Effect of Graded Motor Imagery on Shoulder Dysfunction Post Mastectomy

NCT ID: NCT07240129

Last Updated: 2025-11-20

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 54 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-04-30
• Study Completion Date: 2026-04-30

Brief Summary

One of the most common complications after breast cancer surgery is a functional limitation of the upper body. Up to 67% of breast cancer patients experience arm or shoulder impairment, including pain, numbness, loss of strength, and reduced ROM, after surgery.

Graded motor imagery is effective in reducing pain interference with function using a graded sequence of strategies including left/right judgements (implicit motor imagery), imagined movements (explicit motor imagery) and mirror therapy.

Detailed Description

54 female patients who have shoulder dysfunction post-mastectomy will participate in this study. Their ages will be ranged 35 to 55 years.

In this study the patients will be randomly assigned into two equal groups (27 patients for each group):

1. Group A (study group):

This group includes 27 patients who will receive graded motor imagery (GMI) along with the conventional physiotherapy (It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises). GMI is consists of a three-step process. Each step of will be carried out for two weeks, for 30 minutes on two separate days, for total 6 weeks.

2. Group B (control group):

This group includes 27 patients who will receive conventional physiotherapy treatment for improving ROM and decreasing pain. It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises, 2 times / week for 6 weeks.

Conditions

Shoulder Dysfunction

Study Design

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

Study Groups

Group A (study group)

This group includes 27 patients who will receive graded motor imagery (GMI) along with the conventional physiotherapy (It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises). GMI is consists of a three-step process. Each step of will be carried out for two weeks, for 30 minutes on two separate days, for total 6 weeks

Group Type: ACTIVE_COMPARATOR

Graded Motor Imagery (GMI)

Intervention Type: OTHER

1. Left/right judgements:

It includes left/right judgments of photographs that depict the affected area.

2. Imagined movements:

Movement visualizations will be performed.

3. Mirror therapy:

It includes observation of the movements of unaffected body part in the mirror, 2 times / week for 6 weeks.

Physical therapy program

Intervention Type: OTHER

It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises, 2 times / week for 6 weeks.

Group B (control group)

This group includes 27 patients who will receive conventional physiotherapy treatment for improving ROM and decreasing pain. It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises, 2 times / week for 6 weeks

Group Type: PLACEBO_COMPARATOR

Physical therapy program

Intervention Type: OTHER

It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises, 2 times / week for 6 weeks.

Interventions

Graded Motor Imagery (GMI)

1. Left/right judgements:

It includes left/right judgments of photographs that depict the affected area.

2. Imagined movements:

Movement visualizations will be performed.

3. Mirror therapy:

It includes observation of the movements of unaffected body part in the mirror, 2 times / week for 6 weeks.

Intervention Type: OTHER

Physical therapy program

It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises, 2 times / week for 6 weeks.

Intervention Type: OTHER

Other Intervention Names

A group of exercises

Eligibility Criteria

Inclusion Criteria

• Age range of 35 to 55 years.
• All patients are post-mastectomized unilaterally.
• Female patients only.
• Patients have shoulder ROM restriction.
• Patients have shoulder pain more than 3 months (chronic).
• After 3 months post-surgery.

Exclusion Criteria

• Having double mastectomy.
• Psychopathological disorders.
• Having other orthopedic problems (e.g. tendinitis, dislocation, osteoarthritis, referred pain to shoulder).
• Motor problems (e.g. tremor, dyskinesia).
• Metastasis.
• Visual impairment such that they could not read unaided or with their reading glasses.
• Having previously received GMI treatment.
• Diabetes mellitus.
• Having neurological problems as hemiplegia.
• Patients with lymphedema

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

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Asmaa Abdallah Mohamed

Assistant lecturer

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Asmaa Abdallah, PhD

Role: PRINCIPAL_INVESTIGATOR

Teaching assistant of physical therapy for surgery, cairo university, egypt

Locations

Cairo University

Giza, , Egypt

Countries

Egypt

Other Identifiers

P.T.REC/012/005749

Identifier Type: -

Identifier Source: org_study_id