Impact of Proximal Motor Control Exercise on Scapular Muscles Activation Pattern Post Mastectomy

NCT ID: NCT07103109

Last Updated: 2026-02-11

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-08-05
• Study Completion Date: 2026-08-10

Brief Summary

Mastectomy after breast cancer is usually accompanied by shoulder dysfunction which interferes with the daily life activities of the patients and causes physical and psychological impairments.

This study aims to assess the impact of strength and stabilization exercise on scapular muscles activation pattern after mastectomy.

Detailed Description

A total of 80 patients (n=40 per group), aged 35-55 years, diagnosed with shoulder dysfunction post mastectomy will be recruited for this study. Participants will be recruited from Baheya Hospital and National Cancer Institute. Participants will be screened for eligibility prior to being enrolled in the study participating in the study assessments.

Conditions

Post Mastectomy

Study Design

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

Study Groups

study group

Group Type: EXPERIMENTAL

Proximal stabilization exercises

Intervention Type: OTHER

Patients will receive Scapular mobilization in five manners, superior glide, inferior glide, up-ward rotation, down-ward rotation, and distraction. Each mobilization will be done ten times. A thirty second break will be given between each set. Also scapular strengthening exercises composed of diagonal two (D2) flexion pattern to augment the upper, middle, lower, and serratus anterior muscles' activity level. To activate upper trapezius muscle, shoulder shrug exercise will be used. To activate serratus anterior muscle, Wall slide exercise will be used. Scapular retraction exercise for rhomboids and middle trapezius activation will be done. Strengthening exercises will be performed using weights were initiated with two sets of ten repetitions, beginning with a weight of 0.5 kg and progressed to 0.75, and1kg, it will be applied 5 days per week for 6 weeks

Conventional physical therapy

Intervention Type: OTHER

Patients will receive shoulder joint mobilization, posterior capsular stretching, and ROM exercises in form of Codman/pendulum exercise. To mobilize the shoulder joint, distraction of the glenohumeral joint, posterior glide and caudal glide will be performed to the patients in a supine lying position at a frequency of two to three oscillations/second for one to two minutes. Every direction was repeated three to four times. At the resting position rhythmic oscillations grade I and II will be applied. In posterior capsule stretching each stretch will be repeated ten times for 20 seconds, between each stretching a 30-second break will be given. Pendulum exercise will be demonstrated to the patient at first, then they will performed it in the forward-backward direction, side-to-side direction, and circular pattern, for two to three minutes in each direction, it will be applied 5 days per week for 6 weeks

control

Group Type: ACTIVE_COMPARATOR

Conventional physical therapy

Intervention Type: OTHER

Patients will receive shoulder joint mobilization, posterior capsular stretching, and ROM exercises in form of Codman/pendulum exercise. To mobilize the shoulder joint, distraction of the glenohumeral joint, posterior glide and caudal glide will be performed to the patients in a supine lying position at a frequency of two to three oscillations/second for one to two minutes. Every direction was repeated three to four times. At the resting position rhythmic oscillations grade I and II will be applied. In posterior capsule stretching each stretch will be repeated ten times for 20 seconds, between each stretching a 30-second break will be given. Pendulum exercise will be demonstrated to the patient at first, then they will performed it in the forward-backward direction, side-to-side direction, and circular pattern, for two to three minutes in each direction, it will be applied 5 days per week for 6 weeks

Interventions

Proximal stabilization exercises

Patients will receive Scapular mobilization in five manners, superior glide, inferior glide, up-ward rotation, down-ward rotation, and distraction. Each mobilization will be done ten times. A thirty second break will be given between each set. Also scapular strengthening exercises composed of diagonal two (D2) flexion pattern to augment the upper, middle, lower, and serratus anterior muscles' activity level. To activate upper trapezius muscle, shoulder shrug exercise will be used. To activate serratus anterior muscle, Wall slide exercise will be used. Scapular retraction exercise for rhomboids and middle trapezius activation will be done. Strengthening exercises will be performed using weights were initiated with two sets of ten repetitions, beginning with a weight of 0.5 kg and progressed to 0.75, and1kg, it will be applied 5 days per week for 6 weeks

Intervention Type: OTHER

Conventional physical therapy

Patients will receive shoulder joint mobilization, posterior capsular stretching, and ROM exercises in form of Codman/pendulum exercise. To mobilize the shoulder joint, distraction of the glenohumeral joint, posterior glide and caudal glide will be performed to the patients in a supine lying position at a frequency of two to three oscillations/second for one to two minutes. Every direction was repeated three to four times. At the resting position rhythmic oscillations grade I and II will be applied. In posterior capsule stretching each stretch will be repeated ten times for 20 seconds, between each stretching a 30-second break will be given. Pendulum exercise will be demonstrated to the patient at first, then they will performed it in the forward-backward direction, side-to-side direction, and circular pattern, for two to three minutes in each direction, it will be applied 5 days per week for 6 weeks

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

1. Post-mastectomy female subjects.

2. Age between 35-55 years.

3. All patients have shoulder dysfunction (three months to four months post mastectomy).

Exclusion Criteria

1. Participants who have rheumatoid arthritis.

2. History of trauma or injuries.

3. Neurological deficits (stroke, Parkinsonism).

4. History of surgery on involved shoulder.

5. Diabetic patient.

6. Patients who rejected to participate in the trial, or to summit the formal consent form.

• Minimum Eligible Age: 35 Years
• Maximum Eligible Age: 55 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: No

Sponsors

Benha University

OTHER

Sponsor Role: collaborator

Ahram Canadian University

OTHER

Sponsor Role: lead

Responsible Party

Mahmoud H Mohamed, PhD

Associate Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Mohamed Naeem, Ph.D

Role: STUDY_DIRECTOR

Faculty of Physical Therapy, Beni Sueif university

Locations

Out patient clinic , faculty of Physical Therapy, Ahram Canadian university

Giza, Giza Governorate, Egypt

Site Status: RECRUITING

Out patient clinic , faculty of Physical Therapy, Benha university

Banhā, Qualiobia, Egypt

Site Status: SUSPENDED

Out patient clinic , faculty of Physical Therapy, Beni Sueif university

Banī Suwayf, , Egypt

Site Status: SUSPENDED

Countries

Egypt

Central Contacts

Mahmoud Mohamed, Ph.D

Role: CONTACT

mahmoud.mohamed@fpt.bu.edu.eg

01111750888

Facility Contacts

Mahmoud Hamada Mohamed, egypt, Physical.D

Role: primary

+201111750888

Other Identifiers

Scapular Ms -Mastectomy 2025

Identifier Type: -

Identifier Source: org_study_id