Effect of Resisted Deep Breathing and Myofascial Release in Postmastectomy

Combined Effect of Resisted Deep Breathing and Myofascial Release on Pain, Respiratory Efficiency, Chest Mobility and Lymph Edema in Postmastectomy

This study aims to determine the combined effect of resisted deep breathing and Myofascial release on pain, respiratory efficiency, chest mobility and lymph edema in Postmastectomy.

Study Overview

• Status: Recruiting
• Conditions: Post Mastectomy Lymphedema
• Intervention / Treatment: Other: Resisted Deep Breathing; Other: Myofascial release

Detailed Description

The study will be randomized controlled trial and will conducted in Shokat Khanam hospital and Anmol cancer hospital. Non-probability convenience sampling technique will be used and 48 participants will be recruited in study after randomization. The subjects will be divided into two group. Group A will receive myofascial release. Group B will receive myofascial release with resisted deep breathing. Both Group will receive Baseline treatment which is including transcutaneous electrical nerve stimulation. The total duration of treatment will be 12 weeks and there will be 2 sessions each week. The tools that will be used are Numeric Pain Rating Scale (NPRS) for pain, Circumferential limb measurements for chest mobility or lymph edema and Spirometer for respiratory efficiency. After data collection will be analyzed by using SPSS version 21.

• Study Type: Interventional
• Enrollment (Estimated): 48
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: imran amjad; Phone Number: 03324390125; Email: imran.amjad@riphah.edu.pk

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 6400
      • Recruiting
      • Riphah medical center
      • Contact: hina gul, PhD*; Phone Number: 03214979172; Email: hina.gul@riphah.edu.pk
      • Principal Investigator: amara eman, MSPT(WH)

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Radiation therapy and chemotherapy was finished at least three months
• 6 months after mastectomy for breast cancer being diagnosed without lymphedema or with stage 1 lymphedema
• Complete unilateral Mastectomy
• pain and having one or more of the following symptoms: heaviness, numbness, oppression, stiffness, alterations in the function, or mobility of the limited shoulder range of motion.

Exclusion Criteria:

• Presence of shoulder pathologies for which surgical indications exist
• Musculoskeletal injury in adjacent areas (shoulder or neck etc.)
• bilateral surgery for the treatment of breast cancer
• Bilateral lymphadenectomy
• Open wounds on upper limbs
• Circulatory disorders
• History of shoulder surgery for reasons other than breast cancer.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Resisted Deep Breathing & Myofascial release; Myofascial release is a hands-on therapy aimed at relieving pain and tightness in the fascia, the connective tissue surrounding muscles, by targeting trigger points and stiff areas and Resisted Deep Breathing (RDB) is a physiotherapy breathing technique used to improve respiratory muscle strength, lung expansion, and ventilation efficiency	Other: Resisted Deep Breathing; The total duration of treatment will be 12 weeks and there will be 2 sessions each week; Other: Myofascial release; The total duration of treatment will be 12 weeks and there will be 2 sessions each week
Active Comparator: Myofascial release; Myofascial release is a hands-on therapy aimed at relieving pain and tightness in the fascia, the connective tissue surrounding muscles, by targeting trigger points and stiff areas	Other: Myofascial release; The total duration of treatment will be 12 weeks and there will be 2 sessions each week

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Spirometer	The evaluation of pulmonary function will be performed using conventional spirometry with a Spirobank USB spirometer (Medical International Research, Rome, Italy). The directly measured parameters will include lung volumes, capacities, and flow rates, assessed through the procedures of slow vital capacity (SVC), forced vital capacity (FVC), and maximal voluntary ventilation (MVV), performed in this order	12th week
Circumferential limb measurements	In the proposed study, upper limb volume will be measured using circumference measurements. The anatomical positions of the arm will be selected at 7 cm intervals, including the wrist (the slenderest part), 7 cm above the wrist (lower arm), 7 cm below the elbow (lower arm), at the elbow, 7 cm above the elbow (upper arm), and at the same level as the axilla (upper arm). To minimize measurement error, all measurements will be taken at a constant pressure, with participants seated in a position where the hips and knees are bent at 90 degrees.	12th week
Numerical pain rating scale (NPRS)	Subjective pain will be measured using the Numerical pain Rating Scale (NPRS), which is the simplest and most commonly used pain assessment tool. Patients will be asked to mark a point on a line ranging from 0 (no pain) to 10 (worst imaginable pain) to indicate their pain intensity.	12th week
Chest Mobility	Chest circumference at maximal voluntary inspiration (insp) and maximal voluntary expiration (expir), as well as chest expansion (CE) calculated as the difference between insp and expir will be measured in a sitting position using a tape marked in 0.1 cm increments at the level of the fourth intercostal space. Participants will be instructed about the procedure and asked to exhale fully and hold for expir, and inhale deeply and hold for insp. The highest insp and lowest expir values from three attempts will be recorded, and their difference will represent chest expansion	12th week

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: hina gul, PhD*, Riphah International University

Publications and helpful links

General Publications

• Vijayakumar C, Jain A, Kalaranjani M, Kumbhar US, Kumar AN, Sreenath GJSQUMJ. Effectiveness of Myofascial Release Compared to Manual Lymphatic Drainage in Reducing Post-Treatment Shoulder Pain and Stiffness Among Patients Who Underwent Breast Cancer Surgery and Adjuvant Radiotherapy: Randomised controlled trial. 2025;25(1):328-35.
• Sun R, Liao Y. The impact of combined Gua Sha and myofascial release techniques on upper limb dysfunction in patients with breast cancer and axillary web syndrome: a prospective case series study. Supportive Care in Cancer. 2025;33(4):270
• Lara-Palomo IC, Castro-Sánchez AM, Córdoba-Peláez MM, Albornoz-Cabello M, Ortiz-Comino LJIJoER, Health P. Effect of myofascial therapy on pain and functionality of the upper extremities in breast cancer survivors: A systematic review and meta-analysis. 2021;18(9):4420.
• Yena K, Eun YP, Haneul LJEJop, Medicine r. The effect of myofascial release in patients with breast cancer-related lymphedema: a cross-over randomized controlled trial. 2023;59(1):85.
• AMANY RAW, FATMA SA, NANCY HA, ASHRAF EEJTMJoCU. Effect of Resisted Deep Breathing on Post Mastectomy Lymphedema. 2024;91(12):1443-8.

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2025
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): July 1, 2026

Study Registration Dates

• First Submitted: May 4, 2026
• First Submitted That Met QC Criteria: May 4, 2026
• First Posted (Actual): May 8, 2026

Study Record Updates

• Last Update Posted (Actual): May 8, 2026
• Last Update Submitted That Met QC Criteria: May 4, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Lymphedema; Pain; Chest; Post mastectomy; Myofasical release
• Additional Relevant MeSH Terms: Neurologic Manifestations; Postoperative Complications; Pathologic Processes; Lymphatic Diseases; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Hemic and Lymphatic Diseases; Breast Cancer Lymphedema; Pain; Lymphedema; Therapeutics; Complementary Therapies; Physical Therapy Modalities; Rehabilitation; Therapy, Soft Tissue; Musculoskeletal Manipulations; Massage; Myofascial Release Therapy
• Other Study ID Numbers: REC/RCR & AHS/25/0507

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No