The effects of fascial and joint play techniques on decreased range of motion and
pain as a result of the surgical intervention for breast cancer.
Abstract
Background: It is estimated that 22,700 women will be diagnosed with
breast cancer in 2009. (Canadian Cancer Society, 2009) The common treatments
for breast cancer, such as chemotherapy, radiation, and surgery, can leave many
detrimental side effects on the body. The most common complaints are pain,
oedema, limited range of motion (ROM), and restricted functionality of the
affected limb. The objective of this study is to test the efficiency of fascial
techniques and joint play on increasing the ROM of the shoulder and decreasing
patient perceived pain in post surgical intervention for breast cancer patients.
Other research with regard to the effects of fascial techniques on scar tissue and
limited ROM support this hypothesis. (Brook, 2009) Methods: The patient
recorded her pain using the Brief Pain Inventory at the initial assessment and after
the last treatment. The ROM of the shoulder was tested using a goniometer at the
initial assessment and again after the last treatment. Active and passive ranges
were tested using the star chart for peripheral joints both pre and post treatment in
3 of the 7 sessions. The Resisted ROM (RROM) was tested and graded on a scale
of 1 to 5 for the G/H in 3 out of the 7 treatments. Results: The patient’s perceived
pain decreased from an average of 6/10 pre treatment on the BPI to an average of
2.4/10 post treatment. In most cases of post-modified ridicular mastectomy,
patients find that their range of motion into flexion and abduction are most
affected. Internal and external rotation as well as adduction are also affected, but
to a much lesser extent. In this case, the patient’s ranges increased by 22º in
internal rotation, 37º in external rotation, 1º in flexion, 12º in extension, 5º in
adduction and 90º in abduction. Conclusion: The results from this case study
suggest that fascial techniques and joint play offer an effective therapeutic
treatment for decreased range of motion and pain as a result of treatment for, and
surgical intervention of, breast cancer.