EFFECTS OF INHIBITION COMPRESSION VERSUS SCAPULAR MOBILIZATION TECHNIQUE ON SHOULDER IN PATIENTS WITH MASTECTOMY
DOI:
https://doi.org/10.71000/ymb6r631Keywords:
postmastectomy pain syndrome (PMPS), Breast Neoplasms, Exercise Therapy, Mastectomy, , Physical Therapy Modalities, Range of Motion, SurvivorshipAbstract
Background: Breast cancer is the second most commonly diagnosed cancer among women worldwide, and mastectomy remains a critical surgical intervention in its management. Postoperative complications such as rotator cuff dysfunction, pain, and limited upper limb range of motion affect 17–51% of breast cancer survivors, often impairing their ability to perform daily tasks. Physical rehabilitation techniques have shown promise in addressing these impairments, particularly in restoring functional mobility and enhancing the quality of life.
Objective: This study aimed to compare the effectiveness of inhibition compression therapy and scapular mobilization in improving shoulder function, range of motion (ROM), and pain outcomes in patients following mastectomy.
Methods: A randomized controlled trial (RCT) was conducted over six months at the Gujranwala Institute of Nuclear Medicine. A total of 48 female patients post-modified radical mastectomy were recruited using non-probability convenience sampling and randomly assigned to Group A (inhibition compression, n=24) or Group B (scapular mobilization, n=24). Outcome measures included the Shoulder Pain and Disability Index (SPADI), Constant-Murley Shoulder Outcome Score, and goniometric assessments for flexion, abduction, and external rotation. Data were analyzed using SPSS v25, with a significance level set at p ≤ 0.05.
Results: Both groups showed statistically significant improvements (p < 0.001) in SPADI scores and Constant-Murley scores. Group A showed improvements in flexion from 90.1° to 140.4°, abduction from 80.2° to 135.3°, and external rotation from 40.1° to 78.3°. Group B improved from 92.5° to 128.3° (flexion), 85.0° to 125.7° (abduction), and 43.7° to 70.2° (external rotation).
Conclusion: Scapular mobilization and inhibition compression therapies both effectively reduced pain and improved shoulder ROM following mastectomy. However, inhibition compression yielded greater gains in functional outcomes, highlighting its value in postmastectomy rehabilitation programs.
References
Goethals A, Rose J. Mastectomy. InStatPearls [Internet] 2022 Oct 6. StatPearls Publishing.
Lim DW, Metcalfe KA, Narod SA. Bilateral mastectomy in women with unilateral breast cancer: a review. JAMA surgery. 2021 Jun 1;156(6):569-76.
Kaidar-Person O, Boersma LJ, Poortmans P, Sklair-Levy M, Offersen BV, Cardoso MJ, de Ruysscher D. Residual glandular breast tissue after mastectomy: a systematic review. Annals of Surgical Oncology. 2020 Jul; 27:2288-96.
Kaidar-Person O, Offersen BV, Boersma LJ, de Ruysscher D, Tramm T, Kühn T, Gentilini O, Mátrai Z, Poortmans P. A multidisciplinary view of mastectomy and breast reconstruction: Understanding the challenges. The breast. 2021 Apr 1; 56:42-52.
Gabriel A, Maxwell GP. Anatomy of the Breast. Augmentation Mastopexy: Mastering the Art in the Management of the Ptotic Breast. 2020:1-0.
Nurmik M, Ullmann P, Rodriguez F, Haan S, Letellier E. In search of definitions: Cancer‐associated fibroblasts and their markers. International journal of cancer. 2020 Feb 15;146(4):895-905.
Kunkler IH, Williams LJ, Jack WJ, Cameron DA, Dixon JM. Breast-conserving surgery with or without irradiation in early breast cancer. New England Journal of Medicine. 2023 Feb 16;388(7):585-94.
Murphy AI, Asadourian PA, Mellia JA, Rohde CH. Complications associated with contralateral prophylactic mastectomy: a systematic review and meta-analysis. Plastic and Reconstructive Surgery. 2022 Oct 1; 150:61S-72S.
Angarita FA, Castelo M, Englesakis M, McCready DR, Cil TD. Robot-assisted nipple-sparing mastectomy: systematic review. Journal of British Surgery. 2020 Nov;107(12):1580-94.
Trayes KP, Cokenakes SE. Breast cancer treatment. American family physician. 2021 Aug;104(2):171-8.
Liu R, Xie H, Wang Y, Wang Q, Xie X, Zhang X. Impact of unilateral mastectomy on body posture: A prospective longitudinal observational study. Asia-Pacific Journal of Oncology Nursing. 2024 Feb 1;11(2):100336.
Galasso A, Urits I, A D, Nguyen D, Borchart M, Yazdi C, Manchikanti L, Kaye RJ, Kaye AD, Mancuso KF, Viswanath O. A comprehensive review of the treatment and management of myofascial pain syndrome. Current pain and headache reports. 2020 Aug; 24:1-1.
Chappell AG, Yuksel S, Sasson DC, Wescott AB, Connor LM, Ellis MF. Post-mastectomy pain syndrome: an up-to-date review of treatment outcomes. JPRAS open. 2021 Dec 1; 30:97-109.
Redemski T, Hamilton DG, Schuler S, Liang R, Michaleff ZA. Rehabilitation for Women Undergoing Breast Cancer Surgery: A Systematic Review and Meta-Analysis of the Effectiveness of Early, Unrestricted Exercise Programs on Upper Limb Function. Clin Breast Cancer. 2022;22(7):650-65.
González-Rubino JB, Martín-Valero R, Vinolo-Gil MJ. Physiotherapy protocol to reduce the evolution time of axillary web syndrome in women post-breast cancer surgery: a randomized clinical trial. Support Care Cancer. 2025;33(4):326.
Majed M, Neimi CA, Youssef SM, Takey KA, Badr LK. The Impact of Therapeutic Exercises on the Quality of Life and Shoulder Range of Motion in Women After a Mastectomy, an RCT. J Cancer Educ. 2022;37(3):843-51.
Rizzi S, Haddad CAS, Giron PS, Figueira PVG, Estevão A, Elias S, et al. Exercise Protocol With Limited Shoulder Range of Motion for 15 or 30 Days After Conservative Surgery for Breast Cancer With Oncoplastic Technique: A Randomized Clinical Trial. Am J Clin Oncol. 2021;44(6):283-90.
Yuan R, Wei X, Ye Y, Wang M, Jiang J, Li K, et al. The effects of the mirror therapy on shoulder function in patients with breast cancer following surgery: a randomized controlled trial. J Cancer Surviv. 2024;18(5):1574-89.
Casanovas-Álvarez A, Estanyol B, Ciendones M, Padròs J, Cuartero J, Barnadas A, et al. Effectiveness of an Exercise and Educational-Based Prehabilitation Program in Patients With Breast Cancer Receiving Neoadjuvant Chemotherapy (PREOptimize) on Functional Outcomes: A Randomized Controlled Trial. Phys Ther. 2024;104(12).
Rao MS, Pattanshetty RB. Effect of myofascial release, stretching, and strengthening on upper torso posture, spinal curvatures, range of motion, strength, shoulder pain and disability, and quality of life in breast cancer survivors. Physiother Res Int. 2022;27(2):e1939.
Min J, Kim JY, Ryu J, Park S, Courneya KS, Ligibel J, et al. Early Implementation of Exercise to Facilitate Recovery After Breast Cancer Surgery: A Randomized Clinical Trial. JAMA Surg. 2024;159(8):872-80.
Aboelnour NH, Kamel FH, Basha MA, Azab AR, Hewidy IM, Ezzat M, et al. Combined effect of graded Thera-Band and scapular stabilization exercises on shoulder adhesive capsulitis post-mastectomy. Support Care Cancer. 2023;31(4):215.
Huo H, Wang Q, Zhou S, Cui L. The application of personalized rehabilitation exercises in the postoperative rehabilitation of breast cancer patients. Ann Palliat Med. 2021;10(4):4486-92.
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Copyright (c) 2025 Wardah Zahid, Asima Irshad, Muhammad Hamza, Nafeesa Taj , Atif Ali Attar , Sadia Sukhera, Aqsa Majeed (Author)
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