The Effect of Mirror Therapy After Thoracotomy

Shoulder Pain Clinical Trial

Official title: The Effect of Mirror Therapy on Shoulder Pain and Function in Patients Undergoing Thoracotomy

Status Completed

Clinical Trial Summary

After thoracotomy, limitation in shoulder functions, ipsilateral shoulder pain, decrease in shoulder muscle strength and deterioration in quality of life occur. The exercise program applied after thoracotomy includes active range of motion exercises, postural correction activities, scapular strengthening exercises, and stretching of the chest and shoulder muscles. Mirror therapy can improve motor functions and reduce unilateral pain. This study aims to evaluate the effects of upper extremity exercises based on mirror therapy after thoracotomy on ipsilateral shoulder pain, shoulder joint range of motion, shoulder muscle strength, shoulder function, quality of life, movement and fear of re-injury. The patients were divided into 2 groups as "mirror therapy group" and "control group", by choosing a simple randomization so that they could not see what was written on their pre-prepared papers. Standard medical treatment, care and pulmonary rehabilitation program were applied to both groups. In addition to the routine rehabilitation program after thoracotomy, the study group received a total of 24 sessions of foal therapy, 3 sessions a week, for 8 weeks. Data were collected using the Personal Information Form including the demographic characteristics of the patients, Tampa Kinesiophobia Scale, Numerical Pain Rating Scale (NPRS), Shoulder Active Range of Motion, Pain Catastrophization Scale, Shoulder Pain and Disability Index, Shoulder muscle strength, SF-12. performed before and after treatment.

Clinical Trial Description

Mirror therapy can improve motor functions and reduce unilateral pain. A Mirror therapy applied to patients with shoulder pain and limited shoulder joint range of motion reduces pain intensity, improves active joint range of motion and shoulder functions, and improves kinesiophobia levels. The exercise program applied after thoracotomy includes active range of motion exercises, postural correction activities, scapular strengthening exercises, and stretching of the chest and shoulder muscles. Verbal and tactile cues may be required to complete these exercises. Therefore, mirror therapy can be a helpful tool that provides visual feedback while performing these exercises. This study aims to evaluate the effects of mirror therapy-based upper extremity exercises on ipsilateral shoulder pain, shoulder joint range of motion, shoulder muscle strength, shoulder function, quality of life, movement and fear of re-injury. This study, which was planned as a prospective randomized controlled study; It was performed on patients aged 25-65 years who were admitted to the Akdeniz University Hospital Thoracic Surgery Clinic underwent lung resection (lobectomy, segmentectomy or wedge resection) with standard posterolateral thoracotomy. PS Power and Sample Size Calculations Version 3.0 program was used for sample size calculation. The study titled "The effect of interscalene block on ipsilateral shoulder pain and pulmonary function in patients undergoing lung lobectomy: A randomized controlled trial" by Woo et al. In this direction, the targeted number of patients in the sample was planned as 70 patients, of which at least 35 were controls. The necessary permissions were obtained and the study was carried out at the Akdeniz University Hospital Thoracic Surgery Clinic. The information form prepared in accordance with the standards of the Akdeniz University Faculty of Medicine Clinical Research Ethics Committee and the voluntary consent form were signed by all cases. Demographic data of the cases were recorded on the "Patient Evaluation Form" created by us. In the preoperative period, the age, gender, weight and height measurements, educational status, type of surgery, whether there was any additional systemic disease, smoking, alcohol habits, medications that they constantly used, and previous operations were recorded in both groups. The patients were divided into 2 groups as "study" and "control group", by choosing a simple randomization so that they could not see what was written on their pre-prepared papers. Standard medical treatment, care and pulmonary rehabilitation program were applied to both groups. Patients were mobilized as early as possible. The control group consisted of patients who underwent thoracotomy and underwent routine rehabilitation in the post-surgical period. routine respiratory rehabilitation program; It consists of a) positioning, b) general body exercises, c) airway clearance techniques, d) breathing exercises, e) incentive spirometry and f) mobilization applications. In this study, the study group consisted of patients who would receive mirror therapy in addition to the routine rehabilitation program described above and applied to the control group in the post-thoracotomy period. In the study group, mirror therapy was started with the permission of the responsible doctor after the patient was extubated during the surgical period, that is, after he was awakened from anesthesia and after he became fully conscious and his hemodynamic status stabilized. To be applied in addition to the standard treatment, the study group was placed in such a way that the mirror was in the midline of the body and it was ensured that the healthy extremity could be seen on the reflected face of the mirror, and the patient's extremity would not be seen by leaving it behind the mirror. In this position, first, symmetrical movements were performed for 1-2 minutes to understand the mirror effect, then active shoulder flexion, abduction, and rotation movements were performed bilaterally, each with 15 repetitions.The patients received treatment for 8 weeks, 3 sessions a week, for a total of 24 sessions. Each treatment session lasts between 60 and 90 minutes. Evaluations were made before and after treatment.

Data, Personal Information Form including demographic characteristics of patients, Numerical Pain Rating Scale (NPRS), Shoulder Active Range of Motion, Shoulder Muscle Strength, Shoulder Pain and Disability Index (SPADI), Short Form 12 (SF-12), Tampa Kinesiophobia Scale, It was collected using the Pain Catastrophe Scale (PCS). ;

Related Conditions & MeSH terms

• Post-thoracotomy Pain Syndrome
• Shoulder Pain

• NCT number: NCT05962736
• Study type: Interventional
• Source: Akdeniz University
• Status: Completed
• Phase: N/A
• Start date: March 6, 2022
• Completion date: July 12, 2023