Astym therapy improves function and range of motion following mastectomy

Claire C Davies, Dorothy Brockopp, Krista Moe, Claire C Davies, Dorothy Brockopp, Krista Moe

Abstract

Hypersensitive scar tissue formation along the incision line and drain site is a common side effect following mastectomy. If this scar tissue is not addressed, it can lead to decreased flexibility and function in the involved upper quadrant. Astym(®) treatment is a new approach to soft tissue injuries, and is evidenced in animal studies to promote the healing and regeneration of soft tissues. It has also been found to reduce pain and increase function in people with soft tissue dysfunction. The aim of Astym treatment is to engage the regenerative mechanisms of the body in order to resorb scar tissue, stimulate tissue turnover, and regenerate soft tissues. Handheld instrumentation is applied topically to locate and treat the underlying dysfunctional soft tissue through specific protocols for the application of particular pressures and shear forces. The purpose of this study was to examine the effects of Astym treatment on activities of daily living in women who had undergone a mastectomy following a diagnosis of breast cancer. A quasi-experiment involving 40 women, following a mastectomy, evaluated five outcome measures pre- and post-Astym treatment. All five measurement scores: Disabilities of the Arm, Shoulder, and Hand Outcome Measure; a clothing questionnaire on their ability to wear a bra; Patient-Specific Functional Scale; active range of motion of shoulder flexion; and active range of motion of abduction were also measured and all demonstrated significant changes. In this study, Astym treatment improved active range of motion in the involved quadrant and also improved function in patients following a mastectomy.

Keywords: breast cancer; physical therapy; quality of life; scar tissue treatment.

References

    1. American Cancer Society . Cancer Facts and Figures 2013–14. Atlanta, GA: American Cancer Society Inc; 2013.
    1. Smoot B, Wampler M, Topp KS. Breast cancer treatments and complications: implications for rehabilitation. Rehabil Oncol. 2009;27(3):16–26.
    1. National Cancer Institute Surveillance Epidemiology and End Results (SEER) stat fact sheet. Breast cancer. [Accessed June 10, 2010]. Available from: .
    1. Cheville AL, Troxel AB, Basford JR, Koprnblith AB. Prevalence and treatment patterns of physical impairments in patients with metastatic breast cancer. J Clin Oncol. 2008;26:2621–2629.
    1. Leidenius M, Leppanen E, Krogerus L, von Smitten K. Motion restriction and axillary web syndrome after sentinel node biopsy and axillary clearance in breast cancer. Am J Surg. 2003;185(2):127–130.
    1. Sevier TL, Stegink-Jansen CW. Astym treatment vs. eccentric exercise for lateral elbow tendinopathy: a randomized controlled clinical trial. PeerJ. 2015;3:e967. doi: 10.7717/peerj.967.
    1. Davidson CJ, Ganion L, Gehlsen GM, Verhoestra B, Roepke JE, Sevier TL. Rat tendon morphologic and functional changes resulting from soft tissue mobilization. Med Sci Sports Exerc. 1997;29(3):313–319.
    1. Gehlsen GM, Ganion LR, Helfst RH. Fibroblast responses to variation in soft tissue mobilization pressure. Med Sci Sports Exerc. 1999;31(4):531–535.
    1. Henry P, Panwitz B, Wilson JK. Treatment of a bilateral total knee replacement using augmented soft tissue mobilization. Phys Ther Case Rep. 1999;2(1):27–30.
    1. Henry P, Panwitz B, Wilson JK. Rehabilitation of a post-surgical patella fracture: a case study. Physiotherapy. 2000;86(3):139–142.
    1. Slaven EJ, Mathers J. Management of chronic ankle pain using joint mobilization and Astym® treatment: a case report. J Man Manip Ther. 2011;19(2):108–112.
    1. Branford OA, Brown RA, McGrouther DA, Grobbelaar AO, Mudera V. Shear-aggregated fibronectin with anti-adhesive properties. J Tissue Eng Regen Med. 2011;5(1):20–31. doi: 10.1002/term.284.
    1. McDonald JA, Kelley DG, Broekelmann TJ. Role of fibronectin in collagen deposition: Fab’ to the gelatin-binding domain of fibronectin inhibits both fibronectin and collagen organization in fibroblast extracellular matrix. J Cell Biol. 1982;92(2):485–492.
    1. Davies CC, Brockopp D. Use of ASTYM treatment on scar tissue following surgical treatment for breast cancer: a pilot study. Rehabil Oncol. 2010;28(32):3–12.
    1. Daniels CJ, Morrell AP. Chiropractic management of pediatric plantar fasciitis: a case report. J Chiropr Med. 2012;11(1):58–63.
    1. Solecki TJ, Herbst EM. Chiropractic management of a postoperative complete anterior cruciate ligament rupture using a multimodal approach: a case report. J Chiropr Med. 2011;10(1):47–53.
    1. Schaefer JL, Sandrey MA. Effects of a 4-week dynamic-balance-training program supplemented with graston instrument-assisted soft-tissue mobilization for chronic ankle instability. J Sport Rehabil. 2012;21(4):313–326.
    1. Blanchette MA, Normand MC. Augmented soft tissue mobilization vs natural history in the treatment of lateral epicondylitis: a pilot study. J Manipulative Physiol Ther. 2011;34(2):123–130.
    1. Vardiman JP, Siedlik J, Herda T, et al. Instrument-assisted soft tissue mobilization: effects on the properties of human plantar flexors. Int J Sports Med. 2015;36(3):197–203.
    1. McConnell S, Beaton DE, Bombardier C. The DASH Outcome Measure User’s Manual. Toronto, Canada: Institute for Work and Health; 1999.
    1. Swisher AK, Davison C, Aranda R, et al. Frequency and severity of self-reported upper extremity impairments, activity limitation and participation restrictions following breast cancer treatment. Rehabil Oncol. 2010;28(1):3–9.
    1. Hudak P, Amadio P, Bombardier C. Development of an upper extremity outcome measure: the DASH (Disabilities of the Arm, Shoulder and Hand) Am J Ind Med. 1966;29:602–608.
    1. Stratford P, Guill C, Westaway M, Brinkley J. Assessing disability and change on individual patients: a report of a patient specific measure. Physiother Can. 1995;47:258–263.
    1. Tengrup I, Tennvall-Nittby L, Christiansson I, Laurin M. Arm morbidity after breast-conserving therapy for breast cancer. Acta Oncol. 2000;39(3):393–397.
    1. Gosselink R, Rouffaer L, Vanhelden P, Piot W, Trooster TCM. Recovery of the upper limb function after axillary dissection. J Surg Oncol. 2003;83:204–211.
    1. Lotze M, Duncan M, Gerber L, Woltering E, Rosenberg S. Early versus delayed shoulder motion following axillary dissection. Ann Surg. 1981;193(3):288–295.
    1. Blomqvist L, Stark B, Engler N, Malm M. Evaluation of arm and shoulder mobility and strength after modified radical mastectomy and radiotherapy. Acta Oncol. 2004;43(3):280–283.
    1. Haynes K, Walton JR, Szomor ZL, Murrell GAC. Reliability of five methods for assessing shoulder range of motion. Aust J Physiother. 2001;47(4):289–294.
    1. Atroshi I, Gummesson C, Andersson B, Dahlgren E, Johansson A. The Disabilities of the Arm, Shoulder and Hand (DASH) outcome questionnaire. Reliability and validity of the Swedish version evaluated in 176 patients. Acta Orthop Scand. 2000;71(6):613–618.
    1. Beaton DE, Wright JG, Katz JN. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg. 2005;87(5):1038–1046.
    1. Gummesson C, Atroshi I, Ekdahl C. The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: longitudinal construct validity and measuring self-rated health change after surgery. BMC Musculoskelet Disord. 2003;4:11.
    1. Muir SW, Corea CL, Beaupre L. Evaluating change in clinical status: reliability and measures of agreement for the assessment of glenohumeral range of motion. N Am J Sports Phys Ther. 2010;5(3):98–110.

Source: PubMed

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