Motor Control Retraining Exercises on Shoulder Dysfunction Post Mastectomy

NCT ID: NCT07002983

Last Updated: 2025-06-04

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-05-05
• Study Completion Date: 2026-05-05

Brief Summary

Motor control and strengthening exercises can improve function in shoulder impingement patients by realigning the scapula and changing muscle recruitment patterns. Peripheral musculoskeletal impairments can be associated with cortical reorganisation. Movement retraining using the principles of motor control retrain muscle recruitment patterns and improve scapular kinematics, reducing subacromial impingement, thus improving function and reducing pain.

Furthermore, the need of this study is developed from the lack in the quantitative knowledge and information in the published studies about the effect of motor control retraining exercises on shoulder dysfunction post-mastectomy.

Detailed Description

sixty patients suffering from post-mastectomy shoulder dysfunction will participate in this study. Their ages will range from 40 to 55 years. The participants will be selected from Cairo university hospitals.

Design of the study:

In this randomised controlled trial study (RCT), the patients will be randomly assigned into two equal groups (30 patients for each group):

Group A (study group):

This group will include 30 patients with post mastectomy shoulder dysfunction who will receive motor control retraining exercises in addition to their conventional physical therapy program, three sessions per week for 8 weeks, for 45:60 minutes according to patient's ability.

Group B (control group):

This group will include 30 patients with post mastectomy shoulder dysfunction who will receive conventional physical therapy program in the form of shoulder joint mobilization, posterior capsule stretching and shoulder range of motion exercise (ROM) (Codman's pendulum exercises) for 30 minutes according to patient's ability, three sessions per week for 8 weeks.

Measurement equipment:

• Hand-held dynamometer: for measurement of muscle strength.
• Digital inclinometer: for measurement of shoulder flexion, abduction and scapular upward rotation.
• Shoulder Pain and Disability Index (SPADI): for measurement of shoulder disability.

Therapeutic procedures:

• Motor control retraining exercises of the scapular musculature.

Motor control retraining exercises:

The motor control retraining package was targeted at correcting movement impairments of the scapula by re-educating muscle recruitment. There were two components to the package:

1. Motor control exercises to correct alignment and coordination, which involve a) learning optimal scapular orientation at rest and then controlling optimal orientation during active arm movements; b) muscle specific exercises for trapezius and serratus anterior

2. Manual therapy techniques commonly used in clinical practice to manage symptoms, as trigger point therapy and pectoralis minor supine manual stretch will be performed as necessary.

• Traditional physical therapy.

Conditions

Post Mastectomy

Study Design

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

Study Groups

study group (motor control retraining group)

This group will include 30 patients with post mastectomy shoulder dysfunction who will receive motor control retraining exercises in addition to their conventional physical therapy program, three sessions per week for 8 weeks, for 45:60 minutes according to patient's ability

Group Type: ACTIVE_COMPARATOR

motor control retraining exercises

Intervention Type: OTHER

The motor control retraining package was targeted at correcting movement impairments of the scapula by re-educating muscle recruitment. There were two components to the package:

1. Motor control exercises to correct alignment and coordination, which involve a) learning optimal scapular orientation at rest and then controlling optimal orientation during active arm movements; b) muscle specific exercises for trapezius and serratus anterior

2. Manual therapy techniques commonly used in clinical practice to manage symptoms, as trigger point therapy and pectoralis minor supine manual stretch will be performed as necessary.

traditional physical therapy for shoulder dysfunction

Intervention Type: OTHER

shoulder joint mobilization, posterior capsule stretching and shoulder range of motion exercise (ROM) (Codman's pendulum exercises)

control group ( conventional treatment group)

This group will include 30 patients with post mastectomy shoulder dysfunction who will receive conventional physical therapy program in the form of shoulder joint mobilization, posterior capsule stretching and shoulder range of motion exercise (ROM) (Codman's pendulum exercises) for 30 minutes according to patient's ability, three sessions per week for 8 weeks

Group Type: PLACEBO_COMPARATOR

traditional physical therapy for shoulder dysfunction

Intervention Type: OTHER

shoulder joint mobilization, posterior capsule stretching and shoulder range of motion exercise (ROM) (Codman's pendulum exercises)

Interventions

motor control retraining exercises

The motor control retraining package was targeted at correcting movement impairments of the scapula by re-educating muscle recruitment. There were two components to the package:

1. Motor control exercises to correct alignment and coordination, which involve a) learning optimal scapular orientation at rest and then controlling optimal orientation during active arm movements; b) muscle specific exercises for trapezius and serratus anterior

2. Manual therapy techniques commonly used in clinical practice to manage symptoms, as trigger point therapy and pectoralis minor supine manual stretch will be performed as necessary.

Intervention Type: OTHER

traditional physical therapy for shoulder dysfunction

shoulder joint mobilization, posterior capsule stretching and shoulder range of motion exercise (ROM) (Codman's pendulum exercises)

Intervention Type: OTHER

Other Intervention Names

conventional treatment

Eligibility Criteria

Inclusion Criteria

• The subject selection will be according to the following criteria:

• Female patients with age range between 40-55 years.
• All patients have shoulder dysfunction.
• Patients were 2 months to 4 months post modified radical mastectomy or axillary lymph node dissection.
• Patients received their radiotherapy or chemotherapy or both.

Exclusion Criteria

• The potential participants will be excluded if they meet one of the following criteria:

• Rheumatoid arthritis.
• History of trauma or accidental injuries.
• Neurological involvement (stroke, Parkinsonism).
• History of surgery on involved shoulder.
• Diabetic patient.
• Moderate and severe lymphoedema.

• Minimum Eligible Age: 40 Years
• Maximum Eligible Age: 55 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: No

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Esraa Tarek Mohamed Hashem

assistant lecturer

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Esraa Tarek, PhD

Role: PRINCIPAL_INVESTIGATOR

Teaching assistant physical therapy for surgery cairo university

Locations

Cairo University

Giza, , Egypt

Site Status: RECRUITING

Countries

Egypt

Central Contacts

Esraa Tarek, PhD

Role: CONTACT

esraatarek94@gmail.com

01150176783

Facility Contacts

Esraa Tarek, PhD

Role: primary

esraatarek94@gmail.com

01150176783

Provided Documents

Document Type: Study Protocol

View Document

Other Identifiers

P.T.REC/012/005751

Identifier Type: -

Identifier Source: org_study_id