Breast Cancer Rehabilitation With Acupuncture and Physical Therapy Protocol
Condition: Pain
Study type: Interventional

Summary: 
      The pain is very common complaint, and the neck is one of the most affected spots, mainly due
      to muscle contracture of the cervical and scapular region, triggered by emotional stress
      associated with muscle retraction involved resulting from postoperative scarring or
      post-radiotherapy.O fear fibrosis move the limb and inactivity postoperative lead to gradual
      impairment of muscle strength and flexibility, and loss of ADM, which also predisposes to the
      appearance of pain.

      Goals Study the effectiveness of acupuncture in rehabilitation of physical and functional
      disorders of women undergoing surgery for breast cancer.

        1. Presence of pain by Visual Analog Scale of Pain (VAS).

        2. Shoulder Range of Motion (ROM) by active goniometry of flexion movements, extension,
           adduction, abduction, internal rotation and external rotation

        3. lymphedema presence through top member perimetry.

        4. upper limb function through the DASH questionnaire.

        5. Depressive symptoms through BECK questionnaire.

        6. Quality of life through the EORTC questionnaire.

        7. Muscle strength of flexion, extension, adduction, abduction, internal rotation and
           shoulder external rotation with the Hand Held Dynamometer 01,163 model of Lafayette
           Instrument Company.

      Patients will be divided into three randomized groups with 30 patients per group, who will
      receive weekly treatment for 10 weeks, and the group I treated with standard therapeutic
      exercise, pre-defined, based on stretching the neck muscles, shoulder girdle and exercises
      for ADM upper limb lasting 30 minutes; group II is treated com30 minutes classical
      acupuncture using pre-defined spots, and finally, grupoIII be used in the same acupuncture
      points of the group II, but using the Stiper® in place of the needles. If the patients in
      groups II and III still of pain at the end of 10 sessions will be treated complementarily
      with kinesiotherapy.
    

Detailed description: 
      Objectives General Study the effectiveness of acupuncture in rehabilitation of physical and
      functional disorders of women undergoing surgery for breast cancer.

      Specific

      To evaluate the (the):

        1. Presence of pain by Visual Analog Scale of Pain (VAS).

        2. Shoulder Range of Motion (ROM) by active goniometry of flexion movements, extension,
           adduction, abduction, internal rotation and external rotation

        3. lymphedema presence through top member perimetry.

        4. upper limb function through the DASH questionnaire.

        5. Depressive symptoms through BECK questionnaire.

        6. Quality of life through the EORTC questionnaire.

        7. Muscle strength of flexion, extension, adduction, abduction, internal rotation and
           shoulder external rotation with the Hand Held Dynamometer 01,163 model of Lafayette
           Instrument Company.

      rationale The increased incidence of breast cancer and successful treatment result in greater
      survival. These patients may have chronic condition of pain in the area of the shoulder
      girdle and upper limb, including the thoracic and cervical spine. Knowing that in our
      previous project in which the group treated only with kinesiotherapy showed good results and
      when joined acupuncture no superiority, the investigators created new research study in order
      to determine whether acupuncture and Stiper® in isolated groups, would present equivalence
      results when compared to kinesiotherapy.The investigators propose then treat with acupuncture
      and analyze the rehabilitation of these patients.

      methodology This study will be performed at the Clinic of the Department of Mastology the
      Department of Gynecology, Federal University of São Paulo (UNIFESP) - Paulista School of
      Medicine (EPM). Patients will be recruited, selected and informed about the study objectives,
      relevance, activities to be developed and the possibility of improvement, as well as answer
      your questions and concerns about the disease. Later the patients who wish to participate in
      the study protocol will sign a consent form and specific savy for this project.
    

Intervention name(s): Kinesiotherapy; Acupuncture; Stiper
Intervention type(s): Other; Other; Other
Intervention description(s): Compare the standard treatment of pain, by kinesiotherapy versus acupuncture and Stiper.Standard therapeutic exercise, pre-defined, based on stretching the neck muscles, shoulder girdle and upper limb exercises for ADM lasting 30 minutes.; 30 minutes of classical acupuncture using predefined points.; They will be used the same acupuncture points of the group II, but using the needles in place Stiper.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment