Myofascial Massage for Pain and Immobility Following Breast Cancer Surgery
- Conditions
- Mastectomy; LymphedemaMobility LimitationPain, ShoulderBreast Cancer
- Interventions
- Other: Myofascial MassageOther: Light Touch
- Registration Number
- NCT04233385
- Lead Sponsor
- MetroHealth Medical Center
- Brief Summary
About 25-50% of women who undergo breast cancer surgery develop persistent chest wall pain and shoulder mobility limitations following surgery. The pain and mobility limitations adversely affect quality of life, sleep, and body image. Unfortunately, current treatments for pain and mobility limitations have variable efficacy. Based on a review of relevant pre-, intra-, and post-operative factors, investigators reasoned that myofascial massage may address contributors to pain and mobility limitations following breast cancer surgery. Investigators propose a randomized controlled trial looking at myofascial massage compared to a light touch group to look at the effects on pain and immobility following breast cancer surgery.
- Detailed Description
Myofascial massage is a deep tissue massage that focuses on muscles as well as the connective tissue that surrounds muscles, bones, and ligaments. The study team subsequently conducted a pilot randomized controlled trial involving 21 women with persistent pain and mobility limitations many months after surgery. They found that women who received myofascial massage to the affected breast/chest/shoulder had marked reductions in pain and mobility limitations and significant improvements in quality of life compared to a control group who received relaxation massage. They also established a practice-based research network of over 50 northeast Ohio massage therapists to guide future work.
The study team now proposes a full scale randomized controlled trial involving 202 women with persistent pain and mobility limitations at 2 participating sites. To help differentiate between the specific effects of myofascial massage and non-specific effects due to prolonged touch and attention from a massage therapist, the study will include an active control group that will receive light touch. Participants in each group will receive 30 minutes of treatment twice weekly for 2 months. Primary analyses will determine the impact of myofascial massage on pain and mobility limitations. Secondary analyses will examine the impact of myofascial massage on a number of secondary outcomes, including range of motion, quality of life, sleep, and body image.
Innovative features of the proposed project include a rigorous randomized controlled trial design, inclusion of an active control group, direct targeting of the affected breast/chest/shoulder, assessment of multiple mechanistic and patient-centered outcomes, and involvement of a massage practice-based research network. Investigators anticipate that the project will lead to a new and effective approach for addressing a major source of morbidity for women with breast cancer. Furthermore, the project may serve as a model for future trials of manual therapy among individuals with chronic medical conditions.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- Female
- Target Recruitment
- 132
- 18 years or older
- Female
- Undergone breast cancer surgery 3-18 months ago
- Completed all treatment for breast cancer within the last 18 months (i.e. radiation, IV chemotherapy, surgery)
- Not expected to have any additional surgery (i.e. planning for reconstruction)
- Self reported chronic pain or immobility since surgery
- Under age 18
- Not female
- Surgery < 3 months ago
- End all cancer treatments (surgery, radiation, chemotherapy) > 18 months ago
- Presence of lymphedema
- Open wounds or sores
- Currently on anticoagulants
- Currently receiving massage treatments
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Myofascial Massage Myofascial Massage Participants randomized to this group will receive 30 minutes of myofascial massage to their affected breast, chest, and shoulder areas twice a week for 2 months. Therapists will follow a detailed 8 week protocol developed with a massage therapy consultant and the study team. Light Touch Light Touch Participants randomized to this group will receive 30 minutes of light touch to their affected breast, chest, and shoulder areas twice a week for 2 months.
- Primary Outcome Measures
Name Time Method Change in self reported pain scores Baseline, 1 month, 2 months, 8 months, and 14 months Shoulder Pain and Disability Index "SPADI", 5 pain items rated on a 10 point likert scale, where 0 is no pain at all and 10 is the worst pain imaginable
Change in self reported mobility scores Baseline, 1 month, 2 months, 8 months, and 14 months Shoulder Pain and Disability Index "SPADI", 8 mobility items rated on a 10 point likert scale, where 0 means no issues with mobility and 10 means they are unable to complete the task
- Secondary Outcome Measures
Name Time Method Quality of Life Survey-Functional Assessment of Cancer Therapy - Breast (FACT-B) Baseline, 2 months, 14 months 44-item questionnaire designed to measure physical well-being, social/family well-being, emotional well-being, functional well-being, and additional breast cancer-specific concerns
Grip Strength Baseline, 2 months, 14 months Hand grip strength measured by dynamometer
Tissue Flexibility Baseline, 2 months, 14 months Change in tissue flexibility as measured by adherometer
Range of Motion Baseline, 2 months, 14 months Shoulder range of motion measured by goniometer and objective functional tasks
Pressure/Pain Threshold Baseline, 2 months, 14 months Pressure to pain threshold as measured by algometer
Trial Locations
- Locations (1)
MetroHealth Medical Center
🇺🇸Cleveland, Ohio, United States