Abstract PD4-04: Effectiveness of myofascial techniques in addition to a standard physical therapy program as postoperative intervention for upper limb pain in breast cancer patients: A randomized controlled trial
Notice bibliographique
Résumé
Abstract Background: In addition to fatigue, pain is the most frequent and persistent symptom following cancer and cancer treatment. Despite the effectiveness of several postoperative physical therapy modalities, many patients after breast cancer still have pain at the upper limb region at short and long term. Several authors already recommended the use of myofascial therapy. Therefore, the aim of this study was to investigate short and long term effects of myofascial therapy, in addition to a standard physical therapy program, as postoperative intervention for upper limb pain after breast cancer surgery. Methods: Randomized controlled trial with assessor and patient blinding and intention-to-treat analysis. One hundred forty-seven consecutive patients with breast cancer and unilateral axillary surgery were included. All participants received a standard physical therapy program starting immediately after surgery during 4 months. The intervention group received additionally 8 sessions of myofascial therapy on weekly basis from 2 up to 4 months after surgery. The control group received 8 sessions of a placebo intervention in addition to the same standard physical therapy program. Primary outcomes were prevalence rate of pain (i.e. pain at the operated upper limb region during the past week), maximal pain intensity at this region (Visual Analogue Scale (VAS) (0-100)), pressure hypersensitivity (pressure pain thresholds (kg/cm2) (PPT)) and pain quality (McGill Pain Questionnaire). All measurements were performed at 2 (=baseline), 4, 9 and 12 months post-surgery. Analysis of covariance (ANCOVA) were performed to correct for differences at baseline (i.e. 2 months after surgery). Additionally, effect size is given by means of relative risk reduction (RRR) and mean differences and their 95% confidence interval. Results: Both groups were comparable at baseline. At 4, 9 and 12 months post-surgery, prevalence rates of pain were comparable between the intervention and control group (40%, 53%, 49% versus 41%, 47%, 51%, p=1.000, p=0.508 and p=0.868 and RRR of 3.2% (-0.44 - 0.35), -13% (-0.57 - 0.18) and 2.7% (-0.35 - 0.30), respectively). Pain intensity was comparable between the intervention group and control group as well. PPT of the Upper Trapezius muscle was significantly higher in the intervention group at 4 months (4.86 (2.43) versus 3.69 (2.04) kg/cm2, p=0.012; mean difference -1.2 (-1.9 – 0.4) kg/cm2). PPT of the Supraspinatus muscle was significantly higher in the intervention group at 4 months (4.54 (2.1) versus 3.8 (1.85) kg/cm2, p=0.021; mean difference -0.7 (-1.4 – 0.1) kg/cm2) and at 9 months (3.92 (1.7) versus 3.39 (1.61) kg/cm2, p=0.040; mean difference -0.5 (-1.1 – 0.0) kg/cm2). No significant differences in pain quality were found between groups. Conclusion: Myofascial therapy, in addition to a standard physical therapy program, has beneficial effect as postoperative intervention for pressure hypersensitivity of upper limb muscles after breast cancer surgery. No beneficial effect on pain prevalence rate, pain intensity and pain quality was found. Citation Format: De Groef A, Van Kampen M, Vervloesem N, De Geyter S, Christiaens M-R, Neven P, Geraerts I, Devoogdt N. Effectiveness of myofascial techniques in addition to a standard physical therapy program as postoperative intervention for upper limb pain in breast cancer patients: A randomized controlled trial [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr PD4-04.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,007 | 0,004 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,004 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,013 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».