This study aims to evaluate the effectiveness of a physiotherapy program incorporating visual biofeedback compared to a conventional physiotherapy program in improving shoulder function in women following breast cancer surgery.
Breast cancer survivors frequently experience shoulder dysfunction, including reduced range of motion, decreased strength, altered neuromuscular activity, and impaired scapulohumeral control. While conventional physiotherapy is effective, there is growing interest in interventions targeting motor control and neuromuscular coordination through biofeedback strategies.
Participants will be randomly assigned to either a control group receiving conventional physiotherapy or an experimental group receiving the same program supplemented with visual biofeedback using the MotionGuidance system. Outcomes will include shoulder strength, range of motion, functional performance, electromyographic activity, and muscle oxygen saturation.
Women aged 18 years or older
History of breast cancer surgery (mastectomy or breast-conserving surgery within the last 6 months)
Presence of shoulder pain, reduced range of motion, strength deficit, or functional limitation
Ability to understand and follow study instructions
Presence of metastasis
Post-surgical complications contraindicating exercise
Severe lymphedema (Stage III or IV)
Neurological disorders affecting the upper limb
Parallel
Experimental Group: Physiotherapy + Visual Biofeedback
Procedure/SurgeryParticipants will receive a structured physiotherapy program combined with visual biofeedback using the MotionGuidance system. The intervention includes guided exercises with laser-based visual feedback to improve motor control and movement accuracy.
Shoulder Strength (kg)
Measured using handheld dynamometry (isometric strength in flexion, abduction, and external rotation).
Range of Motion (degrees)
Measured using goniometry (flexion, abduction, internal and external rotation).
Muscle Activity (EMG-microvolts)
Surface electromyography analysis (RMS-Root mean square, and activation timing of shoulder muscles)
Muscle Oxygen Saturation (SmO₂)
Measured using near-infrared spectroscopy (Moxy Monitor).
Handgrip Strength (kg)
Measured using a digital dynamometer.
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