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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):
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.
Group B (control group):
This group includes 27 patients who will receive conventional physiotherapy treatment. 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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A (study group) | Active Comparator | 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 |
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| Group B (control group) | Placebo Comparator | This group includes 27 patients who will receive conventional physiotherapy treatment. 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 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Graded Motor Imagery (GMI) | Other |
It includes observation of the movements of unaffected body part in the mirror, 2 times / week for 6 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| 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." | From baseline to 6 weeks |
| Smartphone clinometer application | The smartphone clinometer application has excellent agreement with a goniometer-based gold standard for measurement of shoulder ROM in both healthy subjects and symptomatic patients. | From baseline to 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| 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 | From baseline to 6 weeks |
| Handheld dynamometer |
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Inclusion Criteria:
Exclusion Criteria:
Eligibility is based on biological gender
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| Name | Affiliation | Role |
|---|---|---|
| Asmaa Abdallah, PhD | Teaching assistant of physical therapy for surgery, cairo university, egypt | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cairo University | Giza | Egypt |
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Design of the study:
In this study the patients will be randomly assigned into two equal groups (27 patients for each group)
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Double blind study design. Randomization and masking were performed by an independent investigator who was not engaged in either the treatment administration or the outcome assessment
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| Physical therapy program | Other | 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. |
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A valid tool for measuring isometric muscle strength in kilograms/newton that provides an objective overview of shoulder flexor and abductor muscles strength |
| From baseline to 6 weeks |