Effect of Core strengthening along with Conventional Physiotherapy on Spinal Dysfunction in post operative modified Radical Mastectomy patients
DOI:
https://doi.org/10.52783/jns.v14.1912Keywords:
Core strengthening, Conventional Physiotherapy, Spinal Dysfunction, Modified Radical Mastectomy.Abstract
Background: Modified Radical Mastectomy is a prevalent surgical intervention for breast cancer, involving the removal of breast tissue and lymph nodes while preserving chest muscles. Subjects often experience post-operative complications, including spinal dysfunction, chronic pain, and reduced mobility. These complications can lead to significant functional restrictions and postural alterations. Exercises are key component of treatment, can mitigate these adverse effects by enhancing spinal stability, alleviating chronic pain, and improving functional capacity. There role in enhancing movement and minimising disability needs to be evaluated
Method: A total of 100 participants were enrolled in this study and randomly assigned to one of two groups: Group A (experimental group) and Group B (control group). Participants in Group A received a comprehensive exercise program consisting of core strengthening exercises in addition to conventional exercises, while those in Group B received conventional exercises only. A range of outcome measures were assessed at pre-test and post-test, including: Numerical Pain Rating Scale ,Spinal Range of Motion, Spinal Manual Muscle Testing ,Functional Rating Index, Spinal Static and Dynamic Stability Test , Postural Assessment.
Result: The results of this study demonstrated significant improvements. Specifically, Group A exhibited: Reduced pain intensity (2.87 ± 0.65 vs 3.10 ± 0.82), Improved Manual Muscle Testing scores (4.56 ± 1.05 vs 4.14 ± 1.03), Enhanced Functional Rating Index scores (38.6 ± 4.2 vs 51.4 ± 14.1), Significant improvements in spinal mobility and postural alignment were observed in Group A compared to Group B.Enhanced spinal static (35.6 ± 4.2 vs 26.3 ± 4.9) and dynamic (60.1 ± 7.2 vs 42.6 ± 7.5) stability test.
Conclusion: The integration of core strengthening exercises into conventional therapy yields significant improvements in spinal function and quality of life following modified radical mastectomy.
Downloads
Metrics
References
Mangone M, Bernetti A, Agostini F, Paoloni M, De Cicco FA, Capobianco SV, Bai AV, Bonifacino A, Santilli V, Paolucci T. Changes in spine alignment and postural balance after breast cancer surgery: a rehabilitative point of view. BioResearch open access. 2019 Jul 1;8(1):121-8.
Sariego J. Breast cancer in the young patient. The American surgeon. 2010 Dec;76(12):1397-400.
Hoe AL, Iven D, Royle GT, Taylor I. Incidence of arm swelling following axillary clearance for breast cancer. British journal of surgery. 1992 Mar;79(3):261-2.
Pisani P, Parkin DM, Bray F, Ferlay J. Estimates of the worldwide mortality from 25 cancers in 1990. International journal of cancer. 1999 Sep 24;83(1):18-29.
Schwartz SI, Brunicardi FC, editors. Schwartz's principles of surgery. McGraw Hill Professional; 2010.
Del Bianco P, Zavagno G, Burelli P, Scalco G, Barutta L, Carraro P, Pietrarota P, Meneghini G, Morbin T, Tacchetti G, Pecoraro P. Morbidity comparison of sentinel lymph node biopsy versus conventional axillary lymph node dissection for breast cancer patients: results of the sentinella–GIVOM Italian randomised clinical trial. European Journal of Surgical Oncology (EJSO). 2008 May 1;34(5):508-13.
Cherny NI, Truong PT. Chapter 79: Brachial plexopathy in patients with breast cancer. Harris JR, Lippman ME, Morrow M, Osborne CK. Diseases of the Breast, 5th edition. Lippincott Williams and Wilkins. 2014.
Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesthesia & Analgesia. 2003 Aug 1;97(2):534-40.
Stubblefield MD, Custodio CM. Upper-extremity pain disorders in breast cancer. Archives of physical medicine and rehabilitation. 2006 Mar 1;87(3):96-9
Lopera-Muñeton C, Valencia-Legarda F, Bedoya-Bedoya OM, Correa-Castaño D, Páramo-Velásquez CA. Body posture and biomechanics in women after mastectomy. InJournal of Physics: Conference Series 2019 Dec 1 (Vol. 1418, No. 1, p. 012009). IOP Publishing.
Ryan SD, Fried LP. The impact of kyphosis on daily functioning. Journal of the American Geriatrics Society. 1997 Dec;45(12):1479-86.
Malicka I, Hanuszkiewicz J, Stefańska M, Barczyk K, Woźniewski M. Relation between trunk muscle activity and posture type in women following treatment for breast cancer. Journal of Back and Musculoskeletal Rehabilitation. 2010 Jan 1;23(1):11-9.
George BA, Shinde SB. Effect of activity specific spinal stabilization exercises on pain and spinal mobility in lumbar spondylosis. Int J Health Sci Res. 2019;9:174-82.
Comerford MJ, Mottram SL. Movement and stability dysfunction–contemporary developments. Manual therapy. 2001 Feb 1;6(1):15-26.
Serel S, Tuzlalı ZY, Akkaya Z, Uzun Ç, Kaya B, Bayar S. Physical effects of unilateral mastectomy on spine deformity. Clinical breast cancer. 2017 Feb 1;17(1):29-33.
Rostkowska E, Bak M, Samborski W. Body posture in women after mastectomy and its changes as a result of rehabilitation. Adv Med Sci. 2006 Jan 1;51(2):287-97.
Kim MS, Cha YJ, Choi JD. Correlation between forward head posture, respiratory functions, and respiratory accessory muscles in young adults. Journal of back and musculoskeletal rehabilitation. 2017 Jan 1;30(4):711-5.
Akuthota V, Nadler SF. Core strengthening. Archives of physical medicine and rehabilitation. 2004 Mar 1;85:86-92.
Smrcina Z, Woelfel S, Burcal C. A systematic review of the effectiveness of core stability exercises in patients with non-specific low back pain. International journal of sports physical therapy. 2022;17(5):766.
Mehta JN, Vaghela NP, Patel H. The effect of physiotherapy in patients with modified radical mastectomy. National Journal of Physiology, Pharmacy and Pharmacology. 2018;8(2):163-6.
Angin S, Karadibak D, Yavuzşen T, Demirbüken İ. Unilateral upper extremity lymphedema deteriorates the postural stability in breast cancer survivors. Contemporary Oncology/Współczesna Onkologia. 2014 Jul 22;18(4):279-84.
Babasaheb SS, Rajesh KK, Yeshwant KS, Patil S. Analysis of spinal dysfunction in breast cancer survivors with lymphedema. Asian Pacific Journal of Cancer Prevention: APJCP. 2021 Jun;22(6):1869.
Shamley D, Lascurain-Aguirrebeña I, Oskrochi R, Srinaganathan R. Shoulder morbidity after treatment for breast cancer is bilateral and greater after mastectomy. Acta Oncologica. 2012 Nov 1;51(8):1045-53.
Hojan K, Manikowska F, Chen BP, Lin CC. The influence of an external breast prosthesis on the posture of women after mastectomy. Journal of Back and Musculoskeletal Rehabilitation. 2016 Jan 1;29(2):337-42.
Malicka I, Hanuszkiewicz J, Stefańska M, Barczyk K, Woźniewski M 2011 Relation between trunk muscle activity and posture type in women following treatment for breast cancer Journal of Back and Musculoskeletal Rehabilitation 23(1) 11
Malicka I, Barczyk K, Hanuszkiewicz J, Skolimowska B, Woźniewski M. Body posture of women after breast cancer treatment. Ortopedia Traumatologia Rehabilitacja. 2010 Aug 31;12(4):353-61.
Malicka I, Barczyk K, Hanuszkiewicz J, Skolimowska B, Wozniewski M, et al. (2010) Body posture of women after breast cancer treatment. Ortop Traumatol Rehabil 12:353-361.
Crosbie J, Kilbreath SL, Dylke E, Refshauge KM, Nicholson LL, Beith JM, Spillane AJ, White K. Effects of mastectomy on shoulder and spinal kinematics during bilateral upper-limb movement. Physical therapy. 2010 May 1;90(5):679-92.
Shamley D, Lascurain-Aguirrebeña I, Oskrochi R, Srinaganathan R. Shoulder morbidity after treatment for breast cancer is bilateral and greater after mastectomy. Acta Oncologica. 2012 Nov 1;51(8):1045-53.
Rangel J, Perez C, Oliveira R, Guirro E. Effects of breast cancer treatment on posture: a current review. Int. J. Phys. Ther. Rehabil. 2019 Jun;5:152.
Brumitt J, Heiderscheit BC, Manske RC, Niemuth P, Mattocks A, Rauh MJ. The lower-extremity functional test and lower-quadrant injury in NCAA division III athletes: a descriptive and epidemiologic report. Journal of sport rehabilitation. 2016 Aug 1;25(3):219-26.
Mohammad Ali Nasab Firouzjah E, Daneshmandi H, Norasteh AA. Effect of Core Stability Training on the Endurance and Strength of Core in Basketball Players with Trunk Dysfunction. Journal of Rehabilitation Sciences & Research. 2020 Jun 1;7(2):80-6.
Abdallah AA, Beltagi AA. Effect of core stability exercises on trunk muscle balance in healthy adult individuals. International Conference on Human Biomechanics. 2014;8(5):243-9.
Kahle NL, Gribble PA. Core stability training in dynamic balance testing among young, healthy adults. Athletic Training & Sports Health Care. 2009 Mar 1;1(2):65-73.
Mohite PP, Kanase SB. Effectiveness of scapular strengthening exercises on shoulder dysfunction for pain and functional disability after modified radical mastectomy: A controlled clinical trial. Asian Pacific Journal of Cancer Prevention: APJCP. 2023;24(6):2099.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
