Impact of Proximal Motor Control Exercises on Scapular Muscles Activation Pattern in Breast Cancer Survivors Following Mastectomy: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 60
- 试验地点
- 4
- 主要终点
- EMG Muscle Activation Amplitude
研究概览
简要总结
This prospective, single-center, assessor-blinded, parallel-group randomized controlled trial investigated whether adding proximal motor control exercises (PMCE) to conventional physiotherapy treatment (CPT) improved shoulder function and scapular muscle activation in women with post-mastectomy shoulder dysfunction. Women aged 35-55 years were randomly allocated to receive either PMCE plus CPT or CPT alone. Both groups attended supervised physiotherapy sessions three times weekly for 6 weeks. Outcomes were assessed at baseline, immediately after treatment, and at 12-week follow-up. The primary outcome was scapular and shoulder muscle activation assessed using surface electromyography (SEMG), while secondary outcomes included shoulder pain and disability assessed using the Shoulder Pain and Disability Index (SPADI).
详细描述
This single-center, prospective, assessor-blinded, randomized controlled trial investigated whether adding proximal motor control exercises (PMCE) to conventional physiotherapy treatment (CPT) improved shoulder function and scapular muscle activation in women with post-mastectomy shoulder dysfunction.
Eligible participants were randomly assigned to receive either PMCE plus CPT or CPT alone. Both groups attended supervised physiotherapy sessions three times weekly for six weeks. PMCE focused on improving scapular alignment, neuromuscular coordination, and activation of scapular stabilizing muscles, whereas CPT included glenohumeral joint mobilization, posterior capsule stretching, and Codman pendulum exercises.
Outcomes were assessed at baseline, immediately after treatment, and at 12-week follow-up. The primary outcome was scapular and shoulder muscle activation assessed using surface electromyography (SEMG). The secondary outcome was shoulder pain and disability assessed using the Shoulder Pain and Disability Index (SPADI).
The study aimed to determine whether PMCE combined with CPT provided greater improvements in neuromuscular and clinical outcomes than CPT alone.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
The SPADI assessor, SEMG examiner, and statistician remained blinded to group allocation throughout data collection and analysis.
入排标准
- 年龄范围
- 35 Years 至 55 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Had stage I-III unilateral breast cancer. Had undergone simple or modified radical mastectomy at least 3 months before enrollment.
- •Had achieved complete postoperative wound healing and were medically stable. Had clearance from their treating physician to participate in exercise. Presented with post-mastectomy shoulder dysfunction, defined as a SPADI score ≥30/100 and a positive Scapular Dyskinesis Test.
排除标准
- •Had undergone bilateral mastectomy. Had evidence of locoregional recurrence or metastatic breast cancer. Had a history of previous shoulder surgery or major shoulder trauma unrelated to breast cancer treatment.
- •Had pre-existing shoulder disorders, including rotator cuff tears, adhesive capsulitis, or advanced glenohumeral osteoarthritis.
- •Had neurological disorders affecting upper-limb function. Had rheumatologic diseases affecting shoulder function. Had uncontrolled diabetes mellitus or any other medical condition contraindicating exercise participation.
研究组 & 干预措施
study group
干预措施: Conventional physical therapy (Other)
study group
干预措施: Proximal Motor Control exercises (Other)
control
干预措施: Conventional physical therapy (Other)
结局指标
主要结局
EMG Muscle Activation Amplitude
时间窗: Baseline and 6 weeks
Surface electromyography (sEMG) will be used to assess the activation patterns of scapular and rotator cuff muscles during functional tasks, such as shoulder flexion, abduction, and external rotation. The sEMG assessment will be conducted using a wireless sEMG system with a sampling rate of 2000 Hz and a bandwidth of 20-500 Hz. Pre-gelled, disposable, self-adhesive Ag/AgCl electrodes will be placed on the muscle belly according to SENIAM guidelines, with an inter-electrode distance of 20 mm. (serratus anterior, upper and lower trapezius, supraspinatus, and infraspinatus) during functional tasks.
EMG Muscle Activation
时间窗: Baseline, 6 weeks and 12 weeks follow up
Surface electromyography (sEMG) was used to assess the activation patterns of the serratus anterior, upper and lower trapezius, supraspinatus, and infraspinatus muscles during arm elevation. The sEMG assessment was conducted using a wireless sEMG system with a sampling rate of 2000 Hz and a bandwidth of 20-500 Hz. Pre-gelled, disposable, self-adhesive Ag/AgCl electrodes were placed over the muscle bellies according to the SENIAM recommendations, with an inter-electrode distance of 20 mm.
次要结局
- Shoulder pain and disability index (SPADI)(Baseline and 6 weeks)
- Shoulder pain and disability index (SPADI)(Baseline, 6 weeks and 12 weeks follow up)
研究者
Mahmoud H Mohamed, PhD
Associate Professor
Ahram Canadian University