Neoplasms

Skin and Connective Tissue Diseases

All Conditions

Breast Neoplasms

Breast Diseases

Skin Diseases

Participants in this group will start shoulder isotonic exercise 7 days after surgery and begin progressive resistance exercise 4 weeks after surgery.

Participants in this group will start shoulder isotonic exercise 7 days after surgery and begin progressive resistance exercise 3 weeks after surgery.

Participants in this group will start shoulder isotonic exercise 3 days after surgery and begin progressive resistance exercise 4 weeks after surgery.

Participants in this group will start shoulder isotonic exercise 3 days after surgery and begin progressive resistance exercise 3 weeks after surgery.

Shoulder isotonic exercise (SIE)：exercise methods for shortening and relaxing the muscles around the shoulder joint.

Progressive resistance exercise (PRE)：A training method that gradually increases the resistance, which will increase the muscle capacity.

7 days SIE plus 4 weeks PRE

7 days SIE plus 3 weeks PRE

3 days SIE plus 4 weeks PRE

3 days SIE plus 3 weeks PRE

Patients who underwent modified radical mastectomy were enrolled in the study. 200 subjects were randomly divided into 4 groups: 7 days postoperative shoulder isotonic training + 4 weeks postoperative progressive resistance training group, postoperative 7 Isometric training for the shoulder joint + progressive resistance training for 3 weeks after surgery group, 3 days postoperative isotope training + 4 weeks postoperative progressive resistance training group, 3 days postoperative shoulder isotonic training + postoperative 3 Weekly progressive resistance training group. The effects of interventional rehabilitation at different time points on the recovery of shoulder function after breast cancer operation were observed. The results of the study will provide evidence-based evidence for the time point of intervention in early functional exercise after modified radical mastectomy for breast cancer.

Effects of Exercise Training at Different Timeline on Shoulder Dysfunction After Breast Cancer Modified Radical Mastectomy

Effect of Exercise Training at Different Timeline on Shoulder Dysfunction in Patients After Breast Cancer Modified Radical Mastectomy: A Randomized Controlled Trial

The study protocol, statistical analysis plan, informed consent form and clinical study report will be shared online about six months after the trial complete.

Visual Analogue Scale（VAS): Used to assess the degree of pain. Draw a 10 cm horizontal line on the paper. One end of the horizontal line is 0, indicating no pain; the other end is 10, indicating severe pain; the middle part indicates different degrees of pain.

The postoperative drainage was the total volume of the chest wall drainage tube and the underarm drainage tube. The volume measurement and recording in the drainage bag were observed daily by the nurse.

The shoulder function was evaluated by the total score of the Constant-Murley Shoulder Score Questionnaire, which ranged from 0 to 100. Higher scores indicate better shoulder function.

In the standard position, the mobility of the shoulder flexion, extension, external rotation and internal rotation was measured by using protractor. The range of flexion is 0-180°, the range of extension is 0-180°, the range of external rotation is 0-90°, and the range of internal rotation is measured. 0-70°. The assessments will be performed in the active and passive state separately.

In the standard position, the muscle strength of the flexion, extension, external rotation and internal rotation of the shoulder joint were assessed according to the "manual muscle test standard".

In the standard position, the grip of the patient's palm is measured using a dynamometer.

The quality of life assessment of breast cancer patients was evaluated by the total score of the EORTC QLQ BR23 Breast Cancer Quality of Life Questionnaire, which ranged from 0 to 92. Higher scores indicate better quality of life.

The quality of life assessment of breast cancer patients was evaluated by the total score of the SF-36 Health status questionnaire, which ranged from 0 to 92. Higher scores indicate better quality of life.

Wuhan University

Principal Investigator

Head and Neck Neoplasms

Mulligan Mobilization Technique in addition to traditional physical therapy program (myofascial release, capsular stretching ex. strengthening ex. and ROM ex.) 3 sessions per week for 6 weeks. The therapist applied passive accessory glide to increase shoulder flexion, abduction, external rotation as the patient moved the arm actively in the desired direction with in a pain free range with dosage: 3 sets for 10 repetitions with 1 minute rest between sets. 3 times a week for 6 weeks.

Traditional physical therapy will include chin tucks, shoulder shrugs, shoulder circle, scapular retraction/adduction and shoulder ROM exercises, including shoulder flexion and abduction to improve glenohumeral \& scapulothoracic motion and shoulder extension \& adduction with moderate resistance and shoulder internal/external rotation with approximately two sets of 15 repetitions.

Traditional physical therapy program (myofascial release, capsular stretching ex. strengthening ex. and ROM ex.) 3 sessions per week for 6 weeks. Traditional physical therapy will include chin tucks, shoulder shrugs, shoulder circle, scapular retraction/adduction and shoulder ROM exercises, including shoulder flexion and abduction to improve glenohumeral \& scapulothoracic motion and shoulder extension \& adduction with moderate resistance and shoulder internal/external rotation with approximately two sets of 15 repetitions.

The therapist applied passive accessory glide to increase shoulder flexion, abduction, external rotation as the patient moved the arm actively in the desired direction with in a pain free range with dosage: 3 sets for 10 repetitions with 1 minute rest between sets. 3 times a week for 6 weeks.

Traditional physical therapy will include chin tucks, shoulder shrugs, shoulder circle, scapular retraction/adduction and shoulder ROM exercises, including shoulder flexion and abduction to improve glenohumeral \& scapulothoracic motion and shoulder extension \& adduction with moderate resistance and shoulder internal/external rotation with approximately two sets of 15 repetitions.

Mulligan Mobilization Technique

Myofascial release, capsular stretching ex. strengthening ex. and ROM ex. 3 sessions per week for 6 weeks. Traditional physical therapy will include chin tucks, shoulder shrugs, shoulder circle, scapular retraction/adduction and shoulder ROM exercises, including shoulder flexion and abduction to improve glenohumeral \& scapulothoracic motion and shoulder extension \& adduction with moderate resistance and shoulder internal/external rotation with approximately two sets of 15 repetitions.

Traditional Physical Therapy Program

Mona Amin, Master

Research Ethical Committee Faculty of Physical Therapy

Faculty of Physical Therapy

Seventy six patients of both genders with age 30 - 50 year old suffering from shoulder dysfunction after neck dissection surgeries will participate in this study. The participants will be selected from Damanhur Oncology Center and randomly will be distributed into two groups equal in number.

Group (A): 38 patients will receive mulligan mobilization technique in addition to traditional physical therapy program (myofascial release, capsular stretching ex. strengthening ex. and ROM ex.) 3 sessions per week for 6 weeks.

Group (B): 38 patients will receive traditional physical therapy program (myofascial release, capsular stretching ex. strengthening ex. and ROM ex.) 3 sessions per week for 6 weeks.

1. Subjects:

   Seventy six patients of both genders with age 30 - 50 year old suffering from shoulder dysfunction after neck dissection surgeries will participate in this study. The participants will be selected from Damanhur Oncology Center and randomly will be distributed into two groups equal in number.

   Group (A): 38 patients will receive mulligan mobilization technique in addition to traditional physical therapy program (myofascial release, capsular stretching ex. strengthening ex. and ROM ex.) 3 sessions per week for 6 weeks.

   Group (B): 38 patients will receive traditional physical therapy program (myofascial release, capsular stretching ex. strengthening ex. and ROM ex.) 3 sessions per week for 6 weeks.
2. Equipment:

Therapeutic equipment:

* Mulligan Mobilization Technique: the therapist applied passive accessory glide to increase shoulder flexion, abduction, external rotation as the patient moved the arm actively in the desired direction with in a pain free range with dosage: 3 sets for 10 repetitions with 1 minute rest between sets. 3 times a week for 6 weeks.
* Traditional physical therapy program: (myofascial release, capsular stretching ex. Strengthening ex. And ROM ex.) 3 sessions per week for 6 weeks. Traditional physical therapy will include chin tucks, shoulder shrugs, shoulder circle, scapular retraction/adduction and shoulder ROM exercises, including shoulder flexion and abduction to improve glenohumeral \& scapulothoracic motion and shoulder extension \& adduction with moderate resistance and shoulder internal/external rotation with approximately two sets of 15 repetitions.

Measurement equipment:

* Digital Goniometer: It's a device which measures joint ranges, together with velocity and acceleration variables, with a high level of precision and at a relatively low-cost, practically similar to current analogical tools. The digital goniometer is a device specifically designed for the measurement of angles of movement of the human body with a resolution of 1°, representing an ideal substitute to traditional goniometers, which are usually based on a scale of 5° increments. For measuring the selected shoulder movements (flexion, abduction, external rotation), the position used as the supine position, in which the participant was asked to lie down restfully on his back.
* Shoulder Pain and Disability Index: The SPADI is a self-reported questionnaire consisting of 13 items divided in two parts: pain and disability subscale. The pain subscale includes five questions about pain intensity at its worst and when lying on the involved side, reaching for something on a high shelf, touching the back of the neck and pushing with the involved arm. The disability subscale includes eight questions about difficulty when washing the hair, washing the back, putting on an undershirt or jumper, putting on a shirt that buttons down the front, putting on your pants, placing an object on a high shelf, carrying an object of 10 pounds (4.5 kilograms) and removing something from your back pocket. Each question of both pain and disability subscale was scaled in 11-numeric ratings ranging from 0 to 10. Each score was summed and transformed to percentage. Finally, the average score between pain and disability subscale comprised the total SPADI scores ranging from 0 (the best) to 100 (the worst).

Mulligan Technique on Shoulder Dysfunction

Effect of Mulligan Technique on Shoulder Dysfunction Post Neck Dissection Surgeries

Digital Goniometer is a device which measures joint ranges, together with velocity and acceleration variables, with a high level of precision and at a relatively low-cost, practically similar to current analogical tools. The digital goniometer is a device specifically designed for the measurement of angles of movement of the human body with a resolution of 1°, representing an ideal substitute to traditional goniometers, which are usually based on a scale of 5° increments. For measuring the selected shoulder movements (flexion, abduction, external rotation), the position used as the supine position, in which the participant was asked to lie down restfully on his back.

The SPADI is a self-reported questionnaire consisting of 13 items divided in two parts: pain and disability subscale. The pain subscale includes five questions about pain intensity at its worst and when lying on the involved side, reaching for something on a high shelf, touching the back of the neck and pushing with the involved arm. The disability subscale includes eight questions about difficulty when washing the hair, washing the back, putting on an undershirt or jumper, putting on a shirt that buttons down the front, putting on your pants, placing an object on a high shelf, carrying an object of 10 pounds (4.5 kilograms) and removing something from your back pocket. Each question of both pain and disability subscale was scaled in 11-numeric ratings ranging from 0 to 10. Each score was summed and transformed to percentage. Finally, the average score between pain and disability subscale comprised the total SPADI scores ranging from 0 (the best) to 100 (the worst).

Cairo University

Assistant Lecturer at Department of Surgery and Burn - Faculty of Physical Therapy - Cairo University

Mouth and Tooth Diseases

Behaviors and Mental Disorders

Rare Diseases

Mouth Neoplasms

Lip Neoplasms

Mouth Diseases

Stomatognathic Diseases

Quality of Life

Oral Cancer

Lip and Oral Cavity Cancer

scapular muscle progressive resistive exercise(PRE)

motor control therapy

transcutaneous electrical nerve stimulation(TENS), shoulder joint ROM, scapular muscle PRE

regular physical therapy

Yueh-Hsia Chen, Master

Head and neck cancer is prevalent in Taiwan, and oral cancer is the most common location. Advanced treatment of oral cancer increases survival rates; however, it also increases the risk of developing shoulder dysfunction, dysphagia, oral dysfunction, donor site morbidity and psychological issues. The probability of shoulder dysfunction after neck dissection is as high as 70%. Rehabilitation effects on shoulder function for head and neck survivors are needed for further studied.The purpose of this randomized clinical trial is to explore the effects of rehabilitation for shoulder function in oral cancer survivors.

Head and neck cancer is prevalent in Taiwan, and oral cancer is the most common location. Advanced treatment of oral cancer increases survival rates; however, it also increases the risk of developing shoulder dysfunction, dysphagia, oral dysfunction, donor site morbidity and psychological issues. The probability of shoulder dysfunction after neck dissection is as high as 70%. Rehabilitation effects on shoulder function for head and neck survivors are needed for further studied.

The purpose of this randomized clinical trial is to explore the effects of rehabilitation for shoulder function in oral cancer survivors. We will recruit 60 newly diagnosed oral cancer subjects through the plastic surgeon's referral from April 2018 to March 2020. The participants will be randomized separated into experimental or control group. Each group would receive regular physical therapy for shoulder function (i.e., transcutaneous electrical stimulation, shoulder joint range of motion exercise, scapular muscle strengthening training). Experimental group would be supplemented by motor control therapy targeting the scapular muscle progressive resistance exercise (exercise plus manual therapy).

Rehabilitation Outcomes of Shoulder Function in Oral Cancer Survivors Cancer Survivors

Visual Analog Scale, the \*total\* range = 0-10

the Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Measure for upper extremity function

measurement for the upper trapezius, middle trapezius, lower trapezius and serrates anterior at the moment of SEMG

measure the muscle activities of the upper trapezius, middle trapezius, lower trapezius and serrates anterior

European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30

European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-H\&N35

duration between return-to-work and operation

Chang Gung Memorial Hospital

3 sessions of shoulder rehabilitation per week for 3 months (36 sessions)

sessions of shoulder rehabilitation

A prospective, monocentric, controlled, randomized study of systematic early shoulder rehabilitation following cervical lymph node dissection for the prevention and treatment of shoulder dysfunction.

Pre-inclusion: information, collection of consent, collection of antecedents and biometric data, clinical examination (goniometric measurement and visual analogic scale of pain), collection of DASH, EORTC QLQ-C30 and H\&N35 questionnaires.

Surgical intervention (J0) and randomization into 2 groups:

Group 1 - systematic early rehabilitation Group 2 - without systematic rehabilitation

M3, M6, M12: collection of complications, adjuvant treatments, number of physiotherapy sessions performed, clinical examination (goniometric measurement and visual analogic scale of pain), collection of DASH, EORTC QLQ- C30 and H\&N35 questionnaires.

Early and Systematic Shoulder Rehabilitation Following Cervical Lymph Node Dissection

The total score is reported. The score is between 0 and 100. The higher the score, the higher the disability.

The reported score is between 0 and 10. The higher the score, the higher the pain.

Goniometric measurement will be performed using a Rippstein's Plurimeter, with standardized position and movement for each measurement:

* Sitting on a chair, the bust is straight, arm hanging down the body.
* The plurimeter is placed on the distal part of the arm.
* The flexion is in the sagittal plane around a transverse axis in the frontal plane.
* The abduction is in the frontal plane around an anteroposterior axis contained in the sagittal plane.

EORTC QLQ-C30 questionnaire has 30 questions and includes the following scale:

- health and overall quality of life, scale have a score between 0 and 100. A high score indicates the preservation of a good quality of life.

EORTC QLQ-C30 questionnaire has 30 questions and includes the following scale:

- operating scale, scale have a score between 0 and 100. A high score for this scale indicates the preservation of a good quality of life.

EORTC QLQ-C30 questionnaire has 30 questions and includes the following scale:

- scale of generic symptoms. scale have a score between 0 and 100. A high score for this scale indicates the presence of symptoms acting as factors of deterioration of certain aspects of the quality of life.

EORTC QLQ-H\&N35 questionnaire evaluates the specific symptoms of patients with head and neck cancers. It consists of 35 items including 7 subscales .

subscale scores are reported, All items and scales give a score between 0 and 100.

For each subscale, a high score indicates the presence of a large number of specific symptoms, acting as factors of deterioration of certain aspects of the quality of life.

(% of rehabilitation sessions performed over 36 sessions)

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Effects of Exercise Training at Different Timeline on Shoulder Dysfunction After Breast Cancer Modified Radical Mastectomy	NCT03658265	Shoulder Dysfun... Breast Cancer Modified Radica...	7 days SIE plus... 7 days SIE plus... 3 days SIE plus... 3 days SIE plus...	25 Years - 75 Years	Wuhan University
Mulligan Technique on Shoulder Dysfunction	NCT05915572	Head and Neck C...	Mulligan Mobili... Traditional Phy...	30 Years - 50 Years	Cairo University
Rehabilitation Outcomes of Shoulder Function in Oral Cancer Survivors Cancer Survivors	NCT03545100	Oral Cancer	motor control t... regular physica...	20 Years - 65 Years	Chang Gung Memorial Hospital
Early and Systematic Shoulder Rehabilitation Following Cervical Lymph Node Dissection	NCT03961802	Rehabilitation	sessions of sho...	18 Years -	Nantes University Hospital

Spots Global Cancer Trial Database for shoulder dysfunction