Effect of myofascial techniques for treatment of persistent arm pain after breast cancer treatment: randomized controlled trial

Groef, An De; Kampen, Marijke Van; Vervloesem, Nele; Dieltjens, Evi; Christiaens, Marie-Rose; Neven, Patrick; Vos, Lore; Vrieze, Tessa De; Geraerts, Inge; Devoogdt, Nele

doi:10.1177/0269215517730863

Cited by 36 publications

(76 citation statements)

References 29 publications

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“…Besides fatigue, pain is the most frequently reported side effect of breast cancer treatment. Despite the effectiveness of physical therapy modalities, such as specific exercises, passive mobilizations, stretching, myofascial therapy, and general exercises (1)(2)(3)(4), prevalence rates of upper limb pain are still high (between 12-82% up to one year after surgery and between 9-72% later on) (5)(6)(7)(8). Better understanding of a patient's pain complaint, especially at long-term, is needed to improve these pain management strategies.…”

Section: Methodsmentioning

confidence: 99%

Unraveling Self-Reported Signs of Central Sensitization in Breast Cancer Survivors with Upper Limb Pain: Prevalence Rate and Contributing Factors

et al. 2018

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Background: Hypersensitivity of the central nervous system to environmental and chemical stimuli is a clinical feature of central sensitization mechanisms that can be assessed with the central sensitization inventory (CSI). Objective: The aim was to determine prevalence rate of this feature and explore the treatment-, patient-, pain-, and psychosocial-related variables associated with the degree of self-reported signs of central sensitization, assessed with the CSI (0-100), in breast cancer survivors at long-term. Study Design: Cross-sectional study. Setting: University Hospitals, Leuven, Belgium. Methods: One hundred and forty-six women with persistent pain, more than one year after breast cancer surgery, were included. The following factors were analyzed by bivariable and multivariable analysis: 1) treatment-related variables (type of surgery, levels of lymph node dissected, radiotherapy, chemotherapy, hormone therapy, and trastuzumab); 2) patient’s related variables (age and body mass index); 3) pain-related variables (pain intensity, pain quality, primary hyperalgesia, and index of widespread pain); and 4) psychosocial variables (the degree of pain catastrophizing and vigilance and awareness to pain). The dependent variable was degree of central sensitization measured with the CSI. Additionally, a stepwise regression was performed. Results: Fifty-five (38%) patients reported signs of central sensitization measured with the CSI (i.e., > 40/100). From multivariable analysis, it appears that more severe pain quality and higher levels of pain catastrophizing contribute to a higher degree of central sensitization. The stepwise regression revealed that up to 24% of variance of the CSI can be explained by these factors. Limitations: A selection bias may be present since patients were all recruited from a larger cohort participating in clinical trials on the effectiveness of physical therapy after breast cancer treatment. Conclusion: Signs of central sensitization cannot be neglected in breast cancer survivors at long term. More severe pain quality and pain catastrophizing contribute to higher levels of central sensitization in this population. Key words

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Section: Methodsmentioning

confidence: 99%

Unraveling Self-Reported Signs of Central Sensitization in Breast Cancer Survivors with Upper Limb Pain: Prevalence Rate and Contributing Factors

et al. 2018

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“…9,11,13 In physical therapy practice, the aim is to treat this underlying cause of pain with myofascial therapy, that is, manual release techniques on trigger points and adhesions. 14,15 The added beneficial effects of myofascial therapy for treatment of persistent pain in the late postoperative stage have already been investigated. 14,15 In this study, women were more than three months after completion of adjuvant breast cancer treatment and had persistent pain and myofascial dysfunctions at the upper limb region.…”

Section: Introductionmentioning

confidence: 99%

“…14,15 The added beneficial effects of myofascial therapy for treatment of persistent pain in the late postoperative stage have already been investigated. 14,15 In this study, women were more than three months after completion of adjuvant breast cancer treatment and had persistent pain and myofascial dysfunctions at the upper limb region. Patients receiving a 12-week standard physical therapy programme and 12 sessions of myofascial therapy had a significantly greater decrease in pain intensity of 20/100 on the Visual Analogue Scale (VAS) after the intervention compared to the control group who only received the standard physical therapy programme.…”

Section: Introductionmentioning

confidence: 99%

“…Patients receiving a 12-week standard physical therapy programme and 12 sessions of myofascial therapy had a significantly greater decrease in pain intensity of 20/100 on the Visual Analogue Scale (VAS) after the intervention compared to the control group who only received the standard physical therapy programme. 14 To our knowledge, the effectiveness of myofascial therapy in the early postoperative stage has not yet been investigated.…”

Section: Introductionmentioning

confidence: 99%

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Myofascial techniques have no additional beneficial effects to a standard physical therapy programme for upper limb pain after breast cancer surgery: a randomized controlled trial

et al. 2017

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“…To anticipate a drop-out rate of approximately 5%, 184 participants in total will be recruited. The drop-out rate is based on previous similar trials at our institution 24 25 29. To handle the potential missing measurements after 1 year, the comparison of the PDI will be based on a multivariate normal model for longitudinal measurements fitted on all repeated measures over time (preoperative, postoperative, 4, 6, 8, 12 and 18 months).…”

Section: Methods and Analysismentioning

confidence: 99%

EduCan trial: study protocol for a randomised controlled trial on the effectiveness of pain neuroscience education after breast cancer surgery on pain, physical, emotional and work-related functioning

et al. 2019

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IntroductionOver the past decades, awareness on the importance of educational interventions in cancer pain management has increased. However, education is often restricted to biomedical pain management instructions. A more modern educational approach, also known as pain neuroscience education (PNE), explains pain from a biopsychosocial perspective. We hypothesise that this more comprehensive educational approach in the early treatment phase of breast cancer will lead to more beneficial effects for cancer pain management. Therefore, the aim of the present study is to investigate the effectiveness of this PNE intervention, in addition to best evidence physical therapy modalities for treatment and prevention of pain, physical, emotional and work-related functioning after breast cancer surgery, compared with a traditional biomedical educational intervention.MethodsA double-blinded randomised controlled trial has been started in November 2017 at the University Hospitals of Leuven. Immediately after breast cancer surgery, all participants (n=184) receive a 12-week intensive standard physical therapy programme. They receive three additional refresher sessions at 6, 8 and 12 months postsurgery. In addition, participants receive three educational sessions during the first-month postsurgery and three ‘booster sessions’ at 6, 8 and 12 months postsurgery. In the intervention group, the content of the education sessions is based on the modern PNE approach. Whereas in the control group, the education is based on the traditional biomedical approach. The primary outcome parameter is pain-related disability 1 year after surgery. Secondary outcomes related to other dimensions of pain, physical, emotional and work-related functioning at 1-week, 4, 6, 8, 12 and 18 months postsurgery.Ethics and disseminationThe study will be conducted in accordance with the Declaration of Helsinki. This protocol has been approved by the ethical committee of the University Hospitals of Leuven. Results will be disseminated via peer-reviewed scientific journals and presentations at congresses.Trial registration number NCT03351075.

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Effect of myofascial techniques for treatment of persistent arm pain after breast cancer treatment: randomized controlled trial

Abstract: Myofascial therapy is an effective physical therapy modality to decrease pain intensity at the arm in breast cancer survivors at three months, but no other benefits at that time were found. There were no long-term effects at 12 months either.

Cited by 36 publications

References 29 publications

Unraveling Self-Reported Signs of Central Sensitization in Breast Cancer Survivors with Upper Limb Pain: Prevalence Rate and Contributing Factors

Unraveling Self-Reported Signs of Central Sensitization in Breast Cancer Survivors with Upper Limb Pain: Prevalence Rate and Contributing Factors

Myofascial techniques have no additional beneficial effects to a standard physical therapy programme for upper limb pain after breast cancer surgery: a randomized controlled trial

EduCan trial: study protocol for a randomised controlled trial on the effectiveness of pain neuroscience education after breast cancer surgery on pain, physical, emotional and work-related functioning

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