PTPilotJournal of physical therapy science2016

Pilot study of effective methods for measuring and stretching for pectoral muscle tightness in breast cancer patients.

So Young Lee, Mi Kyung Sim, Junghwa Do and 2 others

PMID 27942114

WHAT IT FOUND

Measuring and stretching with the arm at 90° or 135° gave larger shoulder horizontal abduction differences and greater improvement than at 45° after a 4 week program that also included gentle shoulder range of motion.

Pain, function and quality of life did not differ.

Key findings

01Horizontal abduction differences between shoulders were larger when the arm was abducted to 90° or 135° than to 45° when measuring pectoral muscle tightness.

02After 4 weeks of a program that included gentle shoulder range of motion exercises and pectoral stretching, shoulder horizontal abduction improved by 10.0° in the 45° group, 25.7° in the 90° group, and 23.3° in the 135° group, with groups B and C showing larger changes than group A.

03Pain, upper-extremity function, and quality of life scores did not differ significantly among the three groups.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The groups were small, with 11, 11, and 10 patients, so the results may be unstable. Outcomes were measured only before and after the 4 week program, so there is no long term follow up. Patient compliance with the stretching program was not controlled. The study did not measure other late complications such as myofascial pain syndrome or rotator cuff disease. Improvement in shoulder horizontal abduction did not lead to significant differences in pain, disability, or quality of life. There were no definitive diagnostic criteria to rule out pectoralis tightness. The stretching program also included gentle shoulder range of motion exercises, so the effect of pectoral stretching alone cannot be separated.

Declared interests

The authors declared no competing interests and stated that no party with a direct interest in the results would confer a benefit on them or on any organization with which they were associated.

The easy way to misread this

Do not read this as proof that pectoral stretching alone improves pain, daily function, or quality of life. The program also included gentle shoulder range of motion, and the study showed larger changes in shoulder horizontal abduction, but pain, disability, and quality of life scores did not differ significantly among groups. The study was small and short.

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