Date of Award

2017

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Peggy Mohr

Keywords

Breast Neoplasms -- surgery; Bursitis -- rehabilitation; Bursitis -- therapy; Case Reports

Abstract

Purpose: The purpose of this case report was to outline the physical therapy interventions and factors affecting rehabilitation of a patient with adhesive capsulitis following breast cancer surgery.

Case Description: A 65 year-old female, with limited range of motion in the right shoulder and right anterior chest pain, was seen at an outpatient physical therapy clinic. Past medical history included unilateral right mastectomy, right lymph node dissection, and chemotherapy. The physical therapy examination and patient history led to the diagnosis of adhesive capsulitis of the right shoulder and fibrosis of the anterior chest wall musculature.

Plan of Care: The patient came to therapy 2-3 times a week for 12 weeks. Interventions included strengthening and stabilization activities for the shoulder and scapular muscles, gleno-humeral joint mobilization, a home exercise program, and patient education. The primary outcome measures were PROM, pain ratings, MMT, and the Focus On Therapeutic Outcomes (FOTO), a functional assessment.

Outcomes: After 12 weeks of intervention, passive and active range of motion (PROM and AROM) increased, shoulder and scapular muscle strength increased, and pain decreased. Overall, she had an increase in her functional mobility via the FOTO assessment.

Discussion: The results of this study focused on intervention options for breast cancer survivors and how to help them cope with their injury. Further education may need to be given to health professionals and patients following surgery to prevent shoulder dysfunction.

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