at post treatment only in group A and no significant difference in group B and C. There was significant reduction in acromions’ horizontal alignment in group A and B only and the greatest improvement was in group A compared to group B and C and in group B compared to C. Conclusions. Both scapular stabilization exercises and Mulligan technique are considered successful treatment for shoulder AROM limitation post-mastectomy, while Mulligan technique is better. Regarding forward head position and asymmetrical scapular height post mastectomy, scapular stabilization is considered more effective for improving these postural deviations.
Key words:
scapular stabilization exercises, Mulligan technique, shoulder kinematic, postural changesmastectomy
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Long-term evaluation of selected parameters of shoulder girdle and quality of life in post-mastectomy women

Aneta Bac, Anna Jędrzejewska, Renata Woźniacka, Edward Golec

Aneta Bac, Anna Jędrzejewska, Renata Woźniacka, Edward Golec – Long-term evaluation of selected parameters of shoulder girdle and quality of life in post-mastectomy women. Fizjoterapia Polska 2011; 11(3); 261-272

Abstract
The purpose of the above study was to evaluate the quality of life and the type of late postoperative complications in women after breast cancer surgery. The research group consisted of 30 women who underwent treatment for breast cancer. The women were members of the “Amazons” Post-Mastectomy Women’s Club in Tarnów (50%) and in Kraków (50%). The questionnaire dealt with the quality of life and health and was based on the EORTC QLQ-30 questionnaire. The examination chart determined the range of active movement in the joints of the shoulder girdle, limb circumference, potential contracture of the pectoral muscles, measurement of muscle strength and hand strength. The quality of life in the examined women who underwent mastectomy did not change dramatically. In the research group, the range of movement in the shoulder joint on the side of the operated breast became limited in all directions and similarly, the strength of the analyzed muscles decreased. The upper limb lymphoedema was registered in half of the examined women. Pain and sleep disorders were the two postoperative complications that most strongly affected the quality of life in post-mastectomy women.
Key words:
breast cancer, Mastectomy, Quality of Life, shoulder girdle
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Comprehensive draining therapy in the treatment of lymphoedema in women after mastectomy

Marek Woszczak, Katarzyna Syrewicz, Iga Woźniak, Łukasz Goździewicz, Katarzyna Bogacz, Karolina Kossakowska

M. Woszczak, K. Syrewicz, I. Woźniak, Ł. Goździewicz, K. Bogacz, K. Kossakowska – Comprehensive draining therapy in the treatment of lymphoedema in women after mastectomy. Fizjoterapia Polska 2019; 19(4); 28-40

Abstract
Introduction. Breast cancer is one of the most dangerous malignancies tumor, and the incidence of this disease is still growing. As a result of treatment and related removal or impairment of lymph node structure, a frequent complication is lymphoedema. There are many methods of treatment, however, the most recommended and currently the most effective is a complex decongestive therapy.
Purpose of this study. The aim of the study was to evaluate the effectiveness of complex decongestive therapy, its influence on the reduction of lymphoedema and the improvement of mobility and strength of the upper limb.
Materials and methods. The study was conducted on a group of 60 women after unilateral mastectomy at the Świętokrzyski Oncology Center in Kielce. The examined patients were divided into two groups: research and control. In the study group consisting of 30 women, KFTU treatments were performed, while other rehabilitation procedures were performed. The therapeutic cycle lasted 10 days. At the beginning and at the end of the treatment, the change in pain severity was assessed on the VAS scale and the range of motion was measured using the goniometric method, the limb circumferences were measured with a centimeter tape and SUR was measured using a dynamometer.
Results. In both groups, after the end of the therapy, all parameters were improved, but in the research group where a complex decongestive therapy was used, the effect was more noticeable. In the study group there was a significant decrease in pain sensation, decreased limb circumference and visible improvement in strength and range of motion.
Conclusions.The use of both methods of treatment brings effects in the form of reduction of lymphatic edema, however, a complex decongestive therapy is a more effective method of improvement.

Key words:
mastectomy, comprehensive draining therapy, lymphoderma

 

 

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