913 - The "Fearless Movement": protocol in tele-Rehabilitation after breast cancer surgery, a pilot study

Objectives: Breast cancer surgery is the main treatment choice in breast cancer therapy, although post operative complications such as pain arm disability and related kinesiophobia are reported. Our aim was to evaluate the efficacy of a telerehabilitation protocol (“Fearless Movement”) related to pain and disability related kinesiophobia after breast cancer surgery.

Design: A total of 20 patients who have undergone breast cancer surgery were randomly divided into 2 groups: control group – CG (age 49,4 ± 2,83 years) and intervention group – ExG (age 47 ± 3,68 years). The ExG underwent four telerehabilitation sessions of one hour focused on functional upper limb awareness and was assigned home exercises to increase upper limb function and reduce pain. Both groups met the physiotherapist online, at one-month and at two-month post intervention for physiotherapy counselling and follow-up. All patients were evaluated for pain by Numerical Rating Scale (NRS), for upper limb function by the Disability of the Arm, Shoulder and Hand scale (DASH) and by the Constant Murley Scale (CM), for kinesiophobia by the Tampa Scale (TAMPA) at one-month post-intervention (T1) and at two months post-intervention (T2).

Results: Significant improvements were found for both groups for DASH, CM and NRS scales. The TAMPA scale showed a significant change only in the teleRehab group. As regards group differences along times, ExG showed a higher significant decrease in all temporal comparation between T1 (one-month post intervention) and T2 (two-month post intervention) compared to group one (p < 0.05) in pain and upper limb function.

Conclusions: In conclusion, this pilot study suggests how fear of movement is an element that could slow down the recovery of upper limb function in women after breast cancer surgery. A short protocol in telerehabilitation added to specific home exercises have proved to be effective in improving functional recovery and in reducing pain related kinesiophobia.