Post MastectomyPNFNCT07547982
Scapular Mobilization and Proprioceptive Neuromuscular Facilitation on Shoulder Dysfunction After Latissimus Dorsi Flap Breast Reconstruction
A study testing scapular mobilization and scapular proprioceptive neuromuscular facilitation exercises and traditional physical therapy in people with Post Mastectomy, run by Cairo University.
Trial summary
this study will be conducted to investigate the effect of scapular mobilization and scapular Proprioceptive neuromuscular facilitation on shoulder dysfunction after latissimus dorsi flap breast reconstruction Read more about this study
- Who is it for?
- Ages 40 to 55 years, women only
- Conditions the study is for
- Post Mastectomy
- What is being tested?
- scapular mobilization and scapular proprioceptive neuromuscular facilitation exercises and traditional physical therapy
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- No sites listed yet
- Study dates
- 25 Apr 2026to 1 Sep 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 40 to 55 years
- Women only
- No healthy volunteers
- Adult
Who may be able to join
- age ranged from 40 to 55 years.
- All patients were female patients suffering from shoulder dysfunction after latissimus dorsi flap breast reconstruction.
- All patients suffering from moderate or severe pain on shoulder joint and limited range of motion that may affect daily activities.
- All patients begun the treatment program 3 to 4 weeks after LDF breast reconstruction.
- Informed consent was obtained from every patient enrolled in the trial.
Who cannot join
- Current metastases.
- Neurological deficit affecting the shoulder functioning during daily activities.
- Pathology of the shoulder joint including rotator cuff tear adhesive capsulitis and tendinitis.
- Pain or disorder of the cervical spine, elbow, wrist or hand.
- Shoulder surgery, shoulder dislocation fracture acromioclavicular joint osteoarthritis.
- Diabetes.
Show all 9Show fewer
- Pregnancy.
- Shoulder manipulation under anesthesia, local corticosteroid injection.
- Psychological disorders.
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
this study will be conducted to investigate the effect of scapular mobilization and scapular Proprioceptive neuromuscular facilitation on shoulder dysfunction after latissimus dorsi flap breast reconstruction
Read the detailed description
Several procedures are available for patients undergoing breast reconstruction including pedicled faps such as latissimus dorsi fap (LDF) and transverse rectus abdomens myocutaneous flap (TRAM), as well as free flap requiring microvascular anastomoses like the deep inferior perforator flap (DIEP). Some of these, like LDF, may be combined with implants to provide adequate volume and symmetry.Surgeons employ the latissimus dorsi flap (LDF) for reconstruction of a large variety of breast cancer surgery defects, including quadrantectomy, lumpectomy, modified radical mastectomy, and others.The Latissimus dorsi (LD) muscle, in its interaction with other muscles of the shoulder plays an important role in shoulder adduction, extension, and internal rotation, as well as scapular depression and lateral flexion of the torso, Daily activities that rely on the function of the LD include swimming, climbing stairs, rising with the aid of the arms, and walking on crutches, There is therefore concern that the LD muscle flap procedure may impair shoulder function.The abnormal scapular biomechanics that occur as a result of dysfunction create abnormal scapular positions that decrease normal shoulder function. Therefore, treatment of shoulder dysfunction should include scapular-mobility exercises, or scapular-mobilization (SM) techniques. scapular mobilization and the combined application of techniques resulted in higher achievements, which may be related to increased scapular mobility and thus, the increased range of motion of the glenohumeral joint after scapular mobilization.
Proprioceptive neuromuscular facilitation is an approach to therapeutic exercise that combines functionally based diagonal patterns of movement with techniques of neuromuscular facilitation to evoke motor responses and improve neuromuscular control and function. Limited research is available on the impact combined effect of scapular mobilization and scapular proprioceptive neuromuscular facilitation on shoulder dysfunction after latissimus dorsi flap breast reconstruction Therefore, this study aims to examine the combined therapeutic effect of both techniques on shoulder dysfunction to aid in planning an ideal physical therapy rehabilitation program for shoulder dysfunction after latissimus dorsi flap breast reconstruction.
- Conditions
- Post Mastectomy
- Being tested
- scapular mobilization and scapular proprioceptive neuromuscular facilitation exercises, traditional physical therapy
- Keywords
- Scapular Mobilization, Proprioceptive Neuromuscular Facilitation, Latissimus Dorsi Flap Breast Reconstruction
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
scapular mobilization and scapular proprioceptive neuromuscular facilitation exercisesOther
for scapular mobilization, The patient will be laying on the affected forearm on their back. The therapist is standing before the patient's affected shoulder, placing the index finger of one hand under the medial scapular border, the other hand grasping the superior border of the scapula. The scapula was moved superiorly and inferiorly for superior and inferior glide, and then the scapula is rotated upward and downward for scapular rotation. Second, with the patient was in the same position the physiotherapist put the ulnar fingers under the medial scapular border and distracted the scapula from the thorax. Sets of 10 repetitions were applied performed at a rate of one cycle per 6 s, with a rest interval of 30 seconds between sets. for PNF is applied by a trained therapist in two diagonals, anterior elevation and posterior depression and posterior elevation and anterior depression with 20 repetitions for each diagonal. plus tradional physical therapy.
traditional physical therapyOther
the patients will recieve the traditional physical therapy program in the form of shoulder Range of motion, stretching and strengthening exercises.
| Study group | Role | What they receive |
|---|---|---|
| scapular mobilization and scapular proprioceptive neuromuscular facilitation exercises | Experimental | eighteen female patients suffering from shoulder dysfunction after latissimus dorsi flap breast reconstruction. They received scapular mobilization and scapular PNF three session per week for 8 weeks in addition to the traditional physical therapy program. Receives: Other: scapular mobilization and scapular proprioceptive neuromuscular facilitation exercises; Other: traditional physical therapy |
| traditional physical therapy | Active comparator | eighteen female patients suffering from shoulder dysfunction after latissimus dorsi flap breast reconstruction. They received a traditional physical therapy program, three sessions per week for eight weeks. Receives: Other: traditional physical therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
pain intensity
The Visual analogue Scale (VAS) will be used for the measurement of pain. It consists of a line usually 100 mm in length, with anchor descriptors such as (in the pain context) "no pain" and "worst pain imaginable"
Measured: up to eight weeks
shoulder and arm disability
Disability of the arm, shoulder and hand questionnaire will be used to assess shoulder and arm disability. This system gives a percentage disability score of upper limbs where 0 indicates no disability and 100 indicates complete disability. The DASH questionnaire consists of 30 questions assessing the impact of upper limb disability (if any) on activities of daily living. There are also optional sections within the questionnaire examining the effect of their limb function at the work place during sports or when playing musical instruments
Measured: up to eight weeks
Secondary outcomes (3)
shoulder range of motion
The baseline bubble inclinometer will be used to assess shoulder ROM.
Measured: up to eight weeks
scapular upward rotation
The baseline bubble inclinometer will be used to assess scapular upward rotation
Measured: up to eight weeks
scapular downward rotation
The baseline bubble inclinometer will be used to assess scapular downward rotation
Measured: up to eight weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Apr 2026
- Study start25 Apr 2026 (estimated)
- Primary completion1 Sep 2026 (estimated)
- Study completion1 Sep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Post MastectomyStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- scapular mobilization, scapular PNF and traditional physical therapy
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 36 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Madonna Magdy Isaac Ibrahim, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07547982
- Sponsor's protocol ID
- P.T.REC/012/006110
- Acronym
- PNF
- Status last verified
- Apr 2026
- First submitted
- 17 Apr 2026
- Last updated
- 23 Apr 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 23 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Scapular Mobilization and Proprioceptive Neuromuscular Facilitation on Shoulder Dysfunction After Latissimus Dorsi Flap Breast Reconstruction
- ClinicalTrials.gov ID
- NCT07547982
- Acronym / sponsor ID
- PNF / P.T.REC/012/006110
- Conditions
- Post Mastectomy
- Keywords
- Scapular Mobilization, Proprioceptive Neuromuscular Facilitation, Latissimus Dorsi Flap Breast Reconstruction
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 36 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 25 Apr 2026 (estimated)
- Primary completion
- 1 Sep 2026 (estimated)
- Study completion
- 1 Sep 2026 (estimated)
- First posted
- 23 Apr 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
this study will be conducted to investigate the effect of scapular mobilization and scapular Proprioceptive neuromuscular facilitation on shoulder dysfunction after latissimus dorsi flap breast reconstruction
Detailed description
Several procedures are available for patients undergoing breast reconstruction including pedicled faps such as latissimus dorsi fap (LDF) and transverse rectus abdomens myocutaneous flap (TRAM), as well as free flap requiring microvascular anastomoses like the deep inferior perforator flap (DIEP). Some of these, like LDF, may be combined with implants to provide adequate volume and symmetry.Surgeons employ the latissimus dorsi flap (LDF) for reconstruction of a large variety of breast cancer surgery defects, including quadrantectomy, lumpectomy, modified radical mastectomy, and others.The Latissimus dorsi (LD) muscle, in its interaction with other muscles of the shoulder plays an important role in shoulder adduction, extension, and internal rotation, as well as scapular depression and lateral flexion of the torso, Daily activities that rely on the function of the LD include swimming, climbing stairs, rising with the aid of the arms, and walking on crutches, There is therefore concern that the LD muscle flap procedure may impair shoulder function.The abnormal scapular biomechanics that occur as a result of dysfunction create abnormal scapular positions that decrease normal shoulder function. Therefore, treatment of shoulder dysfunction should include scapular-mobility exercises, or scapular-mobilization (SM) techniques. scapular mobilization and the combined application of techniques resulted in higher achievements, which may be related to increased scapular mobility and thus, the increased range of motion of the glenohumeral joint after scapular mobilization.
Proprioceptive neuromuscular facilitation is an approach to therapeutic exercise that combines functionally based diagonal patterns of movement with techniques of neuromuscular facilitation to evoke motor responses and improve neuromuscular control and function. Limited research is available on the impact combined effect of scapular mobilization and scapular proprioceptive neuromuscular facilitation on shoulder dysfunction after latissimus dorsi flap breast reconstruction Therefore, this study aims to examine the combined therapeutic effect of both techniques on shoulder dysfunction to aid in planning an ideal physical therapy rehabilitation program for shoulder dysfunction after latissimus dorsi flap breast reconstruction.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- scapular mobilization, scapular PNF and traditional physical therapy
| Arm | Type | Receives |
|---|---|---|
| scapular mobilization and scapular proprioceptive neuromuscular facilitation exercises | Experimental | Other: scapular mobilization and scapular proprioceptive neuromuscular facilitation exercises, Other: traditional physical therapyeighteen female patients suffering from shoulder dysfunction after latissimus dorsi flap breast reconstruction. They received scapular mobilization and scapular PNF three session per week for 8 weeks in addition to the traditional physical therapy program. |
| traditional physical therapy | Active comparator | Other: traditional physical therapyeighteen female patients suffering from shoulder dysfunction after latissimus dorsi flap breast reconstruction. They received a traditional physical therapy program, three sessions per week for eight weeks. |
Who may qualify
- Ages
- 40 to 55 years
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- age ranged from 40 to 55 years.
- All patients were female patients suffering from shoulder dysfunction after latissimus dorsi flap breast reconstruction.
- All patients suffering from moderate or severe pain on shoulder joint and limited range of motion that may affect daily activities.
- All patients begun the treatment program 3 to 4 weeks after LDF breast reconstruction.
- Informed consent was obtained from every patient enrolled in the trial.
Key exclusion criteria (9 listed)
- Current metastases.
- Neurological deficit affecting the shoulder functioning during daily activities.
- Pathology of the shoulder joint including rotator cuff tear adhesive capsulitis and tendinitis.
- Pain or disorder of the cervical spine, elbow, wrist or hand.
- Shoulder surgery, shoulder dislocation fracture acromioclavicular joint osteoarthritis.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| scapular mobilization and scapular proprioceptive neuromuscular facilitation exercisesfor scapular mobilization, The patient will be laying on the affected forearm on their back. The therapist is standing before the patient's affected shoulder, placing the index finger of one hand under the medial scapular border, the other hand grasping the superior border of the scapula. The scapula was moved superiorly and inferiorly for superior and inferior glide, and then the scapula is rotated upward and downward for scapular rotation. Second, with the patient was in the same position the physiotherapist put the ulnar fingers under the medial scapular border and distracted the scapula from the thorax. Sets of 10 repetitions were applied performed at a rate of one cycle per 6 s, with a rest interval of 30 seconds between sets. for PNF is applied by a trained therapist in two diagonals, anterior elevation and posterior depression and posterior elevation and anterior depression with 20 repetitions for each diagonal. plus tradional physical therapy. | Other | scapular mobilization and scapular proprioceptive neuromuscular facilitation exercises |
| traditional physical therapythe patients will recieve the traditional physical therapy program in the form of shoulder Range of motion, stretching and strengthening exercises. | Other | scapular mobilization and scapular proprioceptive neuromuscular facilitation exercises, traditional physical therapy |
Primary outcome
pain intensity
Time frame: up to eight weeks
The Visual analogue Scale (VAS) will be used for the measurement of pain. It consists of a line usually 100 mm in length, with anchor descriptors such as (in the pain context) "no pain" and "worst pain imaginable"
shoulder and arm disability
Time frame: up to eight weeks
Disability of the arm, shoulder and hand questionnaire will be used to assess shoulder and arm disability. This system gives a percentage disability score of upper limbs where 0 indicates no disability and 100 indicates complete disability. The DASH questionnaire consists of 30 questions assessing the impact of upper limb disability (if any) on activities of daily living. There are also optional sections within the questionnaire examining the effect of their limb function at the work place during sports or when playing musical instruments
3 secondary outcomes
shoulder range of motion
Time frame: up to eight weeks
scapular upward rotation
Time frame: up to eight weeks
scapular downward rotation
Time frame: up to eight weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 Apr 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
A study testing scapular mobilization and scapular proprioceptive neuromuscular facilitation exercises and traditional physical therapy in people with Post Mastectomy, run by Cairo University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 23 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact madonna isaac, master (01289962263, madonnamagdy76@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
pain intensity (time frame: up to eight weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Apr 2026.