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Completed

NCT Number: NCT07240129

Effect of Graded Motor Imagery on Shoulder Dysfunction Post Mastectomy

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.

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Key information

Conditions

Shoulder Dysfunction

Age range

35 year–55 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Cairo University

Giza, Egypt

About this study

54 female patients who have shoulder dysfunction post-mastectomy will participate in this study. Their ages will be ranged 35 to 55 years.

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

  • Group A (study group):

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.

  • Group B (control group):

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 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).

Exclusion criteria

  • 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

Treatment and study plan

Graded Motor Imagery (GMI)

Other
  • Left/right judgements:

It includes left/right judgments of photographs that depict the affected area.

  • Imagined movements:

Movement visualizations will be performed.

  • Mirror therapy:

It includes observation of the movements of unaffected body part in the mirror, 2 times / week for 6 weeks.

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.

Other names: A group of exercises

Primary outcomes

  1. Visual analog scale

    Time frame: From baseline to 6 weeks

    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."

  2. Smartphone clinometer application

    Time frame: From baseline to 6 weeks

    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.

Secondary outcomes

  1. Shoulder Pain and Disability Index

    Time frame: From baseline to 6 weeks

    Is a self-administered questionnaire that aims to measure pain and disability associated with shoulder disease with lower scores indicate little pain or disability and higher scores indicate higher pain and disability

  2. Handheld dynamometer

    Time frame: From baseline to 6 weeks

    A valid tool for measuring isometric muscle strength in kilograms/newton that provides an objective overview of shoulder flexor and abductor muscles strength

Sponsors and collaborators

Lead sponsor

Cairo University

Other

Registry information

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Nov 20, 2025
Registry last updated
Jun 24, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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