Year: 2026 | Month: September | Volume: 13 | Issue: 9 | Pages: 19-34
DOI: https://doi.org/10.52403/ijrr.20260904
Breathing Beyond the Blade: A Multimodal Approach to Respiratory Rehabilitation in Post-Mastectomy Pain Syndrome - A Scoping Review
Abirami M1, Deepak Jain N2, Srimonta Das3
1MPT, Department of Cardiovascular and Pulmonary Sciences, Narayana Hrudayalaya Institute of Physiotherapy, Rajiv Gandhi University of Health Sciences, Bengaluru.
2Associate Professor, Department of Cardiovascular and Pulmonary Sciences, Narayana Hrudayalaya Institute of Physiotherapy, Rajiv Gandhi University of Health Sciences, Bengaluru.
3Lecturer, Department of Cardiovascular and Pulmonary Sciences, Narayana Hrudayalaya Institute of Physiotherapy, Rajiv Gandhi University of Health Sciences, Bengaluru.
Corresponding Author: Abirami M
ABSTRACT
Background: Post-Mastectomy Pain Syndrome (PMPS) is a chronic pain condition that develops after breast cancer surgery and is commonly associated with respiratory muscle weakness, reduced chest wall mobility, impaired pulmonary function, cancer-related fatigue, and diminished health-related quality of life. Although respiratory rehabilitation has emerged as an important component of breast cancer survivorship care, evidence regarding multimodal respiratory rehabilitation strategies remain scattered across diverse interventions and study designs.
Objective: To map and synthesize the available evidence on multimodal respiratory rehabilitation interventions for individuals with PMPS, focusing on respiratory muscle training, thoracic mobility, pulmonary function, functional capacity, cancer-related fatigue, pain, and quality of life.
Methods: This scoping review was conducted according to the Joanna Briggs Institute (JBI) methodology and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). A comprehensive search of PubMed, Scopus, Web of Science, PEDro, the Cochrane Library, and Google Scholar identified studies published between January 2000 and August 2025. Eligible studies were selected using the Population–Concept–Context (PCC) framework. Data were extracted, charted, and synthesized descriptively to summarize the scope, characteristics, and outcomes of the available evidence.
Results: 75 studies met the inclusion criteria. The evidence indicates that multimodal respiratory rehabilitation—including respiratory muscle training, breathing exercises, thoracic mobility exercises, scar management, myofascial release, postural correction, structured exercise therapy, and telerehabilitation—improves respiratory muscle strength, chest wall mobility, pulmonary function, functional capacity, pain, cancer-related fatigue, and health-related quality of life. However, considerable heterogeneity was observed in intervention protocols, outcome measures, and follow-up duration across studies.
Conclusion: Multimodal respiratory rehabilitation represents a comprehensive physiotherapy approach for managing PMPS and its associated respiratory and functional impairments. Current evidence supports its potential to enhance clinical outcomes and quality of life. Nevertheless, further high-quality studies are required to establish standardized rehabilitation protocols and determine long-term effectiveness.
Keywords: Post-Mastectomy Pain Syndrome; Respiratory Rehabilitation; Respiratory Muscle Training; Cancer-Related Fatigue; Quality of Life.
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