Effect of Graded Motor Imagery on Shoulder Dysfunction Post Mastectomy

NCT07240129 | Completed DMC

• 1 other identifier: P.T.REC/012/005749
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

One of the most common complications after breast cancer surgery is a functional limitation of the upper body. Up to 67% of breast cancer patients experience arm or shoulder impairment, including pain, numbness, loss of strength, and reduced ROM, after surgery. Graded motor imagery is effective in reducing pain interference with function using a graded sequence of strategies including left/right judgements (implicit motor imagery), imagined movements (explicit motor imagery) and mirror therapy.

Conditions

Shoulder Dysfunction

Keywords

Graded Motor Imagery; Post Mastectomy

Outcome Measures

Primary Outcomes (2)

• Visual analog scale

  A validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between 0 means "no pain" and 10 means "worst pain."

  From baseline to 6 weeks

• Smartphone clinometer application

  The smartphone clinometer application has excellent agreement with a goniometer-based gold standard for measurement of shoulder ROM in both healthy subjects and symptomatic patients.

  From baseline to 6 weeks

Secondary Outcomes (2)

• Shoulder Pain and Disability Index

  From baseline to 6 weeks

• Handheld dynamometer

  From baseline to 6 weeks

Study Arms (2)

Group A (study group)

ACTIVE COMPARATOR

This group includes 27 patients who will receive graded motor imagery (GMI) along with the conventional physiotherapy (It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises). GMI is consists of a three-step process. Each step of will be carried out for two weeks, for 30 minutes on two separate days, for total 6 weeks

Other: Graded Motor Imagery (GMI); Other: Physical therapy program

Group B (control group)

PLACEBO COMPARATOR

This group includes 27 patients who will receive conventional physiotherapy treatment. It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises, 2 times / week for 6 weeks

Other: Physical therapy program

Interventions

Graded Motor Imagery (GMI) OTHER

1. Left/right judgements: It includes left/right judgments of photographs that depict the affected area. 2. Imagined movements: Movement visualizations will be performed. 3. Mirror therapy: It includes observation of the movements of unaffected body part in the mirror, 2 times / week for 6 weeks.

Group A (study group)

Physical therapy program OTHER

It will include exercise like codman's pendulum exercises in flexion-extension, abduction-adduction, and circular motion, active assisted ROM exercises with a wand, capsular stretching, wall ladder, and shoulder wheel exercises, 2 times / week for 6 weeks.

Also known as: A group of exercises

Group A (study group); Group B (control group)

Eligibility Criteria

• Age: 35 Years - 55 Years
• Gender Eligibility Details: Eligibility is based on biological gender
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age range of 35 to 55 years.
• All patients are post-mastectomized unilaterally.
• Female patients only.
• Patients have shoulder ROM restriction.
• Patients have shoulder pain more than 3 months (chronic).

You may not qualify if:

• Having double mastectomy.
• Psychopathological disorders.
• Having other orthopedic problems (e.g. tendinitis, dislocation, osteoarthritis, referred pain to shoulder).
• Motor problems (e.g. tremor, dyskinesia).
• Metastasis.
• Visual impairment such that they could not read unaided or with their reading glasses.
• Having previously received GMI treatment.
• Diabetes mellitus.
• Having neurological problems as hemiplegia.
• Patients with lymphedema

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Cairo University

Giza, Egypt

Location

Study Officials

• Asmaa Abdallah, PhD

  Teaching assistant of physical therapy for surgery, cairo university, egypt

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Double blind study design. Randomization and masking were performed by an independent investigator who was not engaged in either the treatment administration or the outcome assessment
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant lecturer

Model Details: Design of the study: In this study the patients will be randomly assigned into two equal groups (27 patients for each group)

Study Record Dates

• First Submitted: June 26, 2025
• First Posted: November 20, 2025
• Study Start: June 30, 2025
• Primary Completion: January 30, 2026
• Study Completion: January 30, 2026
• Last Updated: June 24, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)