Feasibility of a Hydrotherapy and Self-Management Education Program for Breast Cancer Patients with Shoulder Impairment

Thursday, November 10, 2022

10:01 AM – 10:06 AM

Location: Station 1

Presenting Author(s)

RL

Ryan Lewis, MD

Resident Physician
Johns Hopkins University School of Medicine
Baltimore, Maryland, United States

Non-presenting Author(s)

Pd

Patrice M. de Peiza, OT Reg.(Ont.), MScCH, CLT

Advanced Practice Leader
Toronto Rehab - University Health Network
North York, Ontario, Canada
Eugene K. Chang, MD, FRCPC, MScCH

Assistant Professor
University of Toronto
Toronto, Ontario, Canada
IL

Ilyse Lax

Project Manager, Health System Innovation
Institute for Better Health, Trillium Health Partners, United States
JC

Jennifer Croke, MD, FRCPC, MHPE

Assistant Professor, Department of Radiation Oncology
University of Toronto, University Health Network
Toronto, Ontario, Canada

Presenting Author(s)

David M. Langelier, MD, FRCPC, MSc, CSCN Dip (EMG)

Assistant Professor and Clinical Investigator
University of Toronto
Toronto, Ontario, Canada

Research Objectives: To evaluate the feasibility and acceptability of a multidimensional hydrotherapy and self-management education program for breast cancer patients. Secondary objectives were to explore change on shoulder disability measured by validated patient reported outcomes and therapist measured shoulder range of motion (ROM) and grip strength.

Design: This retrospective cohort study analyzed pre- and post-intervention data collected between January 2017 and March 2020.

Setting: Outpatient rehabilitation clinic in Toronto, Canada.

Participants: A total of 114 participants’ charts were reviewed during the study period. Participant selection utilized a clinically referred sample of breast cancer patients with moderate to severe shoulder impairment and deemed medically fit to participate in aquatic based therapies.

Interventions: Six weekly, small group (n=3-7), supervised, hydrotherapy and educational sessions targeting shoulder mobility, scar management, lymphedema, and pain.

Main Outcome Measures: Feasibility was defined as ≥ 60% retention and ≥ 80% session attendance. Acceptability was defined as ≥ 80% satisfaction (≥ 4 on a 5 point Likert scale).

Results: A total of 88 (82.2%) participants attended at least 80% of the education sessions and 78 (76.5%) attended at least 80% of the aquatic sessions. 60 (96.8%) participants reported satisfaction with educational material; 44 (95.7%) reported satisfaction with hydrotherapy sessions. Statistically significant improvements were observed in DASH, SPADI, grip strength, and most ROM measures.

Conclusions: Combined hydrotherapy and self-management education appears to be a feasible and acceptable rehabilitation intervention for breast cancer survivors with shoulder impairment. While this could represent a potential adjunct to traditional land based therapies, future prospective randomized control trials are required to confirm causation and to explore the effect on functional outcome measures.

Author(s) Disclosures: None

Learning Objectives:

Upon completion, the participant will be able to define hydrotherapy and list its prior uses in the rehabilitation of oncology patients.
Upon completion, the participant will be able to describe the safety and feasibility of a hydrotherapy and self-management education program to address various shoulder impairments following breast cancer treatment.
Upon completion, the participant will be able to describe the preliminary effects of the hydrotherapy program on shoulder range of motion, grip strength and patient reported levels of disability