Occupational/Physical Therapy to Reduce Morbidity Post-Operative Bilateral Breast Reconstruction

Study Overview
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Brief Summary
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The purpose of this study is to demonstrate the benefits of a structured occupational/physical therapy program on upper extremity morbidity for patients who have received bilateral breast reconstruction in comparison to a home therapy program and no post-operative therapy. Hypothesis: Patients who engage in therapist-supervised occupational therapy following bilateral breast reconstruction have less upper extremity morbidity than those patients who complete a home therapy program or no therapy program.

Official Title
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The Use of Occupational/Physical Therapy to Reduce Upper Extremity Morbidity Post-Operative Bilateral Breast Reconstruction

Conditions
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Occupational/Physical Therapy, Post-operative Breast Reconstruction

Intervention / Treatment
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* Other: Home therapy
* Other: Structured In-Office Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 18 years of age Women who have had bilateral breast reconstruction All cancer stages will be included Physically and mentally able to participate in the study within the required time-frame Able to voluntarily give full informed consent to participate in the study Exclusion Criteria: Women undergoing unilateral breast reconstruction Unable to provide informed consent in English Physically unable to engage in the protocol

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Structured In-Office Therapy<br>Structured In-Office Therapy: Study subjects will receive structured, therapist-supervised occupational/physical therapy twice per week for four (4) weeks. Each visit will last approximately sixty (60) minutes. Patients in this arm will receive therapy instruction by a certified occupational therapist on upper extremity stretching, relaxation, cardio rehabilitation, and strength training. These patients will also receive exercise and stretching handouts to use at home between therapy visits. Will complete the DASH at week 1 and week 4. | Other: Structured In-Office Therapy<br>* Study subjects will participate in Structured In-Office Therapy twice a week for four (4) weeks. Each visit will last approximately sixty (60) minutes. Subjects will receive therapy instruction by a certified occupational therapist on upper extremity stretching, relaxation, cardio rehabilitation, and strength training. These subjects will also receive exercise and stretching handouts to use at home between therapy visits.<br>|
| No Intervention: No therapy<br>Study subjects in this arm will not receive post-operative occupational /physical therapy. Will complete the DASH at week 1 and week 4. | |
| Active Comparator: Home Therapy<br>Home Therapy: Study subjects will receive a handout of exercises adapted for post-operative breast reconstruction patients along with an instructional handout for stretching complied by a certified occupational therapist to complete independently at home for four (4) weeks. Will complete the DASH at week 1 and week 4. | Other: Home therapy<br>* Study subjects complete home therapy independently for four (4) weeks based on handouts of exercises adapted for post-operative breast reconstruction patients along with an instructional handout for stretching complied by a certified occupational therapist.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in DASH: Disabilities of the Arm, Shoulder and Hand score | A change in DASH score will be calculated. The DASH: Disabilities of the Arm, Shoulder, and Hand (Appendix D) questionnaire will be utilized to measure physical function and symptoms of the upper limbs. The DASH consists of 30-items to be self-reported by the patient: physical function twenty-one (21) items, pain symptoms five (5) items, and emotional and social function four (4) items. The result of the DASH is a numerical disability score ranging from zero to one hundred (0-100), with zero (0) being no disability and one hundred (100) being the most severe disability. | Week 1 and Week 4 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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breast reconstruction, occupational therapy, physical therapy, upper extremity morbidity