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