Manual Therapy as Treatment for Chronic Musculoskeletal Pain in Female Breast Cancer Survivors: a Systematic Review and Meta-Analysis
Pinheiro da Silva, F.; Moreira, G.és.M.; Zomkowski, K.; Amaral de Noronha, M.; Flores Sperandio, F.
Journal of Manipulative and Physiological Therapeutics 42(7): 503-513
The purpose of this systematic review was to investigate the effectiveness of manual therapy (MT) for chronic musculoskeletal pain (CMP) in the upper limbs and thorax of female breast cancer survivors and to investigate the changes in the quality of life and function of these patients. Systematic searches were performed in the databases MEDLINE/PubMed, Cumulative Index of Nursing and Allied Health/EBSCO, Web of Science, and Physiotherapy Evidence Database, through March 2018, to identify randomized controlled trials investigating whether MT was effective to treat CMP pain in female breast cancer survivors (PROSPERO number CDR42017074175). The database searches retrieved 1562 titles, and after screening, 5 papers were included for full analysis. The manual therapy techniques described in the included studies involved myofascial induction, myofascial release, classic massage, ischemic compression of trigger points, and myofascial therapy. A meta-analysis, using a fixed-effects model, found that MT decreased CMP intensity (standardized mean difference: 0.32; 95% CI 0.06-0.57), but no significant difference was observed in quality of life after the MT intervention in comparison with a control condition (standardized mean difference: 0.14; 95% CI 0.17-0.46). Current evidence suggests that MT is considered effective for treating CMP in the upper limbs and thorax of female breast cancer survivors.