Ninety -three female patients suffering from shoulder dysfunction after breast cancer-related arm lymphedema, will National Cancer Institute (Cairo university) be randomly distributed into three groups equal in number.
In this study the patients will be randomly assigned into three groups (Thirty - one patient for each group): Group (A): Thirty-one patients will receive: Scapular PNF technique, Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) technique for the affected shoulder region plus conventional physiotherapy program in a form of (Complex decongestive therapy (CDT). Group (B): Thirty-one patients will receive Scapular PNF technique for the affected shoulder region plus conventional physiotherapy program in a form of (Complex decongestive therapy (CDT)) Group (C): Thirty-one patients will receive Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) technique for the affected shoulder region plus conventional physiotherapy program in a form of (Complex decongestive therapy (CDT) .
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
93
Complex or combined decongestive physical therapy (CDT): skin care and patient education, manual lymphatic drainage MLD, joints exercises, and compression garments. Scapular PNF: Proprioceptive Neuromuscular Facilitation (PNF) is treatment approach that focus on motor learning, helps the patient to relax, improves coordination, and normalizes the motion. The repeated contractions technique increases active range of motion and strength and guides the patient's motion towards the desired motion, TAPA involves an intervention protocol composed of: 10-min neuro dynamics oriented to the activity 10-min proprioceptive neuromuscular facilitation activities. 10-min proprioceptive anti-edema bandaging, including patient and/or caretaker instructions for placement, as well as assistance on techniques to use for performing everyday activities,
Faculty of Physical Therapy
Cairo, Egypt
Cone formula for lymphedema assessment
the truncated cone formula. V = h C12 + C1C2 + C22 =12 (where V = extremity volume, h = height, C1 = circumference of the top of the cone, C2 = circumference of the base of the cone) as both extremities will be measured from the wrist to the top of the arm (axillary fold) at 4-cm intervals
Time frame: three months
Digital inclinometer for scapular range and shoulder range assessment
The digital inclinometer demonstrates moderate to excellent reliability in evaluating both shoulder and scapular range in case of shoulder disorder
Time frame: three months
Upper limb function/activity performance: Measured with e Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH):
The arm, shoulder, and hand problems quick questionnaire (Quick-Dash) used to evaluate the symptom severity and functional capacity of the patients
Time frame: three months
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Proprioceptive Neuromuscular Facilitation (PNF) is treatment approach that focus on motor learning, helps the patient to relax, improves coordination, and normalizes the motion. The repeated contractions technique increases active range of motion and strength and guides the patient's motion towards the desired motion, Complex or combined decongestive physical therapy (CDT): skin care and patient education, manual lymphatic drainage MLD, joints exercises, and compression garments
Activity-Oriented Proprioceptive Antiedema Therapy TAPA: TAPA involves an intervention protocol composed of: * 10-min neuro dynamics oriented to the activity * 10-min proprioceptive neuromuscular facilitation activities. * 10-min proprioceptive anti-edema bandaging, including patient and/or caretaker instructions for placement, as well as assistance on techniques to use for performing everyday activities, Complex or combined decongestive physical therapy (CDT): skin care and patient education, manual lymphatic drainage MLD, joints exercises, and compression garments