Physiotherapy Intervention and Factors Affecting Rehabilitation of A Patient with Adhesive Capsulitis Following Mastectomy Surgery

Breast cancer is the most common cancer among Indian females having a prevalence of about 25.8 and mortality rate of around 12.7 per 100,000 women. Age related abnormal changes within certain cells increases the risk of developing breast cancer. The primary treatment of breast cancer is surgery. The consequences of surgery includes a range of upper limb dysfunctions. This 42 years-oldfemale, reported with right anterior chest pain andlimited range of motion in the right shoulder. She reported history of unilateral modified radical mastectomy. The case was diagnosed as adhesive capsulitis of right shoulder with muscular fibrosis of anterior chest wall. Intervention was targeted on strengthening and stabilization of scapular and shoulder muscles and mobilizationgleno-humeral joint. Physiotherapy was given for 3-4 days per week for 12 weeks. Also home exercise program and patient education sessions were organized. The primary outcome measures includedpassive range of motion, pain rating, MMT, and Barthel index for functional assessment. Total 12 weeks intervention helped to improve passive and active range of motion. Also, shoulder and scapular muscle strength wasimprovedwith reduction in pain. Functional mobility was improved as assessed by Barthel index. The physical therapy rehabilitation for post-operated breast cancer survivors can be quite helpful to cope with the injury. Additional patient education may be required to prevent dysfunction and promote mobility of shoulder joint.