About this trial
In breast cancer patients, limitation of shoulder joint movement occurs following mastectomy surgery. Studies have reported that damage to the fascia on the pectoralis major muscle during mastectomy surgery contributes to the development of the limitation. The aim of this study is to investigate the effect of release techniques applied to the fascia on the pectoralis major muscle and the fascial chain on the incerasing of shoulder joint range of motion.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Women between the ages of 30-60
Having breast surgery within 2 years
Not have received conservative treatment for shoulder rehabilitation in the last 6 months
Having limitation of movement of the shoulder joint due to breast surgery
Disqualifiers
Not having agreed to participate in the study
Having undergone radical mastectomy surgery
Having connective tissue disease
Presence of brachial plexus paresis/plegia
Trial design
Parallel
Treatments tested in this trial
conventional physiotherapy
Other interventionA basic physiotherapy program consisting of shoulder exercises will be applied to the participants. content of the physiotherapy program * Shoulder passive/active abduction, flexion, internal and external rotation exercises * Posture exercises * Neck stretching exercises * Pectoralis major stretching exercises * Shoulder capsule stretching exercises * Scapular Mobilization exercises
Manual lymphatic drainage
Other interventionmanual lymph drainage is a manual technique that is applied to the lymphatic system with a pressure of 40-50 mmHg and increases the working speed of lymphatic nodules/collectors. Manual lymph drainage will be made to the anterior axillar-axillar, posterior axillar-axillar and axilla-inguinal anastomosis collectors and the arm region (up to the elbow) lymph collectors.
Myofascial relasing
Other interventionit will be done with the thumb or 3rd finger from the acu points of the superficial arm-anterior myofascial chain. 6-8 seconds with thumb to these points. pressure will be applied and vibration will be given clockwise.
Treatment groups
Trial outcomes
Primary outcomes
measurement of tissue stiffness (N/m)
Stiffness values will be measured with myotonPro on centers of coordination located along the myofascial chain .
measurement of passive muscle tone (Hz)
muscle tones will be measured with myotonPro on centers of coordination located along the myofascial chain
measurement of creep of tissue
creep of tissue will be measured with myotonPro on centers of coordination located along the myofascial chain
measurement of the range of shoulder joint motion
The range of shoulder flexion, abduction, extension and external-internal rotation movements will be measured with a universal goniometer.
Secondary outcomes
measurement of skin temperature
measurements will be taken from the area covering 3 cm of the surgical incision with a P45 thermographic camera with high thermal sensitivity (Flir Sistem, ThermaCAM, Sweden).
measurement of pain
Pain will be evaluated by visual analog scale (VAS). In the scale, the patient is asked to mark the most appropriate pain intensity on a scale ranging from 0 (no pain) to 10 (tolerable pain). The higher the score, the greater the pain intensity.
measurement of pain pressure threshold
Pain pressure threshold will be evaluated by a digital algometer (Algometer Commander, Jtech Medical, MM036\_K, 2016).
measurement of grip strength
The grip strength of both hand will be evaluated by "hand-held" dynamometer.
Sponsors and contacts
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