Effect of Kinetic Control Exercise on Shoulder Dysfunction Post Mastectomy

Abstract

Background: Post-mastectomy shoulder dysfunction (PMSD) is a common complication that negatively affects functional ability and quality of life. Impairments in scapular stability and motor control contribute significantly to restricted shoulder movement and pain. Kinetic control exercises may improve shoulder function by enhancing muscle coordination and movement efficiency.

Objective: To investigate the effect of kinetic control exercises on shoulder function in patients with shoulder dysfunction following mastectomy.

Methods: Sixty female patients within age ranged from 40 to 50 were selected from learning hospitals Al Kaser Al Ayni hospital and National Cancer Institution who had undergone unilateral modified radical mastectomy one month after the surgery. They were randomly assigned into two groups. Group A (n = 30) received kinetic control exercises inform of activation local and general Stabilizer, mobilizer, while Group B (n = 30) received traditional therapy inform of stretching and strengthening exercise as shoulder roll, arm circle, wall climb, back climb and hand behind neck. Both groups received three sessions per week for eight weeks. Shoulder range of motion (flexion, extension, abduction, internal rotation, and external rotation) was assessed using a goniometer. Scapular stability and kinetic control were evaluated using a pressure biofeedback unit. Pre- and post-treatment measurements were statistically analyzed.

Results: Both groups showed significant improvements in all shoulder range-of-motion measures (p < 0.001). However, Group A demonstrated significantly greater improvements compared to Group B in shoulder flexion, extension, abduction, and rotational movements (p < 0.01). Pressure biofeedback assessment revealed improved scapular stability and reduced compensatory patterns in the kinetic control group. The geniometer results in this study highlight the clear superiority of kinetic intervention protocols in improving shoulder mobility across all ranges of motion. While control groups achieved only modest gains44% in flexion, 3% in extension, 17% in abduction, 22% in adduction, and 8% in internal rotation—the kinetic groups consistently demonstrated far greater improvements, reaching 109% in flexion, 43% in extension, 85% in abduction, 63% in adduction, and 32% in internal rotation. Similarly, biofeedback readings confirmed significant progress in both groups, though kinetic protocols again produced markedly higher gains: flexion improved by over 200% compared to 36% in the control, abduction by 64% versus 28%, depression by 56% versus 33%, and retraction by 18% versus 16%. Collectively, these findings underscore the therapeutic superiority of kinetic interventions in restoring and enhancing shoulder mobility.

Conclusion: Kinetic control exercises are more effective than traditional rehabilitation alone in improving shoulder mobility and scapular stability after mastectomy. Incorporating kinetic control into post-mastectomy rehabilitation programs is recommended to enhance functional recovery.