Does exercise relieve my pain? A qualitative study about perceptions of patients with low back pain / O exercício alivia minha dor? Estudo qualitativo sobre as percepções de pacientes com dor lombar

ABSTRACT BACKGROUND AND OBJECTIVES: Physical exercise is recommended by the guidelines for the treatment of chronic low back pain, but the patients' perspective on this therapeutic modality is little explored. The aim of this study was to investigate the perception of patients with chronic low back pain about physical exercise for symptom control. METHODS: This is a descriptive qualitative study, which investigated people with chronic low back pain on the waiting list for Physiotherapy outpatient clinic. Data was collected through individual, semi-structured interviews. The interviews were conducted online, investigating the perception of memory from previous experiences of exercise. Thematic content analysis was used to analyze the data. RESULTS: Fourteen adults (10 women and 4 men) were interviewed. The data was categorized into three moments: (1) perceptions during exercise, (2) perceptions after exercise, and (3) long-term perceptions. The perceptions of pain and discomfort that occur at the beginning of any type of exercise or physical activity usually disappear in the first few weeks, however, when they are not well tolerated, they can lead to withdrawal or discontinuing of the practice. Although the majority reported pain relief, a feeling of relaxation and ease in performing functional activities, in the period immediately after exercise some participants noticed exacerbation of the pain and fear of worsening the condition. In the long term, the majority saw benefits (reduction in pain intensity, return to activities and reduced need for painkillers), but for some participants exercise alone does not seem to be enough to reduce pain. CONCLUSION: People with chronic low back pain can have varying perceptions and results in relation to exercise.

RESUMO JUSTIFICATIVA E OBJETIVOS: O exercício físico é recomendado pelas diretrizes para o tratamento da dor lombar crônica, mas a perspectiva dos pacientes sobre essa modalidade terapêutica é pouco explorada. Este estudo teve como objetivo investigar a percepção de pacientes com dor lombar crônica sobre o exercício físico para o controle dos sintomas. MÉTODOS: Trata-se de um estudo qualitativo descritivo, que investigou pessoas com dor lombar crônica na lista de espera para atendimento fisioterapêutico. Os dados foram coletados por meio de entrevistas individuais e semiestruturadas. As entrevistas foram realizadas no formato online, investigando a percepção de memória pela experiência prévia da prática de exercício. Para a análise dos dados foi utilizada a análise de conteúdo temática. RESULTADOS: Quatorze adultos (10 mulheres e 4 homens) foram entrevistados. Os dados foram categorizados em três momentos: (1) percepções durante o exercício físico, (2) percepções após o exercício, e (3) percepções a longo prazo. As percepções de dor e desconforto que ocorrem no início de alguma modalidade de exercício costumam desaparecer nas primeiras semanas, no entanto, quando não são bem toleradas, podem levar à desistência ou interrupção da prática. Embora a maioria tenha relatado alívio da dor, sensação de relaxamento e facilidade para realizar atividades funcionais, no período imediatamente posterior ao exercício alguns participantes perceberam exacerbação da dor e receio de agravamento do quadro. Em longo prazo, a maioria percebeu benefícios (redução da intensidade da dor, retorno às atividades e diminuição da necessidade de analgésicos), mas para alguns participantes somente a prática de exercícios parece não ser suficiente para a redução da dor. CONCLUSÃO: Pessoas com dor lombar crônica podem ter percepções e resultados variados em relação à prática de exercício.

Perceived Pain in Athletes: A Comparison between Endurance Runners and Powerlifters through a Cold Experimental Stimulation and Two Sessions of Various Physical Activation.

Few studies in the literature have illustrated cold hypoalgesia induced by strength training. Objectives of this contribution were to compare the ratings of perceived pain in endurance running (n = 22) and powerlifting (n = 22) male athletes and controls (n = 22) at baseline and after two bouts of 40 min aerobic/strength training respectively, using the Cold Pressor Test (CPT) and simultaneously monitoring changes in blood pressure (BP), heart rate (HR), and body temperature. A two-way repeated measures ANOVA was conducted to examine the effects of training sessions in endurance runners vs. powerlifting athletes vs. controls on the intensity of perceived pain at CPT. A statistically significant two-way interaction between the group and training resulted in p < 0.001, ηp2 = 0.513. A simple main effects analysis showed that as the participants went through the strength training session, pain perception at CPT was significantly lower in powerlifters compared to runners and controls. Considering the physiological parameters, powerlifters reported significantly higher values of BP and HR. This difference was present at baseline but after training as well, and before and after CPT, despite a slight hypotensive effect. The differences reported after CPT at baseline, but very significantly after the strength activation session in the powerlifters, provide interesting insights into the hypoalgesic effect of high-intensity strength training.

A Psychoeducational Intervention in Prenatal Classes: Positive Effects on Anxiety, Self-Efficacy, and Temporal Focus in Birth Attendants.

BACKGROUND: Previous studies have reported associations between high maternal anxiety, temporal perceptions during pregnancy, and a poor sense of self-efficacy. One type of anxiety expecting mothers experience is associated with childbirth, which previous studies have shown can be reduced by antenatal training. Recent contributions have pointed out that current prenatal courses, while providing important and useful knowledge, do not devote sufficient content to the mental health of the parturient and to the psychological issues that can arise before and after the birth. METHODS: In total, 80 pregnant women were provided with a special prepartum course in which ample space was devoted to topics such as maternal mental health, parenting skills and couple relationship, relaxation techniques, and assertiveness. Perception of threat, state anxiety, temporal focus, needs and expectations, and self-efficacy were assessed by comparing this psychoeducational intervention group with a traditional antenatal course group (n = 80), and a control group (n = 80). Two-way mixed ANOVAS (3 × 2) were performed for each dependent variable considered, including the time variable (pre-course-post-course) as a factor within the participants and the group variable as a factor between the subjects. RESULTS: The psychoeducational intervention actually induced significant and positive changes primarily on four dimensions: state anxiety, perceived self-efficacy, the need for information, and reassurance of the pregnant women who participated in this trial. CONCLUSIONS: The study suggests improving the quality of prenatal classes by paying particular attention to the content and communication used within the group, in order to gratify at the highest level, the need for information, reassurance, and sharing that characterize the parturient's request for support. The evidence collected recommends further replicating the intervention protocol described in order to improve the psychophysical well-being of women in a delicate moment such as pregnancy and preparation for childbirth, but especially in terms of the prevention and containment of the risks of psychological distress that currently affect a significant number of women after childbirth.

Both Gender and Agonistic Experience Affect Perceived Pain during the Cold Pressor Test.

BACKGROUND: Differences in pain perception in athletes have recently been highlighted in the literature. OBJECTIVES: To compare gender ratings of perceived pain in athletes with low and high agonistic experiences (N = 200) using the Cold Pressor Test (CPT). METHODS: A three-way repeated measures ANOVA to assess both the effects of the athletes' gender and lower vs. higher agonistic experiences in the intensity of perceived pain at the beginning of the cold box hand immersion (L0) and after a 90 s interval (L1). RESULTS: There was a statistically significant interaction effect between the level of the agonistic experience and gender in the two moments: p < 0.001; ηp2 = 0.266; F(1,49) = 9.771. Simple main effects analysis showed a significative difference for females at L0: F(1,99) = 93.567, p < 0.025, partial η2 = 0.302) and for males at L1: F(1,99) = 173.420, p < 0.025, partial η2 = 0.666. At the initial moment of CPT, the female athletes showed significantly higher perceived intensity than males, regardless of their experience level. After a 90 s interval, a significantly lower pain perception effect associated with the increased competitive experience of male athletes was observed. Female athletes did not appear to benefit from the experience effect on their pain tolerance. CONCLUSIONS: The study confirmed a significant difference in pain perception associated with the athletes' gender and agonistic experience. Separate explanations related to the pattern of pain inhibition and the acquired reduction in pain sensitivity are reported.

Effects of Exercise in the Treatment of Alzheimer's Disease: An Umbrella Review of Systematic Reviews and Meta-Analyses.

The authors aimed to provide an overview of the evidence on the effects of exercise in people with Alzheimer's disease through a comprehensive review of the existing systematic reviews and meta-analyses. A literature search was performed in CINAHL, Cochrane Library, EMBASE, PubMed, SPORTDiscus, Scopus, and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The AMSTAR-2-Tool was used for the quality assessment. Twenty-three reviews fulfilled the criteria. Most of the reviews investigated the effects of aerobic exercise on Alzheimer's disease symptoms. The largest effects of exercise were seen in terms of improved cognition by multiple exercises. The majority of the reviews were rated as being of moderate quality and none were classified as having high quality. Exercise is an effective way to treat Alzheimer's disease symptoms and has a low incidence of related adverse events. As most reviews were evaluated as low-moderate quality, caution is needed in the interpretation of the results.

A psychometric evaluation of the Italian short version of the Fear of Pain Questionnaire-III: Psychometric properties, measurement invariance across gender, convergent, and discriminant validity.

Introduction: The Fear of Pain Questionnaire-III (FPQ-III) is a self-assessment instrument developed specifically to measure fear based on various pain stimuli converging on three factors: severe pain, medical pain, and minor pain. It actually remains the most studied and internationally used tool even in its short versions. The aim of this work was to propose a new validation study oriented to confirm the good psychometric properties of a short model of the FPQ-III for the Italian context. Methods: A large sample of participants was recruited (n = 1,064) and Exploratory Factor Analysis (EFA) as well as Confirmatory Factor Analysis (CFA) were performed. Measurement invariance of the FPQ-III across gender was also evaluated. In order to examine convergent validity, a further convenient sample (n = 292) was used and variables related to the individual's pain experience, locus of control and coping orientations were assessed. A final discriminant assessment using experimental manipulation through fear eliciting videos was performed. Results: The three factors structure of the 13-item version of the questionnaire was confirmed (χ2 = 148.092, CFI = 0.971, TLI = 0.962, RMSEA = 0.046, RMSEA 90% CI = 0.037-0.056) as well as the measurement invariance across gender. Item internal reliability was satisfactory. The results provided evidence of the good predictive validity of the FPQ-III and the discriminant assessment demonstrated that the instrument is suitable in detecting changes in fear of pain induced by specific situational conditions. Discussion: The scale in this short version is suitable for quickly and efficiently gathering information about the perceived intensity of such anticipatory fears that might affect even the healthy person dysfunctionally.

Influence of Cognitive Orientation and Attentional Focus on Pain Perception.

BACKGROUND: Recently, a growing interest has emerged in the role of attention and hypervigilance in the experience of pain. Shifting attention away from pain seems likely to reduce the perception of pain itself. OBJECTIVES: The present study has been designed to test the following overall hypotheses: (1) disposition to catastrophize, self-efficacy perceived in pain resistance (task self-efficacy), previous experiences concerning the tolerance of physical pain, and degree of impulsiveness are significant predictors of the decision to abandon a painful test such as the cold pressor test (CPT); (2) the manipulation of the attentive focus (internal or external) can influence the level of perceived pain. METHODS: Effects of the manipulation of attentional focus (internal and external) on pain perception and response of trial abandonment were evaluated in a sample of university students (n = 246) subjected to the cold pressor test. RESULTS: A significant effect (p < 0.05) was found through a test-retest comparison on the final level of perceived pain among subjects who had received instruction to externalize the focus of their attention (mixed factorial analysis of variance), but no significance was observed with respect to the decision to abandon the experiment. A general explanatory model of the abandonment behavior demonstrating overall good fit measurements was tested too. CONCLUSION: The abandonment of tests has been shown to be predicted mainly by catastrophic attitude. Attentive impulsiveness showed a further positive effect on catastrophic attitude. Perceived self-efficacy in the tolerance of pain limited learned helplessness, which in turn positively influenced catastrophizing.

Psychological variables of CrossFit participants: a systematic review.

Objective: This study aimed to review the existing literature concerning the psychological variables of CrossFit participants. Methodology: This review followed the PRISMA guidelines and was documented in the PROSPERO registry (CRD42018091177). Six electronic databases (SCOPUS, PubMed, SPORTDiscus, Web of Science, EMBASE, and Cochrane) were searched from their inception through July 2020. The methodological quality of the studies was assessed. Results: Thirty-four studies met the inclusion criteria. We observed an increase in satisfaction, clinical addiction, and enjoyment among participants related to exercise, social improvement, and high intrinsic motivation to participate for the purpose of enjoyment, challenge, and affiliation. Perceptions of effort were high among CrossFit participants. Some studies found that the reaction time was impaired after the CrossFit session, whereas others found no changes in mental health, self-esteem, and well-being after training. Conclusion: Adherence and maintenance of the practice of CrossFit are related to psychological variables such as motivation and satisfaction of basic psychological needs. CrossFit participants demonstrated high perception of effort, intrinsic motivation, and reasons for practice such as enjoyment, challenge, and affiliation. The quality assessment demonstrated the need for more detail in the methods section of future investigations. Additional high-quality studies are needed to investigate the effects of CrossFit training on the mental health of participants.

Factors associated with upper limb dysfunction in breast cancer survivors.

OBJECTIVE: To analyze factors associated with upper limb dysfunction in women after breast cancer treatment. METHODOLOGY: A cross-sectional study with 233 women over 18 years of age diagnosed with breast cancer and undergoing at least one cancer treatment (surgery and/or adjuvant treatment). Sociodemographic, anthropometric, and cancer treatment data were collected, as well as current physical and functional complications. Changes in breast tenderness and intercostobrachial nerve pathway, winged scapula, pain, cicatricial adherence, and lymphedema were evaluated by physical examination (inspection and palpation). Upper limb dysfunction was assessed using the DASH questionnaire. Chi-square test and logistic regression were used to verify possible associations between upper limb dysfunction and other variables. RESULTS: The results showed that 55.4% of women had some level of upper limb dysfunction. Evaluating treatment conditions, lymphadenectomy, lymphedema, presence of pain, and intercostobrachial nerve injury were associated with some level of upper limb dysfunction in the crude analysis. The adjusted analysis showed that only upper limb dysfunction remained associated with intercostobrachial nerve injury, regardless of age and body mass index. CONCLUSION: Upper limb dysfunction is frequent after breast cancer treatment and may be associated with neuropathies due to changes in the intercostobrachial nerve pathway.

Effects of exercise in people with haemophilia: An umbrella review of systematic reviews and meta-analyses.

INTRODUCTION: There is considerable evidence to indicate that exercise can have a positive impact on the treatment of people with haemophilia (PWH). However, there is a requirement for in-depth and comprehensive studies. AIM: This study aimed to analyse the evidence regarding the effects of exercise in PWH through an umbrella review of existing systematic reviews and meta-analyses. The secondary objective was to analyse the quality of the evidence. METHODS: This umbrella review followed the PRISMA guidelines and was documented in the PROSPERO registry (CRD42019140785). We searched the PubMed, Web of Science, SPORTDiscus, Scopus, CINAHL and Cochrane Library databases. The methodological quality of the systematic reviews was assessed using AMSTAR 2. RESULTS: Out of a total of 1030 systematic reviews, 10 fulfilled the criteria. Only one study was classified as high quality, and half of the selected studies were classified as low or critically low quality according to AMSTAR 2. Furthermore, most reviews investigated the effects of strength training and aquatic training, with positive results associated with low adverse events. Range of motion, strength and pain were the most investigated variables. All reviews showed overlapping studies. CONCLUSION: Exercise is an effective way to treat haemophilia and has a low incidence of related adverse events. However, caution is needed in the interpretation of the results due to half of the selected reviews showed low or critically low quality and only one have high quality.

Perfil de lesões em praticantes de CrossFit: revisão sistemática / Perfil de lesiones en los practicantes de CrossFit: revisión sistemática / Injury profile in CrossFit practitioners: systematic review

RESUMO O CrossFit se apresenta como um novo método de treinamento físico que vem ganhando popularidade desde sua criação. O objetivo deste estudo foi analisar o perfil de lesões em praticantes de CrossFit por meio de uma revisão sistemática da literatura. Utilizaram-se as recomendações da Declaração PRISMA para condução da revisão sistemática. A busca foi realizada nas bases de dados CINAHL, SciELO, Science Direct, SCOPUS, LILACS, PEDro, PubMed, SPORTDiscus e Web of Science. Avaliou-se a qualidade metodológica dos estudos, entre os quais dez foram considerados elegíveis. A prevalência de lesões nos praticantes de CrossFit variou de 5 a 73,5%, e a taxa de lesão variou de 1,94 a 3,1 lesões a cada 1.000 horas de treinamento. A região corporal mais acometida por lesões nos estudos selecionados foram os ombros, seguidos pelas costas e joelhos. Em relação aos fatores associados às lesões, destacou-se o tipo de exercício realizado e o tempo de prática de CrossFit. O sexo apresentou associação com a prevalência de lesões, estudos demonstraram que os homens apresentaram maior número de lesões em relação às mulheres. A idade esteve entre os fatores que não estiveram associados às lesões. Conclui-se que os ombros são a região corporal mais comumente acometida entre os praticantes de CrossFit, em indivíduos do sexo masculino e com lesões prévias, muitas vezes obtidas em outras modalidades. Ainda, que o CrossFit pode ser praticado com segurança por indivíduos de 18 a 69 anos.

RESUMEN CrossFit es un nuevo método de entrenamiento físico y ha ganado popularidad desde su creación. El objetivo de este estudio fue analizar el perfil de lesiones en practicantes de CrossFit a través de una revisión sistemática. La Declaración PRISMA fue utilizada para la preparación de esta revisión. Se realizó una búsqueda bibliográfica en las siguientes bases de datos: CINAHL, SciELO, Science Direct, SCOPUS, LILACS, PEDro, PubMed, SPORTDiscus y Web of Science. Se evaluó la calidad metodológica de los estudios, entre los cuales diez estudios fueron considerados elegibles. La prevalencia de lesiones en los practicantes de CrossFit tuvo una variación del 5 al 73,5%, y la tasa de lesiones de 1,94 a 3,1 lesiones a cada 1000 horas de entrenamiento. La región corporal más lesionada fueran los hombros, seguido por las espaldas y rodillas. En relación a los factores asociados a las lesiones, se destacan el tipo de ejercicio fue realizado y el tiempo de práctica del CrossFit. En relación al género, los hombres presentaron más lesiones. La edad no estuvo asociada a las lesiones. Se concluye que la región corporal más comúnmente acometida entre los practicantes de CrossFit fueron los hombros, en individuos masculinos y con lesiones previas, muchas veces obtenidas en otras modalidades. Además, el CrossFit puede ser practicado con seguridad por individuos de 18 a 69 años.

ABSTRACT CrossFit is a new form of physical training that has become popular since its inception. This study aimed to analyze the injury profile of CrossFit practitioners through a systematic review. PRISMA recommendations were applied to this systematic review. Electronic search was performed in the databases CINAHL, SciELO, Science Direct, SCOPUS, LILACS, PEDro, PubMed, SPORTDiscus and Web of Science. The methodological quality of the studies was assessed. Ten studies were selected. The prevalence of injuries in CrossFit practitioners ranged from 5 to 73.5%, and the overall injury incidence rate per 1000 training hours ranged from 1.94 to 3.1 injuries. The body region most affected by injuries was the shoulders, followed by the back and the knees. Regarding associated factors, the type of exercise performed and CrossFit training time were related to injuries. Besides that, sex was associated to the prevalence of injuries, with men showing more injuries than women. Age was not related to injury prevalence. It was concluded that the most commonly affected body region among CrossFit practitioners was the shoulders, predominantly in males and with previous injuries, often obtained in other modalities. In addition, CrossFit can be safely practiced by individuals aged 18-69.

Management of Axillary Web Syndrome after Breast Cancer: Evidence-Based Practice / Tratamento da síndrome de rede axilar pós-câncer de mama: prática baseada em evidências

Abstract Axillary web syndrome is characterized as a physical-functional complication that impacts the quality of life of women who have undergone treatment for breast cancer. The present study aims to verify the physiotherapy treatment available for axillary web syndrome after surgery for breast cancer in the context of evidence-based practice. The selection criteria included papers discussing treatment protocols used for axillary web syndrome after treatment for breast cancer. The search was performed in the MEDLINE, Scopus, PEDro and LILACS databases using the terms axillary web syndrome, lymphadenectomy and breast cancer, focusing on women with a previous diagnosis of breast cancer who underwent surgery with lymphadenectomy as part of their treatment. From the 262 studies found, 4 articles that used physiotherapy treatment were selected. The physiotherapy treatment was based on lymphatic drainage, tissue mobilization, stretching and strengthening. The four selected articles had the same outcome: improvement in arm pain and shoulder function and/or dissipation of the axillary cord. Although axillary web syndrome seems to be as frequent and detrimental as other morbidities after cancer treatment, there are few studies on this subject. The publications are even scarcer when considering studies with an interventional approach. Randomized controlled trials are necessary to support the rehabilitation resources for axillary web syndrome.

Resumo A síndrome da rede axilar (ou cordão axilar) é uma complicação físico-funcional que interfere na qualidade de vida de mulheres que foram submetidas a tratamento para o câncer de mama. O objetivo do presente estudo foi verificar os tratamentos fisioterapêuticos disponíveis para a síndrome da rede axilar após o tratamento cirúrgico do câncer de mama no contexto da prática clínica baseada em evidências. Utilizou-se como critério de inclusão artigos que discutissem protocolos de tratamento para a síndrome da rede axilar após o tratamento para o câncer de mama. A pesquisa foi realizada nas bases de dados MEDLINE, Scopus, PEDro e LILACS, utilizando como palavras-chave síndrome da rede axilar linfadenectomia e câncer de mama, com foco em mulheres com diagnóstico de câncer de mama que realizaram cirurgia com linfadenectomia como parte do tratamento. Dos 262 estudos encontrados, foram selecionados 4 artigos que utilizaram fisioterapia, os quais incluíram drenagem linfática, mobilização tecidual, alongamento e fortalecimento. Os quatro artigos selecionados tiveram desfechos similares: melhora da dor no membro superior e na função do ombro e/ou desaparecimento do cordão axilar. Embora a síndrome da rede axilar seja tão frequente e prejudicial quanto as outras morbidades após tratamento para o câncer, existem poucos estudos sobre esse tema. As publicações são ainda mais escassas quando se considera uma abordagem intervencionista. Estudos randomizados controlados são necessários para embasar as técnicas de reabilitação na síndrome da rede axilar após tratamento para o câncer de mama.

Completude das informações do registro hospitalar de câncer em um hospital de Florianópolis / Completeness of the hospital cancer registry at a hospital in Florianópolis

INTRODUÇÃO: O Registro Hospitalar de Câncer (RHC) é uma fonte sistemática de informação que visa ao aprimoramento do serviço prestado a todo paciente oncológico. Seus dados são essenciais para todos os profissionais que assistem ao paciente com neoplasia, uma vez que fornece informações sobre os procedimentos aplicados, permitindo elaborar o perfil de pacientes e direcionar a terapêutica a ser adotada. OBJETIVO: Avaliar a completude do preenchimento dos prontuários oncológicos da Maternidade Carmela Dutra nos anos de 2009 e 2010, com base nas variáveis do RHC. MÉTODOS: Estudo descritivo exploratório, com dados de um banco secundário fornecido pelo RHC. Para análise dos prontuários foram utilizados pontos de corte identificando graus de incompletude de informações. RESULTADOS: Dos 405 registros analisados, 8,9% estão na categoria ruim, 22,7% foram classificados como regular, 32,6% como bom e 35,8% na categoria excelente. Histórico familiar de câncer e etilismo permanece em grande parte dos casos ausentes nos prontuários. CONCLUSÃO: Evidencia-se a importância e a necessidade de melhoria dos registros médicos, com a estruturação de campos obrigatórios e a padronização do sistema de prontuários.

INTRODUCTION: The Hospital Cancer Registry (HCR) is a systematic source of information aimed to improve the service provided to all cancer patients. Its database is essential for all professional who attend to patients with cancer as it provides statistical data that allows to determinate the profile of patients, and so to direct the therapy to be adopted. OBJECTIVE: To evaluate the completeness of the clinical and surgical oncology medical records of Maternity Carmela Dutra in 2009 and 2010, based on the variables of the HCR. METHODS: A descriptive exploratory study was conducted with a secondary database provided by HCR. Cutoff points with different degrees were used for analysis of incompleteness of information from medical records. RESULTS: Of the 405 records analyzed, 8.9% were in the poor category, 22.7% were classified in the fair category, 32.6% in the good and 35.8% in the excellent category. Family history of cancer and alcohol consumption remained largely the missing cases in the medical records. CONCLUSION: This study highlights the importance and need for improvement of medical records, with the structuring of required fields and standardization of medical records system.

Management of Axillary Web Syndrome after Breast Cancer: Evidence-Based Practice.

Axillary web syndrome is characterized as a physical-functional complication that impacts the quality of life of women who have undergone treatment for breast cancer. The present study aims to verify the physiotherapy treatment available for axillary web syndrome after surgery for breast cancer in the context of evidence-based practice. The selection criteria included papers discussing treatment protocols used for axillary web syndrome after treatment for breast cancer. The search was performed in the MEDLINE, Scopus, PEDro and LILACS databases using the terms axillary web syndrome, lymphadenectomy and breast cancer, focusing on women with a previous diagnosis of breast cancer who underwent surgery with lymphadenectomy as part of their treatment. From the 262 studies found, 4 articles that used physiotherapy treatment were selected. The physiotherapy treatment was based on lymphatic drainage, tissue mobilization, stretching and strengthening. The four selected articles had the same outcome: improvement in arm pain and shoulder function and/or dissipation of the axillary cord. Although axillary web syndrome seems to be as frequent and detrimental as other morbidities after cancer treatment, there are few studies on this subject. The publications are even scarcer when considering studies with an interventional approach. Randomized controlled trials are necessary to support the rehabilitation resources for axillary web syndrome.

A síndrome da rede axilar (ou cordão axilar) é uma complicação físico-funcional que interfere na qualidade de vida de mulheres que foram submetidas a tratamento para o câncer de mama. O objetivo do presente estudo foi verificar os tratamentos fisioterapêuticos disponíveis para a síndrome da rede axilar após o tratamento cirúrgico do câncer de mama no contexto da prática clínica baseada em evidências. Utilizou-se como critério de inclusão artigos que discutissem protocolos de tratamento para a síndrome da rede axilar após o tratamento para o câncer de mama. A pesquisa foi realizada nas bases de dados MEDLINE, Scopus, PEDro e LILACS, utilizando como palavras-chave síndrome da rede axilarlinfadenectomia e câncer de mama, com foco em mulheres com diagnóstico de câncer de mama que realizaram cirurgia com linfadenectomia como parte do tratamento. Dos 262 estudos encontrados, foram selecionados 4 artigos que utilizaram fisioterapia, os quais incluíram drenagem linfática, mobilização tecidual, alongamento e fortalecimento. Os quatro artigos selecionados tiveram desfechos similares: melhora da dor no membro superior e na função do ombro e/ou desaparecimento do cordão axilar. Embora a síndrome da rede axilar seja tão frequente e prejudicial quanto as outras morbidades após tratamento para o câncer, existem poucos estudos sobre esse tema. As publicações são ainda mais escassas quando se considera uma abordagem intervencionista. Estudos randomizados controlados são necessários para embasar as técnicas de reabilitação na síndrome da rede axilar após tratamento para o câncer de mama.