Accessory Joint and Neural Mobilizations in Shoulder After Breast Cancer Surgery. Randomized Clinical Trial.

NCT ID: NCT02366793

Last Updated: 2015-09-16

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 18 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2013-09-30
• Study Completion Date: 2014-06-30

Brief Summary

The potential consequences after breast cancer surgery are joint pain and sensitive disorders, the main sign of which is alterations in shoulder mobility. Global kinesitherapy has been shown to be effective at increasing shoulder range of motion restriction. However, literature does not consider specific manual therapy techniques, which means peripheral nerves and articular capsule have not been taken into account. These two tissues are potentially damaged structures during surgery and they are main responsible for shoulder range of motion restriction The main objective of this study is to pilot the effectiveness of accessory joint and nerve mobilization techniques in order to get an overview of the articular capsule and nerve dysfunctions involvement in shoulder motion restriction.

Detailed Description

Background: The potential consequences after breast cancer surgery are joint pain and sensitive disorders, the main sign of which is alterations in shoulder mobility. Design: Prospective randomized and double-blind pilot trial. Objective: To pilot the effectiveness of accessory joint and nerve mobilization techniques in order to get an overview of the joint capsule and nerve involvement in shoulder motion restriction. Participants: 18 women who were undergoing unilateral breast cancer surgery and axillary lymph node dissection. Setting: Women´s Health Research Group at Physical Therapy Department of University of Alcala, Madrid, Spain. Intervention: accessory joint mobilization versus neural mobilization. Follow-up: Six-month follow-up. Key outcomes: Range of motion, sensitive disorder, pain and upper limb functionality.

Conditions

Breast Cancer

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Accessory joint mobilization

Humeral head slides, anterior, posterior and caudal slides.

Group Type: EXPERIMENTAL

Accessory joint mobilization

Intervention Type: OTHER

Three kinds of humeral head slides: anterior, posterior and caudal slides. Subjects remained in supine position during the whole treatment. The techniques were applied in a rhythmical way, with 2 seconds of slide/traction and then a 2-second break. Each technique was carried out for 2 minutes.

Nerve mobilization

neural tissue longitudinal slide using the median neurodynamic test 1 (Butler).

Group Type: EXPERIMENTAL

Nerve mobilization

Intervention Type: OTHER

Neural tissue longitudinal slide using the median neurodynamic test 1 (MNT1) that was described by Butler. The proximal parameters (scapular depression, abduction and humeral external rotation) were introduced with maximum neural tension. On the other hand, the distal parameters (supination, elbow extension, wrist and fingers extension) received the remaining tension that the neural tissue allowed. The parameters were introduced sequentially in the order exposed

Interventions

Accessory joint mobilization

Three kinds of humeral head slides: anterior, posterior and caudal slides. Subjects remained in supine position during the whole treatment. The techniques were applied in a rhythmical way, with 2 seconds of slide/traction and then a 2-second break. Each technique was carried out for 2 minutes.

Intervention Type: OTHER

Nerve mobilization

Neural tissue longitudinal slide using the median neurodynamic test 1 (MNT1) that was described by Butler. The proximal parameters (scapular depression, abduction and humeral external rotation) were introduced with maximum neural tension. On the other hand, the distal parameters (supination, elbow extension, wrist and fingers extension) received the remaining tension that the neural tissue allowed. The parameters were introduced sequentially in the order exposed

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• unilateral breast cancer diagnosis
• breast cancer with axillary lymph node dissection
• be willing to sign the informed consent form

Exclusion Criteria

• bilateral breast cancer diagnosis
• loco-regional recurrence
• systemic disease
• had not undergone the axillary lymph node dissection approach
• to present any contraindication for Physical Therapy.

• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: Yes

Sponsors

University of Alcala

OTHER

Sponsor Role: lead

Responsible Party

IRENE DE LA ROSA DÍAZ

Irene de la Rosa Díaz

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

MARÍA TORRES-LACOMBA, DOCTOR

Role: STUDY_DIRECTOR

SUPERVISOR

Other Identifiers

UAlcala

Identifier Type: -

Identifier Source: org_study_id