1 Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium.
2 Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium.
Clin Rehabil. 2017 Dec;31(12):1625-1635. doi: 10.1177/0269215517708605. Epub 2017 May 19.
To investigate the effects of myofascial techniques, in addition to a standard physical therapy programme for upper limb pain shortly after breast cancer surgery.
Double-blinded (patient and assessor) randomized controlled trial with two groups.
University Hospitals Leuven, Belgium Patients: A total of 147 patients with unilateral axillary clearance for breast cancer.
All participants received a standard physical therapy programme starting immediately after surgery for four months. The intervention group received additionally eight sessions of myofascial therapy from two up to four months after surgery. The control group received eight sessions of a placebo intervention, including static hand placements at the upper body region.
The primary outcome was prevalence rate of upper limb pain. Additionally, pain intensity (Visual Analogue Scale (VAS, 0-100)), pressure hypersensitivity (pressure pain thresholds (PPTs; kg/cm)) and pain quality (McGill Pain Questionnaire) were evaluated. All measurements were performed at 2 (=baseline), 4, 9 and 12 months post-surgery.
At 4, 9 and 12 months post-surgery, prevalence rates of pain, pain intensity and pain quality were comparable between the intervention and control group. PPT of the upper trapezius muscle was significantly higher in the intervention group at four months with a difference of -1.2 (-1.9 to -0.4) kg/cm, P = 0.012). PPT of the supraspinatus muscle was significantly higher in the intervention group at four months (-0.7 (-1.4 to -0.1) kg/cm, P = 0.021) and at nine months (-0.5 (-1.1 to 0.0), P = 0.040).
Myofascial therapy has no added beneficial effect as standard physical therapy modality in the postoperative stage.
研究肌筋膜技术对乳腺癌手术后上肢疼痛的影响，该技术联合标准物理治疗方案使用。
双盲（患者和评估者）随机对照试验，两组患者。
比利时鲁汶大学医院。
共 147 例单侧腋窝清扫的乳腺癌患者。
所有参与者在手术后立即开始接受为期四个月的标准物理治疗方案。干预组在手术后两到四个月期间接受另外八次肌筋膜治疗。对照组接受八次安慰剂干预，包括在上身区域的静态手部放置。
主要结局是上肢疼痛的患病率。此外，评估疼痛强度（视觉模拟评分（VAS，0-100））、压力敏感性（压力疼痛阈值（PPT；kg/cm））和疼痛质量（麦吉尔疼痛问卷）。所有测量均在手术后 2 个月（基线）、4 个月、9 个月和 12 个月进行。
在手术后 4、9 和 12 个月时，干预组和对照组的疼痛、疼痛强度和疼痛质量的患病率相似。在四个月时，干预组的斜方肌上部 PPT 明显较高，差异为-1.2（-1.9 至-0.4）kg/cm，P=0.012）。在四个月时，干预组的冈上肌 PPT 明显较高（-0.7（-1.4 至-0.1）kg/cm，P=0.021）和在九个月时（-0.5（-1.1 至 0.0）kg/cm，P=0.040）。
在术后阶段，肌筋膜疗法作为标准物理治疗方法没有额外的有益效果。
