Breast cancer (BC) survivors frequently complain of functional limitation of the shoulder following cancer treatments. Despite the physical and psychological implications, the optimal management of this disabling condition is still debated. Thus, the aim of this study was to assess the long-term effects of a comprehensive rehabilitation program, including ultrasound (US) guided injection of the sub-acromial deltoid bursa (SAD) combined with a physical rehabilitation protocol.
In this randomized controlled study, adult BC survivors with SAD bursitis were assessed for eligibility and randomly assigned to Group A and Group B. Both groups received corticosteroid US guided injection into the SAD bursa, while only Group A received 5 rehabilitation sessions, 1 hour each. Outcomes were assessed at baseline, after one week (T1), three months (T2), and six months (T3). It was assessed the Numerical Pain Rating Scale (NPRS), handgrip strength (HGS) test, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Oxford Shoulder Score (OSS), Global Perceived Effect (GPE), and safety.
Thirty-seven women were randomly assigned to Group A (n=19; mean age: 56.05 ± 10.30 years) and Group B (n=18; mean age: 58.39 ± 12.09 years). No adverse events were reported. Statistically significant within-group differences were found in both groups in terms of NPRS at T1, T2, and T3 (p <0.05). The between-group analysis showed no differences (p > 0.05) at T1; however, at T2 significant differences were reported in terms of NPRS (2.16 ± 1.39 vs 4.78 ± 1.77; p <0.05), HGS (25.11 ± 3.20 vs 20.33 ± 4.92; p<0.001), OSS (17.00 ± 3.27 vs 33.11 ± 6.471; p<0.0001), and EORTC QLQ-C30 (Functional, Symptom and Global Health subscales, p<0.05). Furthermore, NPRS remained significantly lower in Group A compared to Group B (2.56 ± 1.05 vs 4.65 ± 1.13; p <0.05) at T3.
A comprehensive rehabilitation strategy including US guided injection and physical rehabilitation exercise may be considered safe, feasible, and effective for long-term management of SAD bursitis in BC patients.
The authors.
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All authors have declared no conflicts of interest.