Meme Kanseri Tedavileri İle İlişkili Kronik Ağrıda Mobilizasyon, Egzersiz Ve Ağrı Eğitimlerinin Etkilerinin İncelenmesi

Abstract

The aim of the study was to compare the effects of Pain Neuroscience Education and Biomedical Pain Education on pain (pain severity and pain-related dysfunction), somatosensory function, psychological function and quality of life in patients with chronic pain after breast cancer treatments, with the Standard Physiotherapy Program, in a randomized design. The study included 50 women who had undergone breast cancer treatments with chronic pain. Patients were randomized to either Pain Neuroscience Education (1st Group) or Biomedical Pain Education (2nd Group). The patients received four session training programs and the Standard Physiotherapy Program, which included soft tissue mobilization and exercise for six weeks (2 sessions per week). Primary outcome measures included pain intensity and pain related disability were measured by the Visual Analog Scale and Pain Disability Index, respectively. Secondary outcome measures included somatosensory function, psychological function and quality of life were evaluated by the Digital Pressure Algometer and Semmes Weinstein Monofilaments, Pain Catastrophizing Scale (PCS), Depression, Anxiety-Stress 21 Scale (DASS-21) and Functional Assessment of Cancer Therapy–Breast (FACT-B+4), respectively. In both groups, pain severity and pain-related disability, which are primary outcome measures, improved over time (p<0.05). Considering the changes in secondary outcome measures over time, in the Pain Neuroscience Education group, BAE (lateral trunk and unaffected side quadriceps muscle) and MAE values (inner arm, lateral trunk, unaffected side quadriceps muscle), pain catastrophization, psychological symptoms (anxiety and stress) and all sub-dimensions of quality of life were improved (p<0.05). In the Biomedical Pain Education group, only MAE values (inner side of the upper arm and lateral trunk), pain catastrophization, psychological symptoms (anxiety and stress sub-dimensions) and quality of life (physical, emotional and functional status sub-dimensions) improved (p<0.05). In intergroup comparisons, in secondary outcome measurements, it was found that MAE values in the lateral trunk and quadriceps muscle on the unaffected side showed a significant change in favor of the Pain Neuroscience Education group (p<0.05). Pain Neuroscience Education and Biomedical Pain Education appear to provide similar effects in the short term when given in addition to standard physiotherapy in individuals with chronic upper extremity/shoulder girdle pain after breast cancer surgery. The results should be revealed through further long-term studies and discussed with short-term results.