Effects of myofascial reorganization associated with kinesiotherapy on chronic pain and functionality of breast cancer survivors: development of a study protocol

Abstract Introduction: Breast cancer is the most common type of cancer among women. Treatments can lead to complications modifying upper limbs movement patterns and generating pain and functionality loss. Kinesiotherapy and myofascial reorganization (MR) have shown positive effects reducing chronic pain and improving upper limbs function. We hypothesize that these techniques can maximize results and reduce treatment time in clinical practice. Objective: To develop a study protocol to verify whether MR associated with kinesiotherapy is more effective than isolated kinesiotherapy to treat chronic pain and upper limb dysfunction in breast cancer survivors. Methods: Participants will be divided into two groups: intervention group (myofascial reorganization + kinesiotherapy) and sham group (traditional massage + kinesiotherapy). Six treatment sessions (once a week) and three-time assessment will occur. Instruments for assessing pain and functionality will be Visual Analogue Scale, Body Pain Diagram, Disabilities of the Arm, Shoulder and Hand Questionnaire, and goniometry. Statistical analysis will be conducted based on intention-to-treat analysis. To analyze the difference of means between groups, we will use T-Student or U Mann-Whitney test. Repeated measures ANOVA will be used to check treatments effects. Significance level for all tests will be 5%. Conclusion: We believe that the developed study protocol will show that MR associated with kinesiotherapy improve chronic pain and upper limbs functionality of breast cancer survivors.

引言：乳腺癌是女性最常见的癌症类型。临床治疗可能引发并发症，改变患者上肢运动模式，进而产生疼痛与功能丧失。运动疗法（kinesiotherapy）与肌筋膜重组（myofascial reorganization, MR）已被证实可有效缓解慢性疼痛、改善上肢功能。我们提出假说：两类技术联用可最大化临床疗效，缩短实际治疗时长。
研究目的：本研究旨在开发一项试验方案，以验证肌筋膜重组联合运动疗法，相较于单纯运动疗法，在改善乳腺癌幸存者慢性疼痛与上肢功能障碍方面是否更具疗效。
研究方法：将受试者分为两组：干预组（肌筋膜重组+运动疗法）与假对照组（传统按摩+运动疗法）。共设置6次治疗（每周1次），并开展3次评估。疼痛与功能评估工具包括：视觉模拟评分法（Visual Analogue Scale）、身体疼痛示意图（Body Pain Diagram）、上肢、肩部与手部功能障碍问卷（Disabilities of the Arm, Shoulder and Hand Questionnaire）以及关节测角术（goniometry）。统计分析将遵循意向性治疗分析（intention-to-treat analysis）原则：组间均值差异比较采用t检验或曼-惠特尼U检验；治疗效应分析采用重复测量方差分析（repeated measures ANOVA）。所有检验的显著性水平均设定为5%。
研究结论：我们认为本研究开发的试验方案将证实，肌筋膜重组联合运动疗法可有效改善乳腺癌幸存者的慢性疼痛与上肢功能。