European Journal of Physical and Rehabilitation Medicine 2020 May 14

DOI: 10.23736/S1973-9087.20.06138-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

The recovery of reaching movement in breast cancer survivors: two different rehabilitative protocols in comparison

Teresa PAOLUCCI ¹, Andrea BERNETTI ², Arianna V. BAI ², Serena V. CAPOBIANCO ², Adriana BONIFACINO ³, Giuseppe MAGGI ⁴, Giovanni IPPOLITONI ⁴, Laura TINELLI ⁴, Valter SANTILLI ², Francesco AGOSTINI ² ✉, Marco PAOLONI ², Massimiliano MANGONE ²

¹ Department of Medical, Oral and Biotechnological Sciences, G. D’Annunzio University of Chieti-Pescara, Chieti, Italy; ² Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy; ³ Breast Diagnosis and Treatment Unit, Sant’Andrea Hospital, Rome Italy; ⁴ University Hospital Umberto I of Rome, Rome, Italy

BACKGROUND: Breast-cancer (BC) is the most common cancer in women in the developed world. The about the sequelae of surgery, especially in case of mastectomy or modified radical mastectomy is grown. Nowadays it’s important choose appropriate exercise-programs to allow recovery in "quantity" but also in "quality" "of the movement of the operated upper-limb.
AIM: The aim of this study was to verify whether specific exercises for the scapula may induce changes in fluidity of the reaching movement.
DESIGN: Randomized control-trial double-blind study.
SETTING: Exercise training laboratory and Gait Analysis laboratory.
POPULATION: Sixty-three breast cancer survivors were enrolled.
METHODS: Participants randomized to Single Rehabilitative Treatment (ST), or to Group Rehabilitative Treatment (GT). VAS, DASH and a biomechanical-evaluation of upper limb were performed for each group before treatment (T0=baseline), at the end rehabilitative treatment (T1) and after three months of follow-up (T2).
RESULTS: Respect within group analysis, in the ST and in the GT, for VAS an improvement along evaluation times were observed, respectively at T0 to T1 and at T0 to T2 (p<0,001) without a statistically significant difference between groups. At the same, for the DASH, the results showed the same trend without a statistically significant difference between groups. For biomechanics parameters, at T2 velocity was statistically significantly greater in the ST than in the GT (p=0.029) in contrast with the duration, that was statistically significantly greater in the GT than in the ST (p=0.010).
CONCLUSIONS: Both protocols are effective in reducing pain and for functional recovery of the upperlimb. The adoption of a non-intensive rehabilitation program should be implemented at least in the first year after the operation, with the adoption of specific myofascial exercises on the scapulothoracic joint with better results in the "qualitative" recovery of the achievement.
CLINICAL REHABILITATION IMPACT: Our study emphasizes the importance of rehabilitation in BC survivors after mastectomy, even during the course of radiotherapy and chemotherapy and the adoption of specific myofascial exercises on the scapulo-thoracic joint and specific exercises of muscular stretching on the pectoral muscle. Therefore, the proposed rehabilitation protocol must be "clipped" and "integrated" according to the specific objectives for each individual patient.

KEY WORDS: Breast cancer survivors; Rehabilitation; Gait analysis; Normalized jerk