The Efficacy of Exercise Therapy in Reducing Shoulder Pain Related to Breast Cancer: A Systematic Review
ABSTRACT
ABSTRACT
Purpose: Recent research indicates that physiotherapy interventions, such as exercise and manual therapy, may be effective in decreasing the frequency of side effects linked with breast cancer treatment, including fatigue, pain, nausea, and decreased quality of life. This systematic review aims to determine the efficacy of exercise therapy in reducing shoulder pain related to breast cancer treatment and to identify outcome measures that can be used to assess shoulder pain in this population. Methods: A systematic review of the current literature was conducted using portals such as the Physiotherapy Evidence Database (PEDro), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Ovid MEDLINE (1996 to April 2011), and Allied and Complementary Medicine (AMED) (1985 to April 2011). Databases were searched for relevant studies published up to April 2011. Participants in relevant studies were adults (≥18 years of age) with a primary diagnosis of breast cancer at any point during the treatment of their disease. Results: Six articles were independently appraised by two blinded reviewers. Six studies met the inclusion criteria, each analyzing different types of exercise—shoulder/arm/scapular strengthening/stabilization, postural exercises, general exercises and conditioning, shoulder range-of-motion exercises, and lymphedema exercises—with respect to their efficacy in reducing shoulder pain related to breast cancer treatment. Conclusions: Results suggest that exercise targeting shoulder pain related to breast cancer treatment may be effective. However, definitive conclusions cannot be drawn due to the lack of methodological quality and homogeneity of the studies included. Clinicians should use valid outcome measures, such as the visual analogue scale and brief pain inventory, to evaluate the effectiveness of this treatment.
RÉSUMÉ
Objectif : Des recherches récentes indiquent que les interventions de physiothérapie comme l'exercice et la thérapie manuelle peuvent être efficaces pour réduire la fréquence des effets secondaires liés au traitement du cancer du sein, y compris la fatigue, la douleur, les nausées et une baisse de la qualité de vie. Cette critique systématique vise à déterminer l'efficacité de la thérapie par l'exercice lorsqu'il s'agit d'atténuer une douleur à l'épaule liée à un traitement du cancer du sein et à déterminer les mesures de résultat qu'il est possible d'utiliser pour évaluer la douleur à l'épaule dans cette population. Méthode : On a procédé à un examen systématique des publications courantes en utilisant des portails comme PEDro, CINAHL, PubMed, Ovid MEDLINE (1996 à avril 2011) et AMED (1985 à avril 2011). On a cherché dans des bases de données des études pertinentes publiées jusqu'en avril 2011. Les participants aux études pertinentes étaient des adultes (≥18 ans) qui avaient reçu un diagnostic primaire de cancer du sein à n'importe quel moment au cours du traitement de leur maladie. Résultats : Six articles ont fait l'objet d'examens à l'aveugle effectués par des examinateurs indépendants. Six études ont satisfait aux critères d'inclusion, chacune analysant des types différents d'exercice—renforcement/stabilisation de l'épaule, du bras ou de l'omoplate, exercices posturaux, exercices généraux et conditionnement, exercices portant sur l'amplitude du mouvement de l'épaule et exercices contre le lymphœdème—en ce qui a trait à leur efficacité pour réduire la douleur à l'épaule liée au traitement du cancer du sein. Conclusions : Les résultats indiquent que les exercices prescrits contre la douleur à l'épaule liée au traitement du cancer du sein peuvent être efficaces. On n'a pu toutefois tirer de conclusions définitives parce que les études incluses manquaient de qualité méthodologique et d'homogénéité. Les cliniciens devraient utiliser des mesures de résultat valables comme l'échelle analogue visuelle et le bref inventaire de la douleur pour évaluer l'efficacité du traitement.
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Physiotherapy Canada
Volume 65 • Number 4 • Fall 2013
Pages: 321 - 330
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© Canadian Physiotherapy Association, 2013. All rights reserved.
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Published online: 29 May 2013
Published in print: Fall 2013
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Physiotherapy Canada 2013; 65(4);321–330; doi:10.3138/ptc.2012-06
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