A Pilot Randomized Controlled Trial on the Effects of a Progressive Exercise Program on the Range of Motion and Upper Extremity Grip Strength in Young Adults With Breast Cancer

Ibrahim, Marize; Muanza, Thierry; Smirnow, Nadia; Sateren, Warren B.; Fournier, B.; Kavan, Petr; Palumbo, Michael; Dalfen, Richard; Dalzell, Mary-Ann

doi:10.1016/j.clbc.2017.06.007

Cited by 24 publications

(36 citation statements)

References 31 publications

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“…Baseline data including comparative tumor characteristics, surgical interventions, and treatment interventions have been published in relation to other elements of this study. 23,24 The participants had a mean age of 39.2 years (standard deviation [SD], 5.0). More than half of them had an invasive ductal carcinoma (69.5%) and were estrogen positive (78.0%), progesterone positive (74.6%), or HER2 positive (20.3%), whereas 10.2% were triple negative.…”

Section: Resultsmentioning

confidence: 99%

“…Pain levels recorded on physical examination for isolated shoulder range of movements were recently published, 24 and they have been abbreviated and reproduced in this paper (Figure 2) to allow for a comparison of findings between the exercise intervention group and the control group to help determine the sensitivity of these tools for use in breast cancer patients. At baseline, pain levels with active movement were noted to be slightly greater in the intervention group for flexion and abduction.…”

Section: Resultsmentioning

confidence: 99%

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The long-term effects of posttreatment exercise on pain in young women with breast cancer

Ibrahim¹

2016

JCSO

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The long-term effects of posttreatment exercise on pain in young women with breast cancer B reast cancer is one of the most prevalent cancers in women worldwide, with more than 1 million new cases diagnosed annually. 1 Prognosis for the disease has improved significantly, but 25% to 60% of women living with breast cancer experience some level of pain ranging from mild to severe, the nature of which can evolve from acute to chronic. 2 Pre-, intra-, and post-treatment risk factors have been found to correlate with the development of acute and chronic pain and include young age, type of breast surgery (lumpectomy or total mastectomy), axillary node dissection, radiation therapy, and hormonal therapy. 3-5 Chemotherapy, particularly anthracycline-and taxanebased regimens, has also been shown to induce pain, arthralgia, myalgia, and peripheral neuropathy during treatment. 6 In particular, postradiation pain may result Background Persistent pain after treatment has been identified in breast cancer populations, with prevalence rates ranging from 25%-60%. Age, surgical procedure, axillary node dissection, and radiation therapy have shown correlation with chronic pain development. Objective To conduct a pilot randomized controlled trial targeting young breast cancer patients to determine the effectiveness of a 12-week exercise program on long-term levels of upper-limb pain, as measured by the Brief Pain Inventory-Short Form (BPI-SF), and pain measured by physical examination of specific shoulder movements. Methods Young adults (18-45 years of age) recently diagnosed with breast cancer consenting to participate in this study were randomly allocated to intervention or control groups. The exercise intervention group participated in a 12-week exercise program starting 3-4 weeks after the cessation of radiation therapy, and the control group received standard care consisting of encouragement for an active lifestyle and pamphlets on the benefits of exercise. The location and severity of pain and its interference with daily life were recorded at the following 6 time points: postsurgery and preradiation (T1, baseline), postradiation and preintervention (T2), and 4 points during an 18-month period postradiation (T3-T6 at 3, 6, 12, and 18 months). In addition, clinical physical assessment of range of motion and pain on active shoulder movements were recorded at each time point. Results 59 young breast cancer patients participated in the study (exercise group: n = 29; control group: n = 30). Over the course of the trial, there were no significant differences between study groups in the BPI-SF measures of pain interference and severity scores. Improvements in pain on shoulder movements were noted in the intervention group at 3 and 6 months postintervention (T3 and T4) but were not sustained over time (by T6, 18 months postradiation). Shoulder girdle-chest wall pain improved at 12 and 18 months postradiation in both groups but persisted despite exercise intervention. Recordings of shoulder pain on physical examination of range showed a...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The long-term effects of posttreatment exercise on pain in young women with breast cancer

Ibrahim¹

2016

JCSO

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“…They also reported that early findings in postoperative period did not predict shoulder ROM limitation in the long term. In Ibrahim’s study [2], the authors found that ROM limitations were significantly higher in patients with total mastectomy and radiation to the axilla. There have been controversial issues with regard to the impact of mastectomy on shoulder ROM.…”

Section: Discussionmentioning

confidence: 99%

“…While modified radical mastectomy (MRM) and breast-conserving surgery (BCS) are regular treatment modalities in breast cancer surgery, sentinel lymph node biopsy (SLNB), or axillary lymph node dissection (ALND) could also be used upon the involvement of axillary lymph nodes. Following the treatment at an earlier phase, scar tissue formation, fibrosis, and shortening of soft tissues in the anterior thoracic and axillary regions may cause varying functional losses such as decreased range of mobility and strength [2]. However, chronic inflammatory changes and broken tissue integrity may lead to the development of tension and pain in the shoulder joint capsule and further complications [3].…”

Section: Introductionmentioning

confidence: 99%

Association between Shoulder Range of Motion and Pain Catastrophizing Scale in Breast Cancer Patients after Surgery

et al. 2020

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Background: Prolonged survival period as a result of early diagnosis and treatment in breast cancer has increased the importance of postoperative morbidities. The aim of the present study was to investigate the association of pain catastrophizing with shoulder pain in patients with decreased shoulder range of motion in the postoperative period. Patients and Methods: The present study included 53 patients who underwent surgery due to breast cancer. Patients who had bilateral mastectomy, distant metastases, cervical-cranial originated lesions, patients with problems involving one of the shoulders or upper extremities before the operation, and patients with cognitive impairment, heart failure, or low albumin levels (liver parenchyma disease or renal failure) were excluded. Shoulder range of motion was measured in the postoperative period, and two study groups were established: one with a limited shoulder range of motion level and the other with a normal level. Effects of pain catastrophizing and shoulder pain severity on shoulder range of motion limitation were compared between the two groups. Results: The average age of 53 female patients who had breast surgery was 52.3 ± 10.5 years. In the group with limited shoulder range of motion, the median pain catastrophizing scale value was 27 (range 5–32) and the shoulder pain severity score was 4 (range 0–8), while in the group with normal shoulder range of motion these values were 11 (range 3–39) and 2 (range 0–6), respectively (p < 0.05). In addition, it was found that factors such as surgical treatment modality and postoperative radiotherapy did not significantly affect shoulder range of motion limitation. Conclusion: Determining the pain catastrophizing scale of patients and controlling pain in the early postoperative period could have positive effects on shoulder range of motion.

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“…Even aggressive exercise intervention after radiotherapy could not recover HGS degradation of the affected side in an 18-month followup. 20 It might be caused by delayed participation after several months after surgery, so starting exercise immediately after surgery is expected to help maintain HGS. However, no studies have been conducted on the effects of early exercise participation on HGS, so further studies are needed.…”

Section: J Kptmentioning

confidence: 99%

Changes in Grip Strength and Associations with Grip Strength in Breast Cancer Survivors Treated with Adjuvant Chemotherapy

Son

Lee

et al. 2020

J Kor Phys Ther

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The aim of this study was to identify the change in hand grip strength (HGS) for consecutive 6 months in breast cancer survivors (BCS) undergoing postoperative adjuvant chemotherapy (adjCTX) and to determine the factors relevant to HGS after chemotherapy completion Methods: This study was a retrospective observational cohort study. BCS (N= 38) who underwent breast cancer surgery and subsequent adjCTX were enrolled. The HGS of both sides was measured before adjCTX and 3 weeks, 2 months and 6 months after adjCTX. And we also collected body composition, anthropometric measurements, social demographics and clinical data. Then we analyzed the changes in HGS over time, and correlation of collected data with HGS at 6 months. Results: A significant increase in HGS of the unaffected side was observed within the first 3 weeks of adjCTX and maintained up to 6 months. In correlation analysis, HGS of both sides was positively correlated with the ipsilateral HGS at 3 weeks, and contralateral HGS at 6 months. And skeletal muscle mass was also positively correlated with the HGS of the unaffected side. In addition, subjects treated with targeted therapy had lower HGS of the unaffected side. However, HGS of the affected side was significantly lower in subjects with breast reconstruction and treated without radiotherapy. Conclusions: To maintain the early recovery of HGS, active and continuous exercise intervention for strengthening might be necessary.

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A Pilot Randomized Controlled Trial on the Effects of a Progressive Exercise Program on the Range of Motion and Upper Extremity Grip Strength in Young Adults With Breast Cancer

Cited by 24 publications

References 31 publications

The long-term effects of posttreatment exercise on pain in young women with breast cancer

The long-term effects of posttreatment exercise on pain in young women with breast cancer

Association between Shoulder Range of Motion and Pain Catastrophizing Scale in Breast Cancer Patients after Surgery

Changes in Grip Strength and Associations with Grip Strength in Breast Cancer Survivors Treated with Adjuvant Chemotherapy

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