Muscle Strength Quantitative Trait Locus 1 Clinical Trial
Official title:
Muscle Strength Exercises After Breast Cancer Surgery: a Randomized Clinical Trial
The presence of pain, reduced range of motion and decrease of muscle strength of the upper
limb in the early postoperative period are some of the major deficiencies of the breast
cancer patients.
The objectives of this study were to evaluate muscle strength, range of motion (ROM), pain,
perimetry of the upper limbs and applied questionnaires of the upper lim function and
quality of life, in patients after surgical treatment of breast cancer in different
postoperative periods and different groups following rehabilitation: traditional
postoperatively exercise to perform at home versus traditional exercises associated with
weekly physiotherapy sessions to strength training for shoulder movements.
A clinical trial, randomized, blinded study. The groups were divided according to the type
of rehabilitation (weekly sessions of Physiotherapy-F and Orientation -O). The surgical type
(M-Mastectomy and Q-Quadrantectomy) was also taken into account.
Were not included in the study those patients who underwent previous surgeries of breast
cancer, breast reconstruction, those with some neurological deficit or acute orthopedic
shoulder injury, such as tendonitis or bursitis, patients with previous histories of
shoulder fracture with limited range of motion and tumor stage T4b or N3 or patients with
bone or brain metastases.
All patients underwent preoperative evaluation and guidance of general care; then returned
after one, two, three and six months postoperatively for reassessment and reorientation. The
physiotherapy group, in addition to receiving guidance, had, weekly, physical therapy
sessions with the goal to increase muscle strength in the upper limbs, between one and three
months after surgery.The exercises performed were active-free, with the aid of a stick or
resistance by elastic bands and dumbbells for flexion, extension, adduction, abduction,
external and internal rotation of the shoulder, and elbow flexion and extension, besides
activities to enable movements functional. The mode of execution of the exercises was
isotonic, done slowly and within the joint amplitude reached by the patient, using
resistance according to the muscular capacity of each patient.
All evaluations were performed by the physiotherapy team; the professionals were not aware
of whether the patient belonged to the physiotherapy group or to the guidance group,
constituted by a single evaluator (blinded study).
The evaluations were: muscular strength of the shoulder, evaluated by means of a manual
isokinetic dynamometer, which records the peak of force, in kilograms, during five seconds
of muscle contraction duration; range of motion of the shoulder: measured by a goniometer;
function of the upper limb: ascertained by the application of a specific questionnaire, the
Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) assesses functional capacity
in upper limb diseases and measures the abilities to perform certain activities; pain:
evaluated by the application of the Verbal Numerical Pain Scale (NVA); perimetry: evaluated
with a tape measure in eight distinct points in the upper limbs and quality of life,
analyzed by a European Organization for Research and Treatment of Cancer (EORTC) Quality of
Life C30 (QLQ-C30) questionnaire with a Specific module for breast cancer (BR) 23 - Breast
Specific Module.
;
Allocation: Randomized, Intervention Model: Factorial Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment
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