Nerve Mobilization Techniques After Breast Cancer Surgery
Condition: Breast Cancer Female
MeSH terms: Breast Neoplasms
Study type: Interventional

Summary: 
      Objective: to determine nerve mobilization techniques effectiveness at improving shoulder
      disability in the early breast cancer postsurgical period, and whether the effect was
      maintained at 24-month follow up. Design: prospective randomized and single blind trial where
      participants will be randomly allocated into two groups by EPIDAT 3.1 software. Follow-up
      will be conducted through seven physical therapy assessments: one before surgery, the second
      one after surgery, the third one post-physical therapy intervention, the fourth one after
      three months, the fifth after six months and, the sixth one after twelve months, and the
      seven one after 24 months. Participants: one hundred and forty women, who are undergoing a
      unilateral breast cancer surgery with axillary lymph node dissection in the Breast Cancer
      Unit from "Príncipe de Asturias" Hospital. Intervention: Early physical therapy to control
      group and Early physical therapy plus nerve mobilization to intervention group during the
      three following weeks from surgery. Hypothesis: nerve mobilization helps brachial plexus
      sliding among its interface which improves shoulder disability the inner arm.

      Key outcomes: pain, functional impairment, physical therapy, quality of life. Data analysis:
      quantitative variables through t-student test and qualitative variable though Chi test
      through by Statistical Package for the Social Sciences software.
    

Detailed description: 
      After giving their written informed consent, the participants will be summoned to perform the
      first assessment prior to surgery. Once participants will be discharged from hospital,
      approximately 3-5 days following the surgery, will be summoned to perform the second
      assessment. Those who will fulfil the selection criteria will be randomly allocated into two
      groups by an independent physical therapist. The experimental group will receive Early
      Physical Therapy plus neural mobilization and the control group will receive Early Physical
      Therapy. The same physical therapist will carry out all interventions for both groups. The
      physical therapist who will carry out the randomization process as well as the one who will
      perform the interventions will be the only two study members aware of group allocation. A
      third independent and blinded physical therapist will perform the assessments for all
      participants. Both physical therapists have more than fifteen years' experience in the
      treatment of breast cancer side effects. The ULNT1 will be perform to detect
      mechanosenstiviy-induced pain at presurgical and postsurgical assessments. The test sequence
      and the criteria will be followed to identify a positive test will reproduce from de study of
      de la Rosa.

      In both groups, those women who will develop axillary web syndrome symptoms will receive an
      approach that aim at improving vascular tissue flexibility. If secondary lymphoedema will
      diagnose then complex decongestive physiotherapy will carry out.
    

Intervention name(s): Neural mobilization group; Control group
Intervention type(s): Other; Other
Intervention description(s): See arm/group descriptions; See arm/group descriptions
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Two groups: Experimental group & Control group
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment