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乳腺癌保乳手术并放疗后肌筋膜松解术的疗效:一项随机对照试验。

Effectiveness of myofascial release after breast cancer surgery in women undergoing conservative surgery and radiotherapy: a randomized controlled trial.

机构信息

Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street, 5, 46010, Valencia, Spain.

Medical Oncology Service, Hospital of Sagunto, Ramón y Cajal Avenue, 46520, Sagunto, Valencia, Spain.

出版信息

Support Care Cancer. 2019 Jul;27(7):2633-2641. doi: 10.1007/s00520-018-4544-z. Epub 2018 Nov 24.

Abstract

PURPOSE

The scars derived from the treatment of breast cancer lead to adverse effects such as fibrosis or retractions of the connective tissue. Myofascial release (MR) seeks to reduce restrictions of the fascial system. Therefore, the aim of this study was to analyze the clinical impact of MR treatment on women survivors of breast cancer.

METHODS

We enrolled 24 women with breast cancer, 13 received myofascial release treatment (MR) and 11, a placebo manual lymphatic drainage treatment (PMLD). Both interventions were administered over a period of 4 weeks. The outcomes studied were pain, shoulder range of motion (ROM), functionality, quality of life (QoL), and depression, immediately after treatment and 1 month later.

RESULTS

After 4 weeks of treatment, only the participants who received MR experienced a significant decrease in pain intensity in the short and midterm (p < 0.05). This therapy also achieved a general improvement in ROM (p < 0.05), except for internal rotation, that persisted 1 month after treatment. Regarding functionality, both therapies achieved the level of significance (p < 0.05), but only MRG sustained the improvement in the midterm. General QoL, assessed with FACT-B, and its physical well-being dimension were significantly improved after MR implementation (p < 0.05), while the emotional dimension and the breast cancer subscale improved only with PMLD (p < 0.05).

CONCLUSIONS

In conclusion, an MR-based treatment shows physical benefits (i.e., overall shoulder movement, functionality, and perceived pain) in women after breast cancer surgery.

TRIAL REGISTRATION

This study is registered on ClinicalTrials.gov NCT03182881.

摘要

目的

乳腺癌治疗导致的疤痕会导致不良后果,如纤维化或结缔组织收缩。筋膜松解术(MR)旨在减少筋膜系统的限制。因此,本研究旨在分析 MR 治疗对乳腺癌女性幸存者的临床影响。

方法

我们招募了 24 名乳腺癌女性患者,其中 13 名接受筋膜松解治疗(MR),11 名接受安慰剂手动淋巴引流治疗(PMLD)。两种干预措施均在 4 周内进行。研究的结果是疼痛、肩部活动范围(ROM)、功能、生活质量(QoL)和抑郁,在治疗后立即和 1 个月后进行评估。

结果

在 4 周的治疗后,只有接受 MR 的患者在短期和中期内经历了疼痛强度的显著下降(p<0.05)。这种治疗还实现了 ROM 的总体改善(p<0.05),除了内部旋转,在治疗后 1 个月仍持续。关于功能,两种治疗都达到了显著水平(p<0.05),但只有 MRG 在中期保持了改善。使用 FACT-B 评估的一般 QoL 及其身体幸福感维度在实施 MR 后显著改善(p<0.05),而情绪维度和乳腺癌子量表仅在接受 PMLD 后改善(p<0.05)。

结论

总之,基于 MR 的治疗在乳腺癌手术后的女性中显示出身体上的益处(即,整体肩部运动、功能和感知疼痛)。

试验注册

本研究在 ClinicalTrials.gov 注册,编号为 NCT03182881。

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