One of the most common complications after breast cancer surgery is a functional limitation of the upper body. Up to 67% of breast cancer patients experience arm or shoulder impairment, including pain, numbness, loss of strength, and reduced ROM, after surgery. Graded motor imagery is effective in reducing pain interference with function using a graded sequence of strategies including left/right judgements (implicit motor imagery), imagined movements (explicit motor imagery) and mirror therapy.
54 female patients who have shoulder dysfunction post-mastectomy will participate in this study. Their ages will be ranged 35 to 55 years. In this study the patients will be randomly assigned into two equal groups (27 patients for each group): 1. Group A (study group): This group includes 27 patients who will receive graded motor imagery (GMI) along with the conventional physiotherapy (It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises). GMI is consists of a three-step process. Each step of will be carried out for two weeks, for 30 minutes on two separate days, for total 6 weeks. 2. Group B (control group): This group includes 27 patients who will receive conventional physiotherapy treatment for improving ROM and decreasing pain. It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises, 2 times / week for 6 weeks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
54
1. Left/right judgements: It includes left/right judgments of photographs that depict the affected area. 2. Imagined movements: Movement visualizations will be performed. 3. Mirror therapy: It includes observation of the movements of unaffected body part in the mirror, 2 times / week for 6 weeks.
It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises, 2 times / week for 6 weeks.
Cairo University
Giza, Egypt
Digital goniometer
A device which measures joint ranges.
Time frame: From baseline to 6 weeks
Handgrip dynamometer
A valid tool for measuring handgrip strength in kilograms that provides an objective overview of upper limb functional integrity
Time frame: From baseline to 6 weeks
Visual analog scale
A validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between 0 means "no pain" and 10 means "worst pain."
Time frame: From baseline to 6 weeks
Shoulder Pain and Disability Index
Is a self-administered questionnaire that aims to measure pain and disability associated with shoulder disease with lower scores indicate little pain or disability and higher scores indicate higher pain and disability
Time frame: From baseline to 6 weeks
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