Effectiveness of Water Physical Therapy on Pain, Pressure Pain Sensitivity, and Myofascial Trigger Points in Breast Cancer Survivors: A Randomized, Controlled Clinical Trial
Objective. To evaluate the effects of an 8‐week water physical therapy program on cervical and shoulder pain, pressure sensitivity, and the presence of trigger points (TrPs) in breast cancer survivors. Design. Randomized, controlled trial. Setting. To date, no study has investigated effects of wa...
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| Veröffentlicht in: | Pain medicine (Malden, Mass.) Mass.), 2012-11, Vol.13 (11), p.1509-1519 |
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| creator | Cantarero-Villanueva, Irene Fernández-Lao, Carolina Fernández-de-las-Peñas, César López-Barajas, Isabel B. Del-Moral-Ávila, Rosario de la-Llave-Rincón, Ana Isabel Arroyo-Morales, Manuel |
| description | Objective. To evaluate the effects of an 8‐week water physical therapy program on cervical and shoulder pain, pressure sensitivity, and the presence of trigger points (TrPs) in breast cancer survivors.
Design. Randomized, controlled trial.
Setting. To date, no study has investigated effects of water therapy in breast cancer.
Patients. Sixty‐six breast cancer survivors were randomly assigned into two groups: WATER group, who received a water exercise program or CONTROL group who received the usual care treatment for breast cancer.
Interventions. The WATER therapy program consisted of 24 sessions (3 times/week over 8 weeks) of low‐intensity exercises in a warm pool (32°C). Each session included 10‐minute warm‐up period; 35 minutes of aerobic, low‐intensity endurance, and core stability training; and a 15‐minute cool‐down period (stretching and relaxation).
Outcomes. Neck and shoulder pain (visual analog scale, 0–100 mm), pressure pain thresholds (PPTs) over C5‐C6 zygapophyseal joints, deltoid muscles, second metacarpal, and tibialis anterior muscles, and the presence of TrPs in cervical‐shoulder muscles were assessed at baseline and after the 8‐week program by an assessor blinded to treatment allocation.
Results. The WATER group demonstrated a between‐group improvement for neck pain of −31 mm (95% confidence interval [CI]−49 to −22, P 0.05). Finally, patients in the WATER program showed a greater reduction of active TrPs as compared with the CONTROL group (P |
| doi_str_mv | 10.1111/j.1526-4637.2012.01481.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1492645324</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2815046911</sourcerecordid><originalsourceid>FETCH-LOGICAL-c6171-4d6d15880470c106df1bf1e654024c3a8b78d4120a4ff3ee953fb171cfb1bfca3</originalsourceid><addsrcrecordid>eNqNkkFv0zAYhiMEYmPwF5AlLhzaYie2kyBx2KqyMa1QbUU9Wq7zeXNJ7WInpeE_8R9x1tIDF_Ah_mI_z5dYr5MEETwicbxbjQhL-ZDyLB-lmKQjTGhBRrsnyelx4-mhTrOcnSQvQlhhTDgtsufJSZqWrGA4P01-TbQG1ZgtWAgBOY0WsgGPZg9dMErWaP4AXm465CyaSWMHaOYj2Hp4fEV3YIOJumm6AZK2QtPOaRmU6VVv7u_7Xs7YJqBIX3iQoUFjaVVcv2v91mydD-_RObqNslubn1AN0NjZxru6hgqNa2P3_-Fjy5fJMy3rAK8O81ny9eNkPr4a3ny5_DQ-vxkqTnIypBWvCCsKTHOsCOaVJktNgDOKU6oyWSzzoqIkxZJqnQGULNPLKKr4XGols7Pk7b7vxrvvLYRGrE1QUNfSgmuDILRMOWVZSv-NkrzgeVmyMqJv_kJXrvU2HiRSjOQlIzyLVLGnlHcheNBi481a-k4QLPr0xUr0wYo-ZNGnLx7TF7uovj58oF2uoTqKf-KOwIc98MPU0P13YzGbTvoq-sO9b0IDu6Mv_TfB83jPxOLzpZhPr6eL26trUWa_Ab3yzjY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1151795163</pqid></control><display><type>article</type><title>Effectiveness of Water Physical Therapy on Pain, Pressure Pain Sensitivity, and Myofascial Trigger Points in Breast Cancer Survivors: A Randomized, Controlled Clinical Trial</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Cantarero-Villanueva, Irene ; Fernández-Lao, Carolina ; Fernández-de-las-Peñas, César ; López-Barajas, Isabel B. ; Del-Moral-Ávila, Rosario ; de la-Llave-Rincón, Ana Isabel ; Arroyo-Morales, Manuel</creator><creatorcontrib>Cantarero-Villanueva, Irene ; Fernández-Lao, Carolina ; Fernández-de-las-Peñas, César ; López-Barajas, Isabel B. ; Del-Moral-Ávila, Rosario ; de la-Llave-Rincón, Ana Isabel ; Arroyo-Morales, Manuel</creatorcontrib><description>Objective. To evaluate the effects of an 8‐week water physical therapy program on cervical and shoulder pain, pressure sensitivity, and the presence of trigger points (TrPs) in breast cancer survivors.
Design. Randomized, controlled trial.
Setting. To date, no study has investigated effects of water therapy in breast cancer.
Patients. Sixty‐six breast cancer survivors were randomly assigned into two groups: WATER group, who received a water exercise program or CONTROL group who received the usual care treatment for breast cancer.
Interventions. The WATER therapy program consisted of 24 sessions (3 times/week over 8 weeks) of low‐intensity exercises in a warm pool (32°C). Each session included 10‐minute warm‐up period; 35 minutes of aerobic, low‐intensity endurance, and core stability training; and a 15‐minute cool‐down period (stretching and relaxation).
Outcomes. Neck and shoulder pain (visual analog scale, 0–100 mm), pressure pain thresholds (PPTs) over C5‐C6 zygapophyseal joints, deltoid muscles, second metacarpal, and tibialis anterior muscles, and the presence of TrPs in cervical‐shoulder muscles were assessed at baseline and after the 8‐week program by an assessor blinded to treatment allocation.
Results. The WATER group demonstrated a between‐group improvement for neck pain of −31 mm (95% confidence interval [CI]−49 to −22, P < 0.001; effect size 1.1, 0.81–1.75) and for shoulder‐axillary of −19 mm (−40 to −04, P = 0.046; effect size 0.70, 0.14–1.40). Improvements were also noted for PPT levels over C5‐C6 joints (between‐group differences, affected side: 27.7 kPa, 95% CI 3.9–50.4; unaffected: 18.1 kPa, 95% CI 6.1–52.2). No between‐group differences for PPT over the remaining points were observed (P > 0.05). Finally, patients in the WATER program showed a greater reduction of active TrPs as compared with the CONTROL group (P < 0.05).
Conclusions. An 8‐week water therapy program was effective for improving neck and shoulder/axillary pain, and reducing the presence of TrPs in breast cancer survivors as compared with usual care; however, no significant changes in widespread pressure pain hyperalgesia were found.</description><identifier>ISSN: 1526-2375</identifier><identifier>EISSN: 1526-4637</identifier><identifier>DOI: 10.1111/j.1526-4637.2012.01481.x</identifier><identifier>PMID: 22958507</identifier><identifier>CODEN: PMAEAP</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Inc</publisher><subject>Breast Cancer ; Breast Neoplasms - complications ; Breast Neoplasms - pathology ; Breasts ; Exercise ; Exercise Therapy - methods ; Female ; Humans ; Hyperalgesia - etiology ; Hyperalgesia - rehabilitation ; Middle Aged ; Myofascial Pain Syndromes - etiology ; Myofascial Pain Syndromes - rehabilitation ; Neoplasm Staging ; Pain ; Pain - etiology ; Pain - rehabilitation ; Pain Measurement ; Pressure ; Pressure Sensitivity ; Survivors ; Touch ; Water</subject><ispartof>Pain medicine (Malden, Mass.), 2012-11, Vol.13 (11), p.1509-1519</ispartof><rights>Wiley Periodicals, Inc.</rights><rights>2012 American Academy of Pain Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6171-4d6d15880470c106df1bf1e654024c3a8b78d4120a4ff3ee953fb171cfb1bfca3</citedby><cites>FETCH-LOGICAL-c6171-4d6d15880470c106df1bf1e654024c3a8b78d4120a4ff3ee953fb171cfb1bfca3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1526-4637.2012.01481.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1526-4637.2012.01481.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22958507$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cantarero-Villanueva, Irene</creatorcontrib><creatorcontrib>Fernández-Lao, Carolina</creatorcontrib><creatorcontrib>Fernández-de-las-Peñas, César</creatorcontrib><creatorcontrib>López-Barajas, Isabel B.</creatorcontrib><creatorcontrib>Del-Moral-Ávila, Rosario</creatorcontrib><creatorcontrib>de la-Llave-Rincón, Ana Isabel</creatorcontrib><creatorcontrib>Arroyo-Morales, Manuel</creatorcontrib><title>Effectiveness of Water Physical Therapy on Pain, Pressure Pain Sensitivity, and Myofascial Trigger Points in Breast Cancer Survivors: A Randomized, Controlled Clinical Trial</title><title>Pain medicine (Malden, Mass.)</title><addtitle>Pain Med</addtitle><description>Objective. To evaluate the effects of an 8‐week water physical therapy program on cervical and shoulder pain, pressure sensitivity, and the presence of trigger points (TrPs) in breast cancer survivors.
Design. Randomized, controlled trial.
Setting. To date, no study has investigated effects of water therapy in breast cancer.
Patients. Sixty‐six breast cancer survivors were randomly assigned into two groups: WATER group, who received a water exercise program or CONTROL group who received the usual care treatment for breast cancer.
Interventions. The WATER therapy program consisted of 24 sessions (3 times/week over 8 weeks) of low‐intensity exercises in a warm pool (32°C). Each session included 10‐minute warm‐up period; 35 minutes of aerobic, low‐intensity endurance, and core stability training; and a 15‐minute cool‐down period (stretching and relaxation).
Outcomes. Neck and shoulder pain (visual analog scale, 0–100 mm), pressure pain thresholds (PPTs) over C5‐C6 zygapophyseal joints, deltoid muscles, second metacarpal, and tibialis anterior muscles, and the presence of TrPs in cervical‐shoulder muscles were assessed at baseline and after the 8‐week program by an assessor blinded to treatment allocation.
Results. The WATER group demonstrated a between‐group improvement for neck pain of −31 mm (95% confidence interval [CI]−49 to −22, P < 0.001; effect size 1.1, 0.81–1.75) and for shoulder‐axillary of −19 mm (−40 to −04, P = 0.046; effect size 0.70, 0.14–1.40). Improvements were also noted for PPT levels over C5‐C6 joints (between‐group differences, affected side: 27.7 kPa, 95% CI 3.9–50.4; unaffected: 18.1 kPa, 95% CI 6.1–52.2). No between‐group differences for PPT over the remaining points were observed (P > 0.05). Finally, patients in the WATER program showed a greater reduction of active TrPs as compared with the CONTROL group (P < 0.05).
Conclusions. An 8‐week water therapy program was effective for improving neck and shoulder/axillary pain, and reducing the presence of TrPs in breast cancer survivors as compared with usual care; however, no significant changes in widespread pressure pain hyperalgesia were found.</description><subject>Breast Cancer</subject><subject>Breast Neoplasms - complications</subject><subject>Breast Neoplasms - pathology</subject><subject>Breasts</subject><subject>Exercise</subject><subject>Exercise Therapy - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Hyperalgesia - etiology</subject><subject>Hyperalgesia - rehabilitation</subject><subject>Middle Aged</subject><subject>Myofascial Pain Syndromes - etiology</subject><subject>Myofascial Pain Syndromes - rehabilitation</subject><subject>Neoplasm Staging</subject><subject>Pain</subject><subject>Pain - etiology</subject><subject>Pain - rehabilitation</subject><subject>Pain Measurement</subject><subject>Pressure</subject><subject>Pressure Sensitivity</subject><subject>Survivors</subject><subject>Touch</subject><subject>Water</subject><issn>1526-2375</issn><issn>1526-4637</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkkFv0zAYhiMEYmPwF5AlLhzaYie2kyBx2KqyMa1QbUU9Wq7zeXNJ7WInpeE_8R9x1tIDF_Ah_mI_z5dYr5MEETwicbxbjQhL-ZDyLB-lmKQjTGhBRrsnyelx4-mhTrOcnSQvQlhhTDgtsufJSZqWrGA4P01-TbQG1ZgtWAgBOY0WsgGPZg9dMErWaP4AXm465CyaSWMHaOYj2Hp4fEV3YIOJumm6AZK2QtPOaRmU6VVv7u_7Xs7YJqBIX3iQoUFjaVVcv2v91mydD-_RObqNslubn1AN0NjZxru6hgqNa2P3_-Fjy5fJMy3rAK8O81ny9eNkPr4a3ny5_DQ-vxkqTnIypBWvCCsKTHOsCOaVJktNgDOKU6oyWSzzoqIkxZJqnQGULNPLKKr4XGols7Pk7b7vxrvvLYRGrE1QUNfSgmuDILRMOWVZSv-NkrzgeVmyMqJv_kJXrvU2HiRSjOQlIzyLVLGnlHcheNBi481a-k4QLPr0xUr0wYo-ZNGnLx7TF7uovj58oF2uoTqKf-KOwIc98MPU0P13YzGbTvoq-sO9b0IDu6Mv_TfB83jPxOLzpZhPr6eL26trUWa_Ab3yzjY</recordid><startdate>201211</startdate><enddate>201211</enddate><creator>Cantarero-Villanueva, Irene</creator><creator>Fernández-Lao, Carolina</creator><creator>Fernández-de-las-Peñas, César</creator><creator>López-Barajas, Isabel B.</creator><creator>Del-Moral-Ávila, Rosario</creator><creator>de la-Llave-Rincón, Ana Isabel</creator><creator>Arroyo-Morales, Manuel</creator><general>Blackwell Publishing Inc</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>7TS</scope></search><sort><creationdate>201211</creationdate><title>Effectiveness of Water Physical Therapy on Pain, Pressure Pain Sensitivity, and Myofascial Trigger Points in Breast Cancer Survivors: A Randomized, Controlled Clinical Trial</title><author>Cantarero-Villanueva, Irene ; Fernández-Lao, Carolina ; Fernández-de-las-Peñas, César ; López-Barajas, Isabel B. ; Del-Moral-Ávila, Rosario ; de la-Llave-Rincón, Ana Isabel ; Arroyo-Morales, Manuel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6171-4d6d15880470c106df1bf1e654024c3a8b78d4120a4ff3ee953fb171cfb1bfca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Breast Cancer</topic><topic>Breast Neoplasms - complications</topic><topic>Breast Neoplasms - pathology</topic><topic>Breasts</topic><topic>Exercise</topic><topic>Exercise Therapy - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Hyperalgesia - etiology</topic><topic>Hyperalgesia - rehabilitation</topic><topic>Middle Aged</topic><topic>Myofascial Pain Syndromes - etiology</topic><topic>Myofascial Pain Syndromes - rehabilitation</topic><topic>Neoplasm Staging</topic><topic>Pain</topic><topic>Pain - etiology</topic><topic>Pain - rehabilitation</topic><topic>Pain Measurement</topic><topic>Pressure</topic><topic>Pressure Sensitivity</topic><topic>Survivors</topic><topic>Touch</topic><topic>Water</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cantarero-Villanueva, Irene</creatorcontrib><creatorcontrib>Fernández-Lao, Carolina</creatorcontrib><creatorcontrib>Fernández-de-las-Peñas, César</creatorcontrib><creatorcontrib>López-Barajas, Isabel B.</creatorcontrib><creatorcontrib>Del-Moral-Ávila, Rosario</creatorcontrib><creatorcontrib>de la-Llave-Rincón, Ana Isabel</creatorcontrib><creatorcontrib>Arroyo-Morales, Manuel</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>Physical Education Index</collection><jtitle>Pain medicine (Malden, Mass.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cantarero-Villanueva, Irene</au><au>Fernández-Lao, Carolina</au><au>Fernández-de-las-Peñas, César</au><au>López-Barajas, Isabel B.</au><au>Del-Moral-Ávila, Rosario</au><au>de la-Llave-Rincón, Ana Isabel</au><au>Arroyo-Morales, Manuel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of Water Physical Therapy on Pain, Pressure Pain Sensitivity, and Myofascial Trigger Points in Breast Cancer Survivors: A Randomized, Controlled Clinical Trial</atitle><jtitle>Pain medicine (Malden, Mass.)</jtitle><addtitle>Pain Med</addtitle><date>2012-11</date><risdate>2012</risdate><volume>13</volume><issue>11</issue><spage>1509</spage><epage>1519</epage><pages>1509-1519</pages><issn>1526-2375</issn><eissn>1526-4637</eissn><coden>PMAEAP</coden><abstract>Objective. To evaluate the effects of an 8‐week water physical therapy program on cervical and shoulder pain, pressure sensitivity, and the presence of trigger points (TrPs) in breast cancer survivors.
Design. Randomized, controlled trial.
Setting. To date, no study has investigated effects of water therapy in breast cancer.
Patients. Sixty‐six breast cancer survivors were randomly assigned into two groups: WATER group, who received a water exercise program or CONTROL group who received the usual care treatment for breast cancer.
Interventions. The WATER therapy program consisted of 24 sessions (3 times/week over 8 weeks) of low‐intensity exercises in a warm pool (32°C). Each session included 10‐minute warm‐up period; 35 minutes of aerobic, low‐intensity endurance, and core stability training; and a 15‐minute cool‐down period (stretching and relaxation).
Outcomes. Neck and shoulder pain (visual analog scale, 0–100 mm), pressure pain thresholds (PPTs) over C5‐C6 zygapophyseal joints, deltoid muscles, second metacarpal, and tibialis anterior muscles, and the presence of TrPs in cervical‐shoulder muscles were assessed at baseline and after the 8‐week program by an assessor blinded to treatment allocation.
Results. The WATER group demonstrated a between‐group improvement for neck pain of −31 mm (95% confidence interval [CI]−49 to −22, P < 0.001; effect size 1.1, 0.81–1.75) and for shoulder‐axillary of −19 mm (−40 to −04, P = 0.046; effect size 0.70, 0.14–1.40). Improvements were also noted for PPT levels over C5‐C6 joints (between‐group differences, affected side: 27.7 kPa, 95% CI 3.9–50.4; unaffected: 18.1 kPa, 95% CI 6.1–52.2). No between‐group differences for PPT over the remaining points were observed (P > 0.05). Finally, patients in the WATER program showed a greater reduction of active TrPs as compared with the CONTROL group (P < 0.05).
Conclusions. An 8‐week water therapy program was effective for improving neck and shoulder/axillary pain, and reducing the presence of TrPs in breast cancer survivors as compared with usual care; however, no significant changes in widespread pressure pain hyperalgesia were found.</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>22958507</pmid><doi>10.1111/j.1526-4637.2012.01481.x</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1526-2375 |
| ispartof | Pain medicine (Malden, Mass.), 2012-11, Vol.13 (11), p.1509-1519 |
| issn | 1526-2375 1526-4637 |
| language | eng |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Breast Cancer Breast Neoplasms - complications Breast Neoplasms - pathology Breasts Exercise Exercise Therapy - methods Female Humans Hyperalgesia - etiology Hyperalgesia - rehabilitation Middle Aged Myofascial Pain Syndromes - etiology Myofascial Pain Syndromes - rehabilitation Neoplasm Staging Pain Pain - etiology Pain - rehabilitation Pain Measurement Pressure Pressure Sensitivity Survivors Touch Water |
| title | Effectiveness of Water Physical Therapy on Pain, Pressure Pain Sensitivity, and Myofascial Trigger Points in Breast Cancer Survivors: A Randomized, Controlled Clinical Trial |
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