Efficacy of proprioceptive neuromuscular facilitation in improving shoulder biomechanical parameters, functionality, and pain after axillary lymph node dissection for breast cancer: A randomized controlled study

Guloglu S., BASIM P., ALGUN Z. C.

Complementary Therapies in Clinical Practice, vol.50, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 50
  • Publication Date: 2023
  • Doi Number: 10.1016/j.ctcp.2022.101692
  • Journal Name: Complementary Therapies in Clinical Practice
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, ASSIA, CINAHL, EMBASE, MEDLINE
  • Keywords: Breast cancer, Axillary lymph node dissection (ALND), Proprioceptive neuromuscular facilitation, (PNF), Muscle strength, Upper extremity function
  • Istanbul Medipol University Affiliated: Yes


Purpose: Axillary lymph node dissection and radiotherapy have been associated with pain, physical symptoms, and decreased functional abilities in the upper extremity. This study aimed to evaluate the potential effects of the proprioceptive neuromuscular facilitation (PNF) technique on muscle strength, pain and functionality in this patient group in comparison with progressive resistance training (PRT). Methods: The study was conducted with a randomized clinical trial design. Sixty-six women were included in the study and randomly divided into three groups: the PNF group (n = 22), the PRT group (n = 22), and the control group (n = 22). The participants were evaluated at the baseline and after eight weeks of treatment. Outcome measures were determined as pain (the Visual Analog Scale), upper extremity strength (isokinetic dynamometer), functionality (the Disabilities of the Arm, Shoulder and Hand questionnaire), and perception of change (the Global Rating of Change Scale). Trial registration: ClinicalTrials.gov identifier: NCT05288036. Results: The results showed statistically significant changes in both treatment groups in terms of shoulder flexors/extensors, abductor/adductors, internal/external rotators strength/power/endurance measurement, pain, and functionality (p < 0.05). Concerning functionality and perception of change, the PNF group had a statistically significantly higher improvement compared to the remaining two groups (p < 0.05). Conclusion: PNF is an effective technique in increasing upper extremity muscle strength, reducing pain during rest and activity, and improving functionality in patients receiving breast cancer treatment.