Effect of perioperative pain neuroscience education in patients with post-mastectomy persistent pain: a retrospective, propensity score-matched study

Manfuku, Masahiro; Nishigami, Tomohiko; Mibu, Akira; Yamashita, Hirofumi; Imai, Ryota; Tanaka, Katsuyoshi; Kitagaki, Kazufumi; Hiroe, Kanamori; Sumiyoshi, Kazuhiro

doi:10.1007/s00520-021-06103-1

Cited by 26 publications

(37 citation statements)

References 37 publications

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“…Most studies (39 of 57) were RCT [ 19 – 57 ], five were controlled non randomized clinical trials [ 58 – 63 ], four were prospective cohort studies [ 61 , 64 – 66 ], one was a retrospective cohort study [ 67 ], two was a case–control study [ 68 , 69 ], four were quasi-experimental [ 70 – 73 ], one was a pilot study [ 74 ] and one was a feasibility study [ 75 ]. The studies originated from 22 countries distributed across 4 continents (i.e., Americas, Europe, Asia and Oceania), most of which were high income countries [ 19 – 26 , 29 , 31 , 33 – 36 , 39 – 41 , 44 – 47 , 50 , 52 – 54 , 56 , 57 , 59 , 61 – 69 , 71 , 73 – 75 ] or upper-middle income countries [ 27 , 28 , 30 , 32 , 37 , 38 , 42 , 43 , 48 , 49 , 58 , 60 , 72 ], with only three studies conducted in lower-middle income countries [ 51 , 55 , 70 ]. The body of literature on this topic turned out to be quite recent, with 71.9% (41 of 57) of studies published between 2010 and 2022 and 22.8% (13 out of 57) between 2000 and 2009.…”

Section: Resultsmentioning

confidence: 99%

“…Only patient education and active shoulder ROM or aerobic exercises were implemented in the preoperative period. Six studies used these modalities as stand-alone, while 4 studies [ 48 , 61 , 64 , 69 , 73 ] combined them postoperatively with manual therapy or MLD. Educational strategies primarily focused on sharing information about postoperative complications, activity restrictions, prevention of lymphedema, infections or injuries, and explaining the upcoming surgical procedure.…”

Section: Resultsmentioning

confidence: 99%

“…This modality was always paired with exercises and, in some cases, complemented with MLD [ 26 , 31 , 46 ] . Passive scapular and shoulder joint mobilizations, scar tissue massage and passive shoulder muscle stretching performed by trained physical therapists [ 23 , 26 , 31 , 32 , 37 , 46 , 63 , 69 , 73 ] mainly characterized manual therapy. Two studies also included passive mobilizations of the elbow, wrist, and hand on the affected side [ 31 , 44 ].…”

Section: Resultsmentioning

confidence: 99%

“…Out of all included studies, 10 interventions [36,48,49,51,52,61,64,69,73,75] were initiated before surgery, including eight that were pursued from 4 weeks to 12 months post-surgery. Only patient education and active shoulder ROM or aerobic exercises were implemented in the preoperative period.…”

Section: Preoperative Rehabilitation Interventionsmentioning

confidence: 99%

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Conservative interventions and clinical outcome measures used in the perioperative rehabilitation of breast cancer patients undergoing mastectomy: a scoping review

et al. 2022

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Background Mastectomy is the first-line treatment approach for more than 90% of breast cancer patients. The numerous physical impairments associated with this surgical procedure negatively impact the patient’s quality of life. To date, rehabilitation resources available for breast cancer patients undergoing mastectomy within the institutions affiliated to the Centre intégré universitaire de soins de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec (CIUSSS-MCQ) are lacking and do not always seem to reflect the particularities of breast cancer care pathways. The purpose of this review was to identify and describe the conservative interventions and the clinical outcome measures used in the perioperative physical rehabilitation of women with breast cancer who are awaiting or have undergone mastectomy. We also aimed to report on the barriers and facilitators to study participation and completion. Methods MEDLINE, CINAHL, and the Cochrane Library were searched from inception to January 2021, and we updated the search on July 11, 2022. We included peer-reviewed English and French literature with quantitative designs, describing conservative interventions and clinical outcome measures used within rehabilitation programs designed for women who were awaiting or had undergone mastectomy. Paired reviewers independently reviewed all citations and articles using a two-phase screening process and independently extracted the data. Results Of the 6080 articles identified, 57 met the inclusion criteria. Most interventions were multimodal, which combined exercise with patient education, manual therapy, and/or lymphatic drainage. The most frequently used objective measures of physical function were shoulder range of motion, muscle strength, and signs of lymphedema. In contrast, the primary patient-reported outcome measures were quality of life, shoulder function, and pain. Undergoing another breast surgery, death, and cancer recurrence were the most reported barriers to study completion. Conclusion This scoping review reports on the heterogeneity and wide range of conservative interventions and clinical outcome measures used in the physical rehabilitation of breast cancer patients who had undergone or were scheduled to undergo mastectomy. Tailoring interventions to breast cancer patients’ needs and promoting outpatient rehabilitation interventions appear to be better suited to the particularities of breast cancer care pathways. Further research is needed to better identify barriers and facilitators to study participation and completion.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Preoperative Rehabilitation Interventionsmentioning

confidence: 99%

See 2 more Smart Citations

Conservative interventions and clinical outcome measures used in the perioperative rehabilitation of breast cancer patients undergoing mastectomy: a scoping review

et al. 2022

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“…In the oncology field, PROMS such as TSK and PCS have been used in BCS to measure kinesiophobia and pain catastrophizing, respectively (Gencay-Can et al, 2018;Manfuku et al, 2021;Velthuis, Van den Bussche, et al, 2012). In fact, kinesiophobia seems to increase the risk of lymphedema, depression and anxiety while decreasing upper limb function in BCS (Gencay-Can et al, 2018).…”

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confidence: 99%

Validity and reliability of the Spanish fear‐avoidance components scale in breast cancer survivors

et al. 2021

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Objective: The aim of this study was to carry out a psychometric analysis of the Fear-Avoidance Components Scale (FACS-Sp) in Spanish breast cancer survivors (BCS). Methods: A validation study was carried out in 154 BCS. Participants were recruited from the service of Medical Oncology of the University Clinical Hospital Virgen de la Victoria, in Málaga (Spain). A psychometric analysis of internal consistency, internal structure and convergent validity of the FACS-Sp was performed. Cronbach's alpha was calculated for internal consistency. Exploratory Factor Analysis was used to determine the internal structure of the FACS-Sp. Convergent validity with the Tampa Scale of Kinesiophobia (TSK) and the Pain Catastrophizing Scale (PCS) was determined using the Pearson correlation coefficient. Results: The internal consistency was high (McDonald's ω = 0.91). The Exploratory Factor Analysis yielded one factor explaining the 40.80% of total variance. Convergent validity with the TSK and the PCS was demonstrated. Conclusions:The FACS-Sp has demonstrated to be a valid and reliable measure for assessing pain-related fear avoidance in BCS based on internal consistency, structural validity and convergent validity. Further studies that analyse other measurement properties in different Spanish cancer populations are needed.

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Effectiveness of pain neuroscience education on somatosensory functioning after surgery for breast cancer: A double‐blinded randomized controlled trial

Dams

Gucht

Haenen

et al. 2023

The Anatomical Record

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Pain is one of the most prevalent and long‐term adverse effects described by people who have undergone breast cancer surgery. Non‐helpful perceptions and thoughts about pain may contribute to the transition of acute to persistent pain. Adding educational interventions to the current physical therapy program in this population may help to improve or prevent persistent pain. Pain neuroscience education (PNE) is a type of educational intervention that addresses the experience of pain in a broader sense by explaining pain not only from a biomedical perspective, but also from a psychological and social perspective. A double‐blinded randomized controlled trial (EduCan trial) investigated whether PNE, in addition to a standard physiotherapy program immediately after surgery for breast cancer, was more effective on somatosensory functioning in the short (4 months postoperatively) and long term (18 months postoperatively), than providing a biomedical explanation for pain. Somatosensory functioning was evaluated using a self‐reported questionnaire as well as a comprehensive quantitative sensory testing evaluation. The findings of this study revealed that adding six sessions of PNE to a standard physical therapy program (n = 184) did not result in a significantly different course of somatosensory functioning up to 18 months postoperatively as compared to biomedical pain education. These findings provide an interesting basis for future research into who should receive PNE after surgery for breast cancer (e.g., patient profiling or phenotyping) and how we can tailor it to the individual to increase its effectiveness.

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Effect of perioperative pain neuroscience education in patients with post-mastectomy persistent pain: a retrospective, propensity score-matched study

Cited by 26 publications

References 37 publications

Conservative interventions and clinical outcome measures used in the perioperative rehabilitation of breast cancer patients undergoing mastectomy: a scoping review

Conservative interventions and clinical outcome measures used in the perioperative rehabilitation of breast cancer patients undergoing mastectomy: a scoping review

Validity and reliability of the Spanish fear‐avoidance components scale in breast cancer survivors

Effectiveness of pain neuroscience education on somatosensory functioning after surgery for breast cancer: A double‐blinded randomized controlled trial

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