This study aims to determine the combined effect of resisted deep breathing and Myofascial release on pain, respiratory efficiency, chest mobility and lymph edema in Postmastectomy.
The study will be randomized controlled trial and will conducted in Shokat Khanam hospital and Anmol cancer hospital. Non-probability convenience sampling technique will be used and 48 participants will be recruited in study after randomization. The subjects will be divided into two group. Group A will receive myofascial release. Group B will receive myofascial release with resisted deep breathing. Both Group will receive Baseline treatment which is including transcutaneous electrical nerve stimulation. The total duration of treatment will be 12 weeks and there will be 2 sessions each week. The tools that will be used are Numeric Pain Rating Scale (NPRS) for pain, Circumferential limb measurements for chest mobility or lymph edema and Spirometer for respiratory efficiency. After data collection will be analyzed by using SPSS version 21.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
48
The total duration of treatment will be 12 weeks and there will be 2 sessions each week
The total duration of treatment will be 12 weeks and there will be 2 sessions each week
Riphah medical center
Lahore, Punjab Province, Pakistan
RECRUITINGSpirometer
The evaluation of pulmonary function will be performed using conventional spirometry with a Spirobank USB spirometer (Medical International Research, Rome, Italy). The directly measured parameters will include lung volumes, capacities, and flow rates, assessed through the procedures of slow vital capacity (SVC), forced vital capacity (FVC), and maximal voluntary ventilation (MVV), performed in this order
Time frame: 12th week
Circumferential limb measurements
In the proposed study, upper limb volume will be measured using circumference measurements. The anatomical positions of the arm will be selected at 7 cm intervals, including the wrist (the slenderest part), 7 cm above the wrist (lower arm), 7 cm below the elbow (lower arm), at the elbow, 7 cm above the elbow (upper arm), and at the same level as the axilla (upper arm). To minimize measurement error, all measurements will be taken at a constant pressure, with participants seated in a position where the hips and knees are bent at 90 degrees.
Time frame: 12th week
Numerical pain rating scale (NPRS)
Subjective pain will be measured using the Numerical pain Rating Scale (NPRS), which is the simplest and most commonly used pain assessment tool. Patients will be asked to mark a point on a line ranging from 0 (no pain) to 10 (worst imaginable pain) to indicate their pain intensity.
Time frame: 12th week
Chest Mobility
Chest circumference at maximal voluntary inspiration (insp) and maximal voluntary expiration (expir), as well as chest expansion (CE) calculated as the difference between insp and expir will be measured in a sitting position using a tape marked in 0.1 cm increments at the level of the fourth intercostal space. Participants will be instructed about the procedure and asked to exhale fully and hold for expir, and inhale deeply and hold for insp. The highest insp and lowest expir values from three attempts will be recorded, and their difference will represent chest expansion
Time frame: 12th week
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