Myofascial Induction Effects on Neck-Shoulder Pain in Breast Cancer Survivors: Randomized, Single-Blind, Placebo-Controlled Cross-Over Design

Publication date: Available online 18 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Eduardo Castro-Martín, Lucía Ortiz-Comino, Tania Gallart-Aragón, Bernabé Esteban-Moreno, Manuel Arroyo-Morales, Noelia Galiano-Castillo
ObjectivesTo investigate the immediate effects of myofascial induction (MI) with placebo electrotherapy as control on perceived pain, cervical/shoulder range of motion (ROM) and mood state in breast cancer survivors (BCSs) with shoulder/arm morbidity. Our secondary objective was to examine the relationships between pain modifications and cervical/shoulder ROM on the side affected by breast cancer.DesignRandomized, single-blind, placebo-controlled cross-over study.SettingPhysical therapy laboratory.ParticipantsTwenty-one BCSs who had a diagnosis of stage I-IIIA breast cancer and had completed adjuvant therapy (except hormonal treatment).InterventionDuring each session, the BCSs received either an MI (fascial unwinding) intervention focused on the upper limb area following the Pilat approach or placebo pulsed shortwave therapy (control group). Each session lasted 30 minutes, and an adequate wash-out period of 4 weeks between sessions was established.Main Outcome MeasuresThe Visual Analogue Scale (VAS) for pain and anxiety, shoulder-cervical goniometry for ROM, the Profile of Mood States (POMS) for psychological distress and the Attitudes Towards Massage (ATOM) Scale were used.ResultsAn analysis of covariance (ANCOVA) revealed significant time x group interactions for VAS affected arm (P=0.031) but not for VAS cervical (P=0.332), VAS non-affected arm (P=0.698) or VAS anxiety (P=0.266). The ANCOVA also revealed significant interactions for affected shoulder flexion (P<0.001), abduction (P<0.001), external rotation (P=0.004) and internal rotation (P=0.001). Significant interactions for affected cervical rotation (P=0.022) and affected cervical lateral flexion (P=0.038) were also found. A significant negative correlation was found between changes in VAS affected arm and shoulder/arm internal rotation ROM (r=-0.46; P=0.03).ConclusionsA single MI session decreases pain intensity and improves neck-shoulder ROM to a greater degree than placebo electrotherapy for BCSs experiencing pain.



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