Efficacy of physical therapy interventions on quality of life and upper quadrant pain severity in women with post-mastectomy pain syndrome: a systematic review and meta-analysis

Priya Kannan, Hiu Ying Lam, Tsz Kiu Ma, Chiu Ngai Lo, Ting Yan Mui, Wing Yan Tang, Priya Kannan, Hiu Ying Lam, Tsz Kiu Ma, Chiu Ngai Lo, Ting Yan Mui, Wing Yan Tang

Abstract

Purpose: To determine the efficacy of physical therapy interventions on quality of life (QoL) and pain severity in post-mastectomy pain syndrome (PMPS).

Methods: Multiple databases were searched from database inception to October 2020. Searches were limited to human studies published in either English or Chinese in peer-reviewed journals with full text available for randomized controlled trials conducted on females. Trials comparing the effectiveness of physical therapy interventions against control conditions on QoL and pain were included.

Results: Eighteen trials were included in the review. The pooled analysis of the four exercise trials revealed a significant effect of the intervention on general [standardized mean difference [SMD]: 0.87 (95%CI: 0.36, 1.37); p = 0.001], physical [SMD: 0.34 (95%CI: 0.01, 0.66); p = 0.044], and mental health components [SMD: 0.27 (95%CI: 0.03, 0.51); p = 0.027] of QoL compared with the control condition. Meta-analyses of six exercise trials, two myofascial release trials, and two acupuncture trials revealed a significant improvement in pain severity in the treatment group than in the control group. However, meta-analyses of two studies revealed a non-significant effect of compression therapy compared to control on pain severity.

Conclusion: Our meta-analyses found that exercise is beneficial for improving the QoL and pain severity of women with PMPS. Future studies are needed to determine the optimal parameters for exercise interventions designed to improve QoL and pain severity in women with PMPS. The effect of acupuncture, myofascial release, and compression therapy remains inconclusive, and future research is required to validate the effect of these interventions on PMPS.

Keywords: Acupuncture; Decongestive therapy; Exercise; Post-mastectomy pain syndrome; Quality of Life.

Conflict of interest statement

The authors declare that they have no conflicts of interest to disclose.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Flowchart of the study selection. PT Physical therapy, *Ineligible women: Women without upper quadrant pain, #Ineligible outcome measures: Outcome measures out of scope of interest of the current meta-analytic review
Fig. 2
Fig. 2
Effect of interventions on quality of life
Fig. 3
Fig. 3
Effect of interventions on pain severity
Fig. 3
Fig. 3
Effect of interventions on pain severity

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