EFFECT OF ACUPUNCTURE AND EXERCISE THERAPY IN REHABILITATION OF PHYSICAL DYSFUNCTIONS ON WOMEN BREAST CANCER SURVIVORS

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Introduction: The treatment of breast cancer can trigger physical dysfunctions and psychological difficulties such as pain, depression, limitation of upper limb function, and shoulder range of motion (ROM) deficits. Exercise therapy is a treatment well established in the literature for these disorders and acupuncture is an alternative to it. However, most studies using acupuncture only assess pain. Objective: The aim of this study was to compare three distinct rehabilitation treatments (exercise therapy, acupuncture, and Stiper®) in women undergoing breast cancer surgery, assessing pain, depression, upper limb function, and ROM parameters. Methods: In total, 79 women with pain above 3 on the visual analog scale (VAS) and with more than 90 days of surgery were included. The research was approved by the Research Ethics Committee (CEP) of the Universidade Federal de São Paulo/Hospital São Paulo on May 13, 2016, under number 1.543.582, and registered in the Clinical Trials Registry on January 11, 2016, with number NCT02798263. They were divided into three groups that received weekly treatment for 10 weeks: group I (G1) treated with standard, predefined exercise therapy, based on stretching of the cervical muscles, shoulder girdle, and shoulder ROM exercises with a duration of 30 min; group II (G2) treated with 30 min of acupuncture using predefined points; and group III (G3) treated with the same acupuncture points as group II, however, using the Stiper ® (silicon oxide micronized quartz pellet) in place of needles. Results: In all, 67 patients completed the treatment, being 26 from G1, 23 from G2, and 18 from G3. There was a decrease in pain over time in all groups (first session compared with the fifth (p <0.001) and with the tenth (p<0.001), but not between groups. There was a statistically significant difference in depressive symptoms using the Beck questionnaire over time in the three groups (between the first and tenth sessions [p=0.001], between the first and fifth sessions [p=0.052], but not between groups). Regarding the DASH questionnaire for shoulder function, there were significant differences over time at all evaluated moments (p <0.001), but not between groups. Conclusion: The rehabilitation of physical dysfunctions in women who survived breast cancer through exercise therapy, acupuncture, and Stiper® proved to be effective, without superiority between the groups. We conclude that acupuncture showed equivalent results when compared with exercise therapy, thus being an effective approach in the rehabilitation of these women.