De Groef An, Van Kampen Marijke, Verlvoesem Nele, Dieltjens Evi, Vos Lore, De Vrieze Tessa, Christiaens Marie-Rose, Neven Patrick, Geraerts Inge, Devoogdt Nele
Department of Rehabilitation Sciences; Department of Physical Medicine and Rehabilitation , University Hospitals Leuven, KU Leuven - University of Leuven, Herestraat 49, 3000, Leuven, Belgium.
Multidisciplinary Breast Center, University Hospitals Leuven, Leuven, Belgium.
Support Care Cancer. 2017 Jul;25(7):2119-2127. doi: 10.1007/s00520-017-3616-9. Epub 2017 Feb 14.
Besides pain, myofascial dysfunctions may contribute to the presence of upper limb impairments such as impaired range of motion, decreased strength, lymphedema, and altered postures and kinematics. Therefore, the aim of this study was to investigate the effect of myofascial therapy in addition to a standard physical therapy program for treatment of upper limb dysfunctions in breast cancer survivors.
Fifty women treated for a unilateral breast cancer with pain and myofascial dysfunctions at the upper limb region. The intervention group received 12 sessions of myofascial therapy consisting of release techniques on myofascial trigger points and adhesions in addition to a standard physical therapy program for 3 months. The control group received 12 sessions of a placebo intervention in addition to the same standard physical therapy program during the 3 months. Outcome parameters are active shoulder range of motion (inclinometer); arm lymphedema (perimeter); upper limb strength (handheld dynamometer); scapular statics and dynamics (acromion-table and pectoralis minor index, inclinometer); shoulder function (Disability of Shoulder, Arm and Hand questionnaire); and quality of life (Short Form 36). Measures were taken before and after the intervention at 6 and 12 months follow-up.
No differences between groups were found for all outcome parameters over the course of 1 year. However, overall beneficial effects of the standard physical therapy program for active shoulder range of motion and shoulder function were found in both groups up to 1 year follow-up.
Myofascial therapy has no additional beneficial effect for improvement of upper limb function in breast cancer survivors.
除疼痛外，肌筋膜功能障碍可能导致上肢功能障碍，如活动范围受限、力量下降、淋巴水肿以及姿势和运动学改变。因此，本研究的目的是调查在标准物理治疗方案基础上，肌筋膜治疗对乳腺癌幸存者上肢功能障碍的治疗效果。
五十名接受单侧乳腺癌治疗且上肢区域存在疼痛和肌筋膜功能障碍的女性。干预组除接受为期3个月的标准物理治疗方案外，还接受12次肌筋膜治疗，包括对肌筋膜触发点和粘连进行松解技术。对照组在3个月期间除接受相同的标准物理治疗方案外，还接受12次安慰剂干预。结果参数包括主动肩部活动范围（倾角计）；手臂淋巴水肿（周长）；上肢力量（手持测力计）；肩胛骨静态和动态（肩峰-桌面和胸小肌指数，倾角计）；肩部功能（肩、臂和手功能障碍问卷）；以及生活质量（简短健康调查问卷36项）。在干预前以及干预后6个月和12个月随访时进行测量。
在1年的时间里，两组在所有结果参数上均未发现差异。然而，在长达1年的随访中，两组均发现标准物理治疗方案对主动肩部活动范围和肩部功能具有总体有益效果。
肌筋膜治疗对改善乳腺癌幸存者的上肢功能没有额外的有益效果。
