1
|
Oncu H, Calik-Kutukcu E, Vardar Yagli N, Inal-Ince D, Saglam M, Unal F, Aksoy S. Reliability and validity of the 6-minute pegboard and ring test for functional exercise capacity in patients with breast cancer. Physiother Theory Pract 2024:1-13. [PMID: 38739486 DOI: 10.1080/09593985.2024.2353260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 05/05/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Chronic pain, sensory disturbances, and lymphedema are frequent after breast cancer, leading to arm dysfunction. There is a need for objective performance-based clinical exercise tests for the upper extremity in patients with breast cancer. OBJECTIVE The aim of this study was to evaluate the validity and reliability of the 6-minute pegboard and ring test (6PBRT) in breast cancer survivors. METHODS Forty-eight women with breast cancer (mean age = 55.40 ± 10.40 years) were included. All patients performed 6PBRT on the first day and one week later to investigate the test-retest reliability of the 6PBRT, and intraclass correlation coefficients (ICC) were calculated. The peak workload (Wpeak) and oxygen consumption level (VO2peak) during the arm ergometer test were used as outcomes for the criterion validity of the 6PBRT. RESULTS The 6PBRT showed good test - retest reliability with an ICC1,2 value of 0.871 [95% confidence interval (CI) 0.769-0.928]. The first 6PBRT score was very strongly correlated with the second test score (r = 0.866, p < .001). The 6PBRT score was significantly correlated with VO2peak (r = 0.634, p < .001), and Wpeak (r = 0.546, p < .001). While the 6PBRT score had less effect on VO2peak, the determination of VO2peak in the model was very good (R2 = 0.832). CONCLUSION The 6PBRT has good test-retest reliability and is a valid test in individuals with breast cancer. These findings suggest that 6PBRT is a practical, useful, valid and reliable assessment tool for determining functional arm exercise capacity in patients with breast cancer.
Collapse
Affiliation(s)
- Hacer Oncu
- Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ebru Calik-Kutukcu
- Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Naciye Vardar Yagli
- Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Deniz Inal-Ince
- Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Melda Saglam
- Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ferhat Unal
- Data Management Unit, Middle East Technical University, Ankara, Turkey
| | - Sercan Aksoy
- Institute of Oncology, Department of Medical Oncology, Hacettepe University, Ankara, Turkey
| |
Collapse
|
2
|
Kim A, Beom J, Yang EJ, Choi WJ, Ji M, Yi C. Factors affecting upper limb functional recovery after mastectomy with immediate breast reconstruction: a prospective study. Physiother Theory Pract 2024:1-11. [PMID: 38616681 DOI: 10.1080/09593985.2024.2343043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/08/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Little is known about the differences in postoperative shoulder function following two common approaches for immediate breast reconstruction (IBR): abdominal-based breast reconstruction and implant-based breast reconstruction (ABR and IMBR). It was hypothesized that postoperative upper limb function would differ between the ABR and IMBR due to incomplete detachment of the pectoral muscles. PURPOSE This study aimed to investigate the factors for shoulder function recovery post-IBR and compare recovery outcomes between ABR and IMBR. METHODS This single-center prospective follow-up study included 60 patients who underwent IBR for 4 months postoperatively. Patients were invited to complete functional measurements 1 and 4 months postoperatively. The primary outcome was improvement in upper limb disability based on the Q-DASH score. Secondary outcomes were functional shoulder recovery markers: shoulder flexibility, strength, movement accuracy, scapular alignment, body schema accuracy, and neuropathic pain. Repeated-measures analyzes of variance and linear regression were performed. RESULTS Within-group differences were found for most variables (p < .05) except for neuropathic pain (p = .929). However, there was no overall main group effect (p > .05). Multivariate regression analysis established significant models for ABR and IMBR (R2 = 0.430, p = .002 and R2 = 0.442, p < .001, respectively). However, the variables included in the model showed between-group differences. CONCLUSION Postoperative shoulder function was comparable between the two IBR approaches. However, different factors were associated with improved upper limb disability between ABR and IMBR. Acute rehabilitation focused on resolving muscle tightness and pain may help mitigate upper limb disabilities following IBR.Trial registration number: KCT 0006501.
Collapse
Affiliation(s)
- Asall Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
| | - Jaewon Beom
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
| | - Eun Joo Yang
- Institute of Convergence Science, Yonsei University, Seoul, South Korea
| | - Woochol Joseph Choi
- Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Gangwon-do, South Korea
| | - Myungki Ji
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
| | - Chunghwi Yi
- Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Gangwon-do, South Korea
| |
Collapse
|
3
|
Yildiz TI, Kara D, Demirci S, Sevinç C, Ulusoy B, Eraslan L, Aksoy T, Huri G, Duzgun I. Recovery of the shoulder kinematics after reverse shoulder arthroplasty. Clin Biomech (Bristol, Avon) 2023; 107:106013. [PMID: 37267895 DOI: 10.1016/j.clinbiomech.2023.106013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND There is very limited information about the changes in shoulder kinematics in patients with reverse shoulder arthroplasty. The aim of the study was to investigate the changes in the scapulohumeral rhythm and shoulder kinematics over time after the reverse shoulder procedure. METHODS Nineteen patients with reverse shoulder arthroplasty (age: 65.8 ± 10.3 years) were included to the study. During arm elevation in the sagittal and scapular planes, operated shoulder kinematics (humerothoracic elevation, glenohumeral elevation, scapulohumeral rhythm, and scapular rotations) were assessed using an electromagnetic tracking system at the postoperative 3rd, 6th, and 18th months. Asymptomatic shoulder kinematics were also assessed at the postoperative 18th month. Shoulder function was assessed using The Disabilities of the Arm Shoulder and Hand score at the postoperative 3rd, 6th, and 18th months. FINDINGS Maximum humerothoracic elevation increased from 98° to 109° over the postoperative period (p = 0.01). The scapulohumeral rhythm was similar on the operated and asymptomatic shoulders at the final follow-up (p = 0.11). Both the operated and asymptomatic shoulder demonstrated similar scapular kinematics at the postoperative 18th month (p > 0.05). The Disabilities of the Arm Shoulder and Hand score decreased over time in the postoperative period (p < 0.05). INTERPRETATION Shoulder kinematics may be improved after reverse shoulder arthroplasty in the postoperative period. Focusing on scapular stabilization and deltoid muscle control in the postoperative rehabilitation program may enhance the shoulder kinematics and upper extremity function.
Collapse
Affiliation(s)
- Taha Ibrahim Yildiz
- Afyonkarahisar Saglik Bilimleri University, Institution of Health Science, Turkey.
| | - Dilara Kara
- Hacettepe University, Institution of Health Science, Turkey
| | - Serdar Demirci
- Balikesir University, Institution of Health Science, Turkey
| | - Ceyda Sevinç
- Hacettepe University, Institution of Health Science, Turkey
| | - Burak Ulusoy
- Cankiri University, Institution of Health Science, Turkey
| | - Leyla Eraslan
- Hacettepe University, Institution of Health Science, Turkey
| | - Taha Aksoy
- Hacettepe University, Institution of Health Science, Turkey
| | - Gazi Huri
- Hacettepe University, Institution of Health Science, Turkey
| | - Irem Duzgun
- Hacettepe University, Institution of Health Science, Turkey
| |
Collapse
|
4
|
Wills RAM, Maciukiewicz JM, Mourtzakis M, Dickerson CR. Examining the Effect of Time-From-Treatment on Activities of Daily Living Kinematics in Breast Cancer Survivors. J Appl Biomech 2023:1-6. [PMID: 37225172 DOI: 10.1123/jab.2022-0245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/23/2023] [Accepted: 04/02/2023] [Indexed: 05/26/2023]
Abstract
Breast cancer affects one in 8 females with a 5-year survival rate of 89%. Up to 72% of breast cancer survivors have trouble with activities of daily living (ADL) following treatment. Increased time-from-treatment improves some measures of function, yet ADL limitations persist. Therefore, this study assessed the effect of time-from-treatment on upper extremity kinematics during ADLs in breast cancer survivors. Twenty-nine female breast cancer survivors were divided into 2 groups: <1 year (n = 12) and 1-2 years (n = 17) from treatment. Kinematics were collected during 6 ADL tasks, and humerothoracic joint angles were quantified. A 2-way mixed analysis of variance assessed the effects of time-from-treatment and arm on maximum angles for each ADL. Decreased maximum angle existed for breast cancer survivors with increased time-from-treatment during all ADLs. Breast cancer survivors in the 1-2 years group used ∼28° to 32° lower elevation, ∼14° to 28° lower axial rotation, and ∼10° to 14° lower plane of elevation range across tasks. Decreased ranges of arm movement during ADLs with increased time-from-treatment may reflect compensatory movement strategies. Recognizing this shift in strategies and accompanying underlying disease progression can help inform responses to functional performance limitations in breast cancer survivors as delayed effects are present posttreatment.
Collapse
Affiliation(s)
- Rebecca A M Wills
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON,Canada
| | - Jacquelyn M Maciukiewicz
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON,Canada
| | - Marina Mourtzakis
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON,Canada
| | - Clark R Dickerson
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON,Canada
| |
Collapse
|
5
|
Min J, Yeon S, Ryu J, Kim JY, Yang EJ, Kim SI, Park S, Jeon JY. Shoulder function and health outcomes in newly diagnosed breast cancer patients receiving surgery: a prospective study. Clin Breast Cancer 2023; 23:e247-e258. [PMID: 36990840 DOI: 10.1016/j.clbc.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Breast cancer surgery is associated with upper-body morbidities that may last several years postsurgery. Research has not determined if the type of surgery leads to differential effects on shoulder function, activity levels, and QoL during the early rehabilitation period. The main objective of this study is to examine changes in shoulder function, health, and fitness outcomes from the day before to surgery to 6 months postsurgery. PATIENTS AND METHODS We recruited breast cancer patients (N = 70) scheduled to receive breast cancer surgery at Severance Hospital in Seoul to participate in this prospective study. Shoulder range of motion (ROM) and upper body strength, the disabilities of Arm, Shoulder, and Hand (quick-DASH), body composition, physical activity levels, and QoL were measured at baseline (presurgery) and then weekly for 4 weeks, and at 3 months and 6 months postsurgery. RESULTS During 6 months after surgery, shoulder ROM was reduced only affected arm while shoulder strength was significantly declined in both affected and unaffected arms. Within 4 weeks postsurgery, patients who underwent total mastectomy were significantly less recovered than patients with partial mastectomy in ROM of flexion (P < .05) and abduction (P < .05). However, shoulder strength of both arms observed no interaction between surgical type and time. We observed significant changes in body composition, quick-DASH score, physical activity levels, and QoL from presurgery to 6-months postsurgery. CONCLUSIONS Shoulder function, activity levels, and QoL improved significantly from surgery to 6-months postsurgery. Surgery type influenced changes in shoulder ROM.
Collapse
|
6
|
Improving Evidence-Based Methods of Characterizing Shoulder-Related Quality of Life for Survivors of Breast Cancer. REHABILITATION ONCOLOGY 2023. [DOI: 10.1097/01.reo.0000000000000332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
|
7
|
Kim A, Yang EJ, Ji M, Beom J, Yi C. Distorted body schema after mastectomy with immediate breast reconstruction: a 4-month follow up study. PeerJ 2022; 10:e14157. [PMID: 36213497 PMCID: PMC9536299 DOI: 10.7717/peerj.14157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/08/2022] [Indexed: 01/21/2023] Open
Abstract
Background After breast cancer, some patients report residual pain-related upper limb disability without physical impairment. Although pain and altered proprioception are known to affect the working body schema (WBS), there is little available evidence investigating the WBS of breast cancer survivors (BrCS). WBS-body representations in the brain-affect the "neuromatrix" that modulates pain sensitivity and the threshold for threatening stimuli. The aim of this study was to investigate whether WBS was disrupted after mastectomy with immediate breast reconstruction (IBR) for breast cancer and whether pain and proprioceptive changes affected WBS. Methods Thirty-five BrCS participated in the 4-month follow-up study. They were observed at 1 and 4 months postoperatively. The main outcome measures were the left right judgement test (LRJT) results, absolute angle error, pectoralis minor length index (PMI), pain, and Quick-Disabilities of the Arm, Shoulder, and Hand (Q-DASH) score. They were measured at each observation, and parametric tests were performed to identify the nature of WBS. Results Both the reaction time and accuracy of the hand LRJT were poorer than those of the foot and back LRJT (p < 0.001). The hand LRJT reaction time and accuracy were unchanged over the total follow-up period (p = 0.77 and p = 0.47, respectively). There was a weak correlation between the LRJT reaction time and PMI (r = -0.26, p = 0.07), pain severity (r = 0.37, p = 0.02), and Q-DASH score (r = 0.37, p = 0.02). There was also a weak correlation between LRJT accuracy and Q-DASH score (r = -0.31, p = 0.04). The LRJT accuracy of BrCS who underwent surgery on their dominant side was higher than that of BrCS who underwent surgery on their non-dominant side (p = 0.002). Regression analysis found a weak but significant relationship between the early hand LRJT results and late pain severity (adjusted R2 = 0.179, p = 0.007). A similar relationship was found between early hand LRJT results and Q-DASH score (adjusted R2 = 0.099, p = 0.039). Conclusion To the best of our knowledge, this is the first study providing the nature of WBS after mastectomy with IBR. In this population, it is necessary to postoperatively preserve WBS integrity for pain and upper limb disability.
Collapse
Affiliation(s)
- Asall Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea,Department of Physical Therapy, The Graduate school, Yonsei University, Wonju, South Korea
| | - Eun Joo Yang
- Department of Rehabilitation Medicine, Daelim Catholic Hospital, Seoul, South Korea
| | - Myungki Ji
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jaewon Beom
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Chunghwi Yi
- Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, South Korea
| |
Collapse
|
8
|
Koehler L, Day A, Hunter D, Blaes A, Haddad T, Shanley R. Five-Year Cumulative Incidence of Axillary Web Syndrome and Comparison in Upper Extremity Movement, Function, Pain, and Lymphedema in Survivors of Breast Cancer With and Without Axillary Web Syndrome. Arch Phys Med Rehabil 2022; 103:1798-1806. [PMID: 35398047 PMCID: PMC9452471 DOI: 10.1016/j.apmr.2022.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/07/2022] [Accepted: 03/08/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine the cumulative incidence and natural history of axillary web syndrome (AWS) and its related postoperative risk for physical impairments in a cohort of women followed for 5 years post breast cancer surgery. DESIGN Prospective, longitudinal study. SETTING Academic health center. PARTICIPANTS Women (N=36) with and without AWS after breast cancer surgery with sentinel node biopsy or axillary lymph node dissection. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Participants were assessed for AWS, shoulder goniometric flexion and abduction range of motion, function (Disability of the Arm, Shoulder, and Hand), lymphedema (bioimpedance spectroscopy, girth measures, tissue dielectric constant), and pain (visual analog scale) at 2, 4, 12, and 78 weeks and 5 years after breast cancer surgery. Analysis of variance compared range of motion, function, lymphedema, and pain in women identified with AWS with those without AWS across visits. Univariate logistic regression assessed if AWS was a risk factor for physical impairment at 5 years. RESULTS The cumulative incidence of AWS was 57%. Fifty percent (14/28) of the women who completed all study visits had signs of AWS at 5 years. Abduction active range of motion was significantly lower in women with AWS at 2 and 4 weeks post surgery. AWS was identified as a risk factor for reduced shoulder motion at 5 years. Regardless of AWS, 75% of the women experienced 1 or more upper extremity physical impairments at 5 years, which is an increase from 66% at 78 weeks in the same cohort. CONCLUSIONS AWS is associated with reduced shoulder range of motion in the early postoperative time period, can persist for 5 years after breast cancer surgery, and increases the risk of long-term reduced shoulder range of motion. Long-term physical issues are apparent after breast cancer surgery regardless of AWS.
Collapse
Affiliation(s)
- Linda Koehler
- Division of Physical Therapy, Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota; Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota; Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.
| | - Amanda Day
- Division of Physical Medicine and Rehabilitation, Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | - David Hunter
- Radiology, University of Minnesota, Minneapolis, Minnesota
| | - Anne Blaes
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota; Hematology/Oncology, University of Minnesota, Minneapolis, Minnesota
| | - Tufia Haddad
- Department of Oncology, Mayo Clinic, Rochester, Minnesota
| | - Ryan Shanley
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota; Clinical and Translational Science Institute, Biostatistical Design and Analysis Center, University of Minnesota, Minneapolis, Minnesota, United States
| |
Collapse
|
9
|
Effectiveness of a Home-Based Exercise Intervention in the Fitness Profile of Hispanic Survivors of Breast Cancer. REHABILITATION ONCOLOGY 2021; 39:175-183. [PMID: 34712520 DOI: 10.1097/01.reo.0000000000000253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background Home-based exercise interventions might be a desirable long-term option for breast cancer survivors to enhance compliance and long-term health benefits. Purpose To assess the effectiveness of a home-based intervention aimed at helping survivors of breast cancer meet the physical activity guidelines of the American College of Sports Medicine. Methods Eighty-nine women (age: 55.4 ± 10 years; BMI: 31 ± 6.5 kg/m2) from two cancer centers serving Hispanic women participated in this study. Women performed a baseline assessment of cardiorespiratory fitness, muscle endurance and strength, flexibility, range of motion, and extremity disability. After baseline measures, women were randomized into a control (C) or exercise (E) group. The exercise intervention consisted of a walking program, elastic band strengthening, and flexibility exercises performed at home. The outcome measures were reassessed 16 weeks after baseline measures. Results The intervention showed a strong effect of time on muscle strength and shoulder range of motion, and time and group for self-reported disability. There were no differences in sedentary behavior, physical fitness, and disability measures across intervention groups, including both exercise groups combined and changes over time between intervention groups. Conclusion It appears that a home-based intervention affects only upper body strength and related disability, indicating that other components might need closer monitoring for significant changes to occur across time.
Collapse
|
10
|
Absolute and Relative Handgrip Strength as Indicators of Self-Reported Physical Function and Quality of Life in Breast Cancer Survivors: The EFICAN Study. Cancers (Basel) 2021; 13:cancers13215292. [PMID: 34771456 PMCID: PMC8582513 DOI: 10.3390/cancers13215292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 12/27/2022] Open
Abstract
Simple Summary Breast cancer is the most diagnosed type of cancer worldwide and it has a high survival rate. Thus, side effects related to breast cancer and treatments compromise lots of people’s physical functions and health-related quality of life. For this reason, it is important to manage these side effects in the follow up after treatments. The handgrip strength and the handgrip strength relative to body mass index may constitute useful, simple, quick and economically feasible tools that may help clinicians detecting these side effects, which is key to undertake actions for improving the physical function and health-related quality of life of breast cancer survivors. Abstract Background: Although breast cancer (BC) is the most prevalent type of cancer in the world, its high survival rate implies that many people live long after the treatments and face their side effects. The physical function (PF) and health-related quality of life (HRQoL) of people surviving BC decreases significantly, which makes important to identify markers that may be associated with a better health status and prognosis. Previous studies suggest that handgrip strength (HGS) and HGS relative to the body mass index (rHGS) are good indicators of PF and HRQoL in different populations. However, it is unknown whether this applies to BC survivors. This study aimed to evaluate the association of HGS and rHGS with PF and HRQoL in this population. Methods: Sixty female BC survivors participated. Handgrip strength was assessed with a dynamometer. Arm volume was estimated and upper limb impairments, as well as cancer-related fatigue, depression, life satisfaction and HRQoL, were assessed using standardized questionnaires. Results: Higher levels of HGS and rHGS were associated with higher levels of HRQoL, lower cancer-related fatigue, and fewer problems with the affected arm. Conclusions: These results suggest that HGS may be a good indicator of self-reported PF and HRQoL in female BC survivors.
Collapse
|
11
|
Babasaheb SS, Rajesh KK, Yeshwant KS, Patil S. Analysis of Spinal Dysfunction in Breast Cancer Survivors with Lymphedema. Asian Pac J Cancer Prev 2021; 22:1869-1873. [PMID: 34181345 PMCID: PMC8418831 DOI: 10.31557/apjcp.2021.22.6.1869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Indexed: 11/25/2022] Open
Abstract
Background: To study and analyse the spinal dysfunction in breast cancer survivors with lymphedema. Methods: This study was carried out by analysing total 116 breast cancer survivor women, who were having lymphedema. Out of 116 subjects, 39 undergone radical mastectomy (RM), 39 undergone modified radical mastectomy (MRM) and 38 undergone breast conserving surgery (BCS). Thesesubjects were assessed for spinal function bytaking range of motionusing goniometer, lymphedema measurement usinginch tape, spinal stability test and functional rating index. Results: The spinal range of motion wassignificantly reduced in patients suffering from lymphedema in breast cancer survivors. The strength and endurance were significantly reduced in abdominals, extensors and lateral muscles of spine. There wasmarked effect seen on quality of life of patients assessed by using functional rating index due to spinal dysfunction in lymphedema patients. Conclusion: This study showed that there is statistically significant spinal dysfunction caused due to lymphedema in breast cancer survivors.
Collapse
Affiliation(s)
- Shinde Sandeep Babasaheb
- Department of Musculoskeletal Sciences, Faculty of Physiotherapy, Krishna Institute of Medical Sciences, Deemed to Be University, Karad, Maharashtra, India
| | - Kulkarni Kajol Rajesh
- Department of Musculoskeletal Sciences, Faculty of Physiotherapy, Krishna Institute of Medical Sciences, Deemed to Be University, Karad, Maharashtra, India
| | - Kolekar Shital Yeshwant
- Department of Musculoskeletal Sciences, Faculty of Physiotherapy, Krishna Institute of Medical Sciences, Deemed to Be University, Karad, Maharashtra, India
| | - Sanjaykumar Patil
- Department of Obstetrics and Gynaecology, Krishna Institute of Medical Sciences, Deemed to Be University, Karad, Maharashtra, India
| |
Collapse
|
12
|
Evaluation of Late Postural Complications in Breast Cancer Patients Undergoing Breast-Conserving Therapy in Relation to the Type of Axillary Intervention-Cross-Sectional Study. J Clin Med 2021; 10:jcm10071432. [PMID: 33916060 PMCID: PMC8036801 DOI: 10.3390/jcm10071432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/12/2021] [Accepted: 03/22/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose: The aim of the study was to evaluate posture in patients undergoing breast-conserving therapy (BCT) in relation to the type of surgical intervention to the axilla. Methods: The study was conducted on patients who had undergone breast-conserving surgical treatment for breast cancer 5–6 years earlier. In 54 patients, BCT+ALND (axillary lymph node dissection) was performed, while 63 patients were subjected to BCT+SLND (sentinel lymph node dissection). The control group consisted of 54 females. The study was conducted using digital postural assessment. Results: No statistically significant differences were observed with respect to the parameters between the BCT+SLNB and BCT+ALND groups (p > 0.05). However, the differences were highly significant between the CG (control group) and the studied groups (BCT+ALND, BCT+SLNB) for the following parameters: BETA angle of thoracolumbar spine inclination (p = 0.002), GAMMA angle of thoracic spine inclination (p = 0.0044), TKA (thoracic kyphosis angle) (p < 0.0001) and shoulder level inclination (p = 0.0004). The BCT+ALND patients were characterized by higher dependency of raised shoulder (p = 0.0028) and inferior angle of the scapula (p = 0.00018) on the operated side compared to BCT+SLNB patients. Conclusions: Postural imbalance occurs independent of the type of axillary intervention. Disturbances within the upper torso (abnormal position of shoulders and inferior angles of scapulae) are more pronounced in patients after ALND.
Collapse
|
13
|
De Groef A, Van der Gucht E, Dams L, Evenepoel M, Teppers L, Toppet–Hoegars J, De Baets L. The association between upper limb function and variables at the different domains of the international classification of functioning, disability and health in women after breast cancer surgery: a systematic review. Disabil Rehabil 2020; 44:1176-1189. [DOI: 10.1080/09638288.2020.1800835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- An De Groef
- Department of Rehabilitation Sciences, KU Leuven – University of Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
| | - Elien Van der Gucht
- Department of Rehabilitation Sciences, KU Leuven – University of Leuven, Leuven, Belgium
| | - Lore Dams
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
| | - Margaux Evenepoel
- Department of Rehabilitation Sciences, KU Leuven – University of Leuven, Leuven, Belgium
| | - Lien Teppers
- Faculty of Rehabilitation Science, Hasselt University, Diepenbeek, Belgium
| | | | - Liesbet De Baets
- Faculty of Rehabilitation Science, Hasselt University, Diepenbeek, Belgium
| |
Collapse
|
14
|
Boing L, Vieira MDCS, Moratelli J, Bergmann A, Guimarães ACDA. Effects of exercise on physical outcomes of breast cancer survivors receiving hormone therapy - A systematic review and meta-analysis. Maturitas 2020; 141:71-81. [PMID: 33036706 DOI: 10.1016/j.maturitas.2020.06.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/14/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Side-effects of hormone therapy can impair the physical health of breast cancer survivors. Exercise has been clearly shown to improve the quality of life of breast cancer survivors. Less is known about the effects of exercise on physical outcomes for breast cancer survivors receiving hormone therapy. OBJECTIVE To investigate the effects of exercise on physical outcomes of breast cancer survivors receiving hormone therapy. METHODS Five electronic databases were searched by two authors using the terms "Breast Neoplasms" [MeSH] and "Tamoxifen" [MeSH] and "Aromatase Inhibitors" [MeSH] and "Exercise" [MeSH]. Randomized and non-randomized clinical trials were included. Risk of bias was assessed by the Cochrane Collaboration tool and ROBINS-I, and the quality of evidence was evaluated using GRADE. Pooled effects were reported as standardized mean differences (SMDs) and 95 % confidence intervals (CIs) using a random effects model. RESULTS Eleven studies were included in the meta-analysis. Two hundred and fourteen breast cancer survivors receiving hormone therapy, tamoxifen, or aromatase inhibitors participated in interventions based on aerobic plus resistance exercise or walking activity. The physical outcomes reported in the articles were: cardiorespiratory fitness, pain, bone mineral density, grip strength, and body fat percentage. Exercise effects were found only for cardiorespiratory fitness (SMD = 0.37; 95 % CI: 0.11; 0.63; I2 = 93 %) and pain (SMD = -0.55; IC95 % -1.11; -0.00; I2 = 80 %), with low quality of evidence. No effects were observed for the other variables. CONCLUSIONS Aerobic plus resistance exercise had positive effects on cardiorespiratory fitness and pain in breast cancer survivors receiving hormone therapy. However, high-quality randomized clinical trials are required to confirm this finding.
Collapse
Affiliation(s)
- Leonessa Boing
- College of Health and Sport Science, Santa Catarina State University, Brazil.
| | | | - Jéssica Moratelli
- College of Health and Sport Science, Santa Catarina State University, Brazil
| | - Anke Bergmann
- Clinical Research Program, National Cancer Institute, Brazil
| | | |
Collapse
|
15
|
Møller T, Andersen C, Lillelund C, Bloomquist K, Christensen KB, Ejlertsen B, Tuxen M, Oturai P, Breitenstein U, Kolind C, Travis P, Bjerg T, Rørth M, Adamsen L. Physical deterioration and adaptive recovery in physically inactive breast cancer patients during adjuvant chemotherapy: a randomised controlled trial. Sci Rep 2020; 10:9710. [PMID: 32546796 PMCID: PMC7297957 DOI: 10.1038/s41598-020-66513-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 05/18/2020] [Indexed: 12/22/2022] Open
Abstract
Cardiorespiratory fitness is an independent risk factor for cardiovascular disease and shortened life expectancy in breast cancer survivors. This randomised controlled trial (n = 153) was designed for patients with a physically inactive lifestyle prediagnosis and concurrently referred to adjuvant chemotherapy. We compared two 12-week exercise interventions aimed at physiological and patient-reported outcomes (cardiorespiratory fitness, muscle strength, metabolic markers, physical activity, pain, fatigue), including a 39-week follow-up. A supervised hospital-based moderate to high intensity group exercise intervention was compared to an instructed home-based individual pedometer intervention. The two 12-week interventions included oncologists’ recommendations and systematic health counselling. Outcomes were measured at baseline and week 6, 12 and 39. Primary outcome cardiorespiratory fitness declined significantly during chemotherapy and was restored in both interventions at follow-up. The interventions effectively engaged breast cancer patients in sustaining physical activities during and following adjuvant treatment. A composite metabolic score improved significantly. Positive cardiorespiratory fitness responders had improved clinical effects on fatigue, pain and dyspnoea versus negative responders. We conclude that a loss of cardiorespiratory fitness among physically inactive breast cancer patients may be restored by early initiated interventions and by adapting to physical activity recommendations, leading to a decreased cardiovascular risk profile in breast cancer survivors.
Collapse
Affiliation(s)
- Tom Møller
- The University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Department, 9701, Copenhagen, Denmark. .,University of Copenhagen, Faculty of Health and Medical Sciences, Department of Public Health, Copenhagen, Denmark.
| | - Christina Andersen
- The University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Department, 9701, Copenhagen, Denmark
| | - Christian Lillelund
- The University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Department, 9701, Copenhagen, Denmark
| | - Kira Bloomquist
- The University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Department, 9701, Copenhagen, Denmark
| | - Karl Bang Christensen
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Public Health, Copenhagen, Denmark
| | - Bent Ejlertsen
- Copenhagen University Hospital, Rigshospitalet, Department of Oncology, 7301, Copenhagen, Denmark
| | - Malgorzata Tuxen
- Copenhagen University Hospital, Rigshospitalet, Department of Oncology, 7301, Copenhagen, Denmark
| | - Peter Oturai
- Copenhagen University Hospital, Rigshospitalet, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen, Denmark
| | - Ulla Breitenstein
- Copenhagen University Hospital, Rigshospitalet, Department of Oncology, 7301, Copenhagen, Denmark
| | - Cecilie Kolind
- Copenhagen University Hospital, Herlev Hospital, Department of Oncology, Herlev, Denmark
| | - Pernille Travis
- Copenhagen University Hospital, Herlev Hospital, Department of Oncology, Herlev, Denmark
| | - Tina Bjerg
- Copenhagen University Hospital, Rigshospitalet, Department of Oncology, 7301, Copenhagen, Denmark
| | - Mikael Rørth
- Copenhagen University Hospital, Rigshospitalet, Department of Oncology, 7301, Copenhagen, Denmark
| | - Lis Adamsen
- The University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Department, 9701, Copenhagen, Denmark.,University of Copenhagen, Faculty of Health and Medical Sciences, Department of Public Health, Copenhagen, Denmark
| |
Collapse
|
16
|
Paolucci T, Bernetti A, Bai AV, Capobianco SV, Bonifacino A, Maggi G, Ippolitoni G, Tinelli L, Santilli V, Agostini F, Paoloni M, Mangone M. The recovery of reaching movement in breast cancer survivors: two different rehabilitative protocols in comparison. Eur J Phys Rehabil Med 2020; 57:137-147. [PMID: 32406224 DOI: 10.23736/s1973-9087.20.06138-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Breast cancer (BC) is the most common cancer in women in the developed world. The about the sequelae of surgery, especially in case of mastectomy or modified radical mastectomy is grown. Nowadays it is important choose appropriate exercise programs to allow recovery in "quantity" but also in "quality" of the movement of the operated upper limb. AIM The aim of this study was to verify whether specific exercises for the scapula may induce changes in fluidity of the reaching movement. DESIGN Randomized control-trial double-blind study. SETTING Exercise training laboratory and gait analysis laboratory. POPULATION Sixty-three breast cancer survivors were enrolled. METHODS Participants randomized to single rehabilitative treatment (ST), or to group rehabilitative treatment (GT). VAS, DASH and a biomechanical evaluation of upper limb were performed for each group before treatment (T0=baseline), at the end rehabilitative treatment (T1) and after three months of follow-up (T2). RESULTS Respect within group analysis, in the ST and in the GT, for VAS an improvement along evaluation times were observed, respectively at T0 to T1 and at T0 to T2 (P<0.001) without a statistically significant difference between groups. At the same, for the DASH, the results showed the same trend without a statistically significant difference between groups. For biomechanical parameters, at T2 velocity was statistically significantly greater in the ST than in the GT (P=0.029) in contrast with the duration, that was statistically significantly greater in the GT than in the ST (P=0.010). CONCLUSIONS Both protocols are effective in reducing pain and for functional recovery of the upper limb. The adoption of a non-intensive rehabilitation program should be implemented at least in the first year after the operation, with the adoption of specific myofascial exercises on the scapulo-thoracic joint with better results in the "qualitative" recovery of the achievement. CLINICAL REHABILITATION IMPACT Our study emphasizes the importance of rehabilitation in BC survivors after mastectomy, even during the course of radiotherapy and chemotherapy and the adoption of specific myofascial exercises on the scapulo-thoracic joint and specific exercises of muscular stretching on the pectoral muscle. Therefore, the proposed rehabilitation protocol must be "clipped" and "integrated" according to the specific objectives for each individual patient.
Collapse
Affiliation(s)
- Teresa Paolucci
- Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University of Chieti-Pescara, Pescara, Italy
| | - Andrea Bernetti
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Arianna V Bai
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Serena V Capobianco
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Rome, Italy
| | | | | | | | | | - Valter Santilli
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Rome, Italy -
| | - Marco Paoloni
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Massimiliano Mangone
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Rome, Italy
| |
Collapse
|
17
|
Bertoli J, de Souza Bezerra E, Dias Reis A, Amice da Costa Barros Ê, Gobbo LA, Forte Freitas Júnior I. Long-Term Side Effects of Breast Cancer on Force Production Parameters. J Strength Cond Res 2020; 36:1450-1458. [DOI: 10.1519/jsc.0000000000003631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
18
|
Harrington SE, Hoffman J, Katsavelis D. Measurement of Pectoralis Minor Muscle Length in Women Diagnosed With Breast Cancer: Reliability, Validity, and Clinical Application. Phys Ther 2020; 100:429-437. [PMID: 32043149 DOI: 10.1093/ptj/pzz174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/23/2019] [Indexed: 11/13/2022]
Abstract
BACKGROUND Decreased pectoralis minor muscle length is common after primary breast cancer treatment and can result in an abnormal position of the scapula. This position can contribute to shoulder pain and pathomechanics and can lead to problems such as impingement syndrome, rotator cuff tears, and frozen shoulder. Currently, there are limited reliable methods for measuring pectoralis minor length. OBJECTIVE The objective of this study was to examine the reliability and validity of measuring pectoralis minor length in women diagnosed with breast cancer. DESIGN This was a cross-sectional reliability and validity study. METHODS Bilateral pectoralis minor length (in centimeters) was assessed using a palpation meter in women (N = 29) diagnosed with breast cancer by 2 licensed physical therapists who were masked to the measures. Bilateral pectoralis minor length was also measured using a motion capture system to assess validity. RESULTS Intratester reliability (intraclass correlation coefficient, ICC [3,k] = 0.971; 95% confidence interval [CI] = 0.939-0.986; standard error of measurement [SEM] = 0.16 cm) and intertester reliability (ICC[3,k] = 0.915; 95% CI = 0.81-0.962; SEM = 0.31 cm) were excellent for the palpation meter on the affected side and the unaffected side (intratester reliability: ICC[3,k] = 0.951; 95% CI = 0.897-0.977; SEM = 0.19 cm; intertester reliability: ICC[3,k] = 0.945; 95% CI = 0.877-0.975; SEM = 0.22 cm). Significant correlations were found between the motion capture system and the palpation meter on the affected side (r = 0.87) and the unaffected side (r = 0.81). Bland-Altman plots between the palpation meter and the motion capture system demonstrated that all the measures fell within the limits of agreement. LIMITATIONS This study encountered possible errors with the accuracy of the motion capture system tracking because of the proximity of the markers and inherent volumetric restrictions. CONCLUSIONS The palpation meter is a reliable, valid, easily administered, and cost-effective tool for assessing pectoralis minor length in women with breast cancer.
Collapse
Affiliation(s)
- Shana E Harrington
- Department of Exercise Science, Physical Therapy Program, University of South Carolina, Blatt PE Center, 101G, Columbia, SC 29208 (USA)
| | - Julie Hoffman
- Department of Physical Therapy, Creighton University, Omaha, Nebraska
| | | |
Collapse
|
19
|
Yeo SM, Kang H, An S, Cheong I, Kim Y, Hwang JH. Mechanical Properties of Muscles around the Shoulder in Breast Cancer Patients: Intra-rater and Inter-rater Reliability of the MyotonPRO. PM R 2019; 12:374-381. [PMID: 31359596 DOI: 10.1002/pmrj.12227] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 07/22/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Patients with breast cancer typically experience changes in the properties of muscles around the shoulder. However, there is no appropriate evaluation tool for these changes. OBJECTIVE The primary objective was to investigate the inter-rater and intra-rater reliability of muscle-related parameters measured by the MyotonPRO, a myotonometer device. The secondary objective was to investigate differences in properties of muscle around the shoulder between the mastectomy side and the other side. DESIGN Cross-sectional reliability study. SETTING Outpatient clinic in a tertiary care university-affiliated hospital. PARTICIPANTS Twenty-two patients with breast cancer who underwent mastectomy. METHODS Muscle tone, stiffness, and elasticity of the pectoralis major (PM), sternocleidomastoid (SCM), and upper trapezius (UT) were measured using the MyotonPRO. Rater 1 performed two sets of measurements with a time interval of 30 minutes to determine intra-rater reliability. Rater 2 performed measurements during the interval between the two sets of rater 1. Reliability was assessed using intraclass correlation coefficients (ICCs) and Bland-Altman analysis. A paired t-test was used to compare muscle properties between the affected and unaffected sides. MAIN OUTCOME MEASUREMENTS Frequency (tone, Hz), stiffness (N/m), and decrement (elasticity). RESULTS Intra-rater reliability was excellent (ICC > 0.75, 0.85-0.98) for all parameters of the PM, SCM, and UT in the affected and unaffected upper limbs of patients with breast cancer. Inter-rater reliability was fair to excellent for all parameters except unaffected PM elasticity (ICC = 0.34). There were significant differences in all parameters of the PM between the affected and unaffected sides. There were no significant differences in the parameters of the SCM and UT between the two sides. CONCLUSIONS Our findings indicate that the MyotonPRO device is a feasible tool to quantify PM, UT, and SCM muscle properties (stiffness, tone, and elasticity) in patients with breast cancer. LEVEL OF EVIDENCE III.
Collapse
Affiliation(s)
- Seung Mi Yeo
- Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyojeong Kang
- Department of Physical Therapy, Graduate School of Sahmyook University, Seoul, Republic of Korea
| | - Soyeon An
- Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Inyae Cheong
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of Korea
| | - Yoon Kim
- Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Ji Hye Hwang
- Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| |
Collapse
|
20
|
A Systematic Review of Electronic Health (eHealth) interventions to improve physical activity in patients with breast cancer. Breast Cancer 2019; 27:25-46. [DOI: 10.1007/s12282-019-00982-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 05/27/2019] [Indexed: 11/26/2022]
|
21
|
Three-dimensional scapular kinematics, shoulder outcome measures and quality of life following treatment for breast cancer - A case control study. Musculoskelet Sci Pract 2019; 40:72-79. [PMID: 30711913 DOI: 10.1016/j.msksp.2019.01.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 01/14/2019] [Accepted: 01/23/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND There are no conclusive results concerning changes in scapular kinematics associated with upper limb dysfunctions after breast cancer surgery. OBJECTIVE To compare the three-dimensional (3-D) scapular kinematics during elevation of the arm between women after breast cancer surgery and controls. Shoulder range of motion (ROM), muscle strength, pain intensity, upper limb function, and quality of life were also assessed. METHODS Forty-two women were assigned to two groups (surgery group, n = 21; control group, n = 21). 3-D scapular kinematics was collected during elevation of the arm in the scapular plane. ROM was assessed using a digital inclinometer, muscle strength using a manual dynamometer, pain with the Visual Analogue Scale (VAS), upper limb function with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and quality of life with the 36-item Short-Form Health Survey (SF36). RESULTS The surgery group presented decreased scapular upward rotation at 120° of arm elevation in the scapular plane (p < .05; d = -0.88), decreased shoulder external rotation ROM and strength of shoulder abduction and external rotation when the affected side was compared to the non-affected side and control group. Moreover, the surgery group also reported higher pain, increased upper limb disability and poorer quality of life compared with healthy controls. CONCLUSION Scapular upward rotation seems to be decreased at 120° of arm elevation in women following breast cancer surgery. In addition, shoulder external rotation ROM, abduction strength, external rotation strength, function, and quality of life are also impaired in these women. They also experienced pain during the studied movements.
Collapse
|
22
|
Estimating the Reliability and Validity of the Upper Extremity Functional Index in Women After Breast Cancer Surgery. Clin Breast Cancer 2018; 18:e1261-e1267. [DOI: 10.1016/j.clbc.2018.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 02/13/2018] [Accepted: 02/13/2018] [Indexed: 12/22/2022]
|
23
|
Is kinesiophobia associated with lymphedema, upper extremity function, and psychological morbidity in breast cancer survivors? Turk J Phys Med Rehabil 2018; 65:139-146. [PMID: 31453554 DOI: 10.5606/tftrd.2019.2585] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 07/05/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to the effects of kinesiophobia on lymphedema, upper extremity function, depression/anxiety, and quality of life in breast cancer survivors. Patients and methods Between January 2015 and January 2016, a total of 81 breast cancer survivors (mean age 54.1±10.8 years; range 44 to 70 years) were included. Lymphedema was evaluated based on the circumference measurements. The Tampa Scale for Kinesiophobia (TSK), the Quick Disabilities of Arm, Shoulder, and Hand (Q-DASH) Questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Short Form-36 (SF-36) were applied to all patients. Results We found a significantly higher rate of lymphedema in the patients with kinesiophobia. Kinesiophobic patients had also significantly higher mean scores of TSK, Q-DASH, HADS-A, and HADS-D and lower mean scores of the SF-36 physical scores. Correlation analysis demonstrated that presence of lymphedema, Q-DASH, HADS-A, and HADS-D scores were significantly associated with the TSK scores. Conclusion Kinesiophobia increases the risk for lymphedema, depression/anxiety, and decreased upper extremity functioning in breast cancer survivors. Identifying kinesiophobia in breast cancer survivors, psychosocial providers may help to prevent undesirable effects of kinesiophobia.
Collapse
|
24
|
Brookham RL, Cudlip AC, Dickerson CR. Examining upper limb kinematics and dysfunction of breast cancer survivors in functional dynamic tasks. Clin Biomech (Bristol, Avon) 2018; 55:86-93. [PMID: 29704746 DOI: 10.1016/j.clinbiomech.2018.04.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 04/11/2018] [Accepted: 04/12/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Comorbidities within the breast cancer population can reduce quality of life. Current breast cancer survivor upper limb kinematic strategies unfortunately lack robust connection with performing important activities of daily living. METHODS Accordingly, fifty breast cancer survivors performed 88 dynamic tasks (divided into range of motion-reach, range of motion-rotate, activity of daily living, and work tasks). Humerothoracic and scapulothoracic angles were extracted from motion capture data. Bilateral differences existed for range of motion, and maximal and minimal scapulothoracic and humerothoracic angles. FINDINGS Generally, the affected side used less range of motion across task types. Humerothoracic angles on the affected side experienced 6.7° less range of motion in plane of elevation in range of motion-reach (p < 0.01), 2.3° less elevation angle range of motion in range of motion-rotate (p = 0.01), and 7.1° more internal rotation range of motion in range of motion-rotate (p < 0.01). Scapulothoracic angles on the affected side had 2° more anterior/posterior tilt range of motion in work tasks (p = 0.03), 3.4° less maximal protraction in activity of daily living tasks (p = 0.01), and 3.5° less minimum downward rotation in range of motion-rotate (p < 0.01). INTERPRETATION A reduced range of motion on the affected side suggests the breast cancer population had less varied movement strategies, keeping movements in narrower ranges to avoid disability, pain, or subacromial impingement. This investigation produced an unprecedentedly diverse collection of three-dimensional humerothoracic and scapulothoracic kinematics for a breast cancer population. Documentation of physical capability, dysfunction, and adaptive strategies is a crucial step towards developing targeted strategies for enhancing functional recovery in breast cancer survivors.
Collapse
Affiliation(s)
| | - Alan C Cudlip
- Department of Kinesiology, University of Waterloo, Waterloo, Canada
| | - Clark R Dickerson
- Department of Kinesiology, University of Waterloo, Waterloo, Canada.
| |
Collapse
|
25
|
Ortiz A, Tirado M, Hughes DC, Gonzalez V, Song J, Mama SK, Basen-Engquist K. Relationship between physical activity, disability, and physical fitness profile in sedentary Latina breast cancer survivors. Physiother Theory Pract 2018; 34:783-794. [PMID: 29319387 DOI: 10.1080/09593985.2018.1424978] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To report baseline data from a physical activity (PA) intervention for Latina breast cancer survivors, and assess the relationship between PA, fitness, and disability. METHODS Eighty-nine Latina breast cancer survivors from San Juan, PR and Houston, TX (age: 55.4 ± 9.9 years; BMI: 29.87 ± 5.62 kg/m2; ≥ 3 months post-treatment) participated in this study. At baseline participants completed fitness testing (six-minute walk test [6MWT], 30-second sit-stand; grip strength, lower and upper extremity and low back strength, shoulder range of motion, balance testing), and assessment of physical activity (PA) and disability. PA was assessed using the International Physical Activity Questionnaire (IPAQ). A subsample (n = 27) received an accelerometer to compare objective versus self-reported PA. RESULTS Participants exhibited low PA (M = 76.5 MET·minutes/week; SD = 183.4), poor fitness (6MWT M = 436.4 meters, SD = 99.1; 30s sit-stand, M = 11.6 stands, SD = 3.1), and no detectable disability. In an adjusted model lower extremity fitness was associated with PA, with a one repetition increase in sit-to-stand associated with 49 additional minutes of self-reported PA plus walking per week. The correlation between IPAQ moderate-vigorous PA and accelerometer was 0.38 (p = 0.047). CONCLUSION Latina breast cancer survivors have low physical activity and fitness levels that increase their risk of disability, cardiometabolic comorbidities, and potential cancer recurrence.
Collapse
Affiliation(s)
- Alexis Ortiz
- a School of Physical Therapy, Texas Woman's University - Houston Center - Physical Therapy , Houston TX USA
| | - Maribel Tirado
- b Puerto Rico Comprehensive Cancer Center , San Juan , Puerto Rico , USA
| | - Daniel C Hughes
- c Institute for Health Promotion Research, University of Texas Health Sciences Center , San Antonio , TX USA
| | - Velda Gonzalez
- d University of South Florida, School of Nursing , Tampa , FL USA
| | - JaeJoon Song
- e Department of Biostatistics , MD Anderson Cancer Center , Houston , TX USA
| | - Scherezade K Mama
- f Department of Kinesiology , Pennsylvania State University, University Park , PA , USA
| | - Karen Basen-Engquist
- g Center for Energy Balance in Cancer Prevention and Survivorship , Duncan Family Institute for Cancer Prevention and Risk Assessment, MD Anderson Cancer Center , Houston , TX , USA
| |
Collapse
|
26
|
Harder H, Holroyd P, Burkinshaw L, Watten P, Zammit C, Harris PR, Good A, Jenkins V. A user-centred approach to developing bWell, a mobile app for arm and shoulder exercises after breast cancer treatment. J Cancer Surviv 2017; 11:732-742. [PMID: 28741202 PMCID: PMC5671540 DOI: 10.1007/s11764-017-0630-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 07/10/2017] [Indexed: 12/03/2022]
Abstract
PURPOSE The study aim was to develop a mobile application (app) supported by user preferences to optimise self-management of arm and shoulder exercises for upper-limb dysfunction (ULD) after breast cancer treatment. METHODS Focus groups with breast cancer patients were held to identify user needs and requirements. Behaviour change techniques were explored by researchers and discussed during the focus groups. Concepts for content were identified by thematic analysis. A rapid review was conducted to inform the exercise programme. Preliminary testing was carried out to obtain user feedback from breast cancer patients who used the app for 8 weeks post surgery. RESULTS Breast cancer patients' experiences with ULD and exercise advice and routines varied widely. They identified and prioritised several app features: tailored information, video demonstrations of the exercises, push notifications, and tracking and progress features. An evidence-based programme was developed with a physiotherapist with progressive exercises for passive and active mobilisation, stretching and strengthening. The exercise demonstration videos were filmed with a breast cancer patient. Early user testing demonstrated ease of use, and clear and motivating app content. CONCLUSIONS bWell, a novel app for arm and shoulder exercises, was developed by breast cancer patients, health care professionals and academics. Further research is warranted to confirm its clinical effectiveness. IMPLICATIONS FOR CANCER SURVIVORS Mobile health has great potential to provide patients with information specific to their needs. bWell is a promising way to support breast cancer patients with exercise routines after treatment and may improve future self-management of clinical care.
Collapse
Affiliation(s)
- Helena Harder
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, UK.
| | - Patrick Holroyd
- School of Engineering and Informatics, University of Sussex, Brighton, UK
| | - Lynn Burkinshaw
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Phil Watten
- School of Engineering and Informatics, University of Sussex, Brighton, UK
| | - Charles Zammit
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Peter R Harris
- School of Psychology, University of Sussex, Brighton, UK
| | - Anna Good
- School of Psychology, University of Sussex, Brighton, UK
| | - Val Jenkins
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| |
Collapse
|
27
|
De Groef A, Meeus M, De Vrieze T, Vos L, Van Kampen M, Christiaens MR, Neven P, Geraerts I, Devoogdt N. Pain characteristics as important contributing factors to upper limb dysfunctions in breast cancer survivors at long term. Musculoskelet Sci Pract 2017; 29:52-59. [PMID: 28319882 DOI: 10.1016/j.msksp.2017.03.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 02/10/2017] [Accepted: 03/11/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to explore the treatment, patient, and impairment-related risk factors associated with upper limb dysfunctions in breast cancer survivors. METHODS A cross-sectional study was performed in 274 women treated for breast cancer. The following risk factors were analysed by bivariable and multivariable analysis: 1) treatment-related variables (type of surgery, levels of lymph node dissected, radiotherapy, chemotherapy, hormone therapy and trastuzumab); 2) patient's related variables (age and Body Mass Index); 3) and finally impairment-related variables such as pain (intensity, quality and pressure hypersensitivity, signs of central sensitisation, the degree of pain catastrophizing and vigilance and awareness to pain), active ROM and upper limb strength were investigated. The dependent variable was upper limb function measured with the Disability of Arm, Shoulder and Hand (DASH) questionnaire. Additionally, a stepwise regression was performed. RESULTS An impaired upper limb function was noted in 170 (62%) of patients. Mean time after surgery was 1.5 (1.6) years. From multivariable analysis, it appears that in particular certain pain characteristics such as pain intensity, pain quality, signs of central sensitisation and pain catastrophizing are contributing to upper limb dysfunctions after breast cancer treatment at long term. Additionally, higher age, shoulder ROM and handgrip strength are possible contributing factors. The stepwise regression analysis revealed that central sensitisation mechanisms alone can explain about 40% of the variance in upper limb function. CONCLUSIONS At long term, especially pain and central sensitisation mechanisms contribute to upper limb function in breast cancer survivors.
Collapse
Affiliation(s)
- An De Groef
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium.
| | - Mira Meeus
- Univeristy of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Antwerp, Belgium
| | - Tessa De Vrieze
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium
| | - Lore Vos
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium
| | - Marijke Van Kampen
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium
| | - Marie-Rose Christiaens
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium; KU Leuven - University of Leuven, Oncology Department, Department of Surgical Oncology, Belgium
| | - Patrick Neven
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium; Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | - Inge Geraerts
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium
| | - Nele Devoogdt
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium
| |
Collapse
|
28
|
Lee SY, Sim MK, Do J, Jeong SY, Jeon JY. Pilot study of effective methods for measuring and stretching for pectoral muscle tightness in breast cancer patients. J Phys Ther Sci 2016; 28:3030-3035. [PMID: 27942114 PMCID: PMC5140794 DOI: 10.1589/jpts.28.3030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 07/19/2016] [Indexed: 12/01/2022] Open
Abstract
[Purpose] To evaluate differences in pectoral muscle tightness according to arm abduction
angle and to determine the best arm abduction angle for stretching of pectoral muscle
tightness in breast cancer patients. [Subjects and Methods] Horizontal abduction
differences of shoulders were measured bilaterally by arm abduction to 45°, 90°, and 135°
to determine the best arm abduction angle for measuring pectoral muscle tightness.
Thirty-two patients were divided into three pectoral muscle stretching groups (A: 45°, B:
90°, and C: 135°). We measured the shoulder range of motion, scores of the Disabilities of
the Arm, Shoulder, and Hand, European Organization for Research and Treatment of Cancer
Quality of Life Questionnaire and the Breast Module, and pain levels (using a visual
analog scale) before and after therapy. [Results] The differences in degree of horizontal
abduction between shoulders were significantly larger for arm abduction to 90° and 135°
than that to 45°. Groups B and C showed greater improvements in horizontal abduction
limitations than group A. [Conclusion] Horizontal abduction differences between shoulders
are prominent when arms are abducted to 90° and 135°. The appropriate arm abduction angle
for measuring horizontal abduction and effective stretching of pectoral muscle tightness
may be >90°.
Collapse
Affiliation(s)
- So Young Lee
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Republic of Korea; Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Republic of Korea
| | - Mi Kyung Sim
- Ilsan Median Rehabilitation Hospital, Republic of Korea; Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Republic of Korea
| | - Junghwa Do
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea
| | - Soon Young Jeong
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea
| | - Jae Yong Jeon
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea
| |
Collapse
|
29
|
Foley MP, Hasson SM. Effects of a Community-Based Multimodal Exercise Program on Health-Related Physical Fitness and Physical Function in Breast Cancer Survivors: A Pilot Study. Integr Cancer Ther 2016; 15:446-454. [PMID: 27151593 PMCID: PMC5739165 DOI: 10.1177/1534735416639716] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/09/2016] [Accepted: 02/26/2016] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Breast cancer and oncological treatment can result in significant acute and late localized and systemic negative effects on health-related physical fitness and physical function. The aim of this single-arm study was to examine the effects of a 12-week community-based multimodal exercise program on health-related physical fitness and physical function in breast cancer survivors. METHODS A total of 52 female breast cancer survivors (mean age = 59.7 ± 10.4 years) completed supervised exercise training consisting of (1) aerobic conditioning, (2) resistance training, and (3) balance and flexibility training, for 30 minutes each, totaling 90 minutes twice weekly for 12 weeks. Pretreatment and posttreatment outcome measures-mobility: (1) Timed Up and Go (TUG) and (2) 6-minute walk test (6MWT); muscular strength: (3) leg press strength and (4) chest press strength; upper-extremity flexibility: (5) back scratch test; and balance: (6) functional reach (FR) and (7) single-leg stance time-were assessed and compared. RESULTS Postintervention assessment measures given as percentage improvement and effect size (ES) for mobility, TUG (18%, 0.59), and 6MWT (14%, 0.74) were significantly (P < .001) improved. Outcome measures of muscular strength, leg press strength (32%, 0.58) and chest press strength (40%, 0.61), both significantly (P < .001) improved. Postintervention assessment measure of upper-extremity flexibility (42%, 0.41) showed significant (P < .001) improvements. Outcome measures for balance, FR (18%, 0.75) and single leg stance time (24%, 0.30), showed significant (P < .001) improvements. CONCLUSIONS Outcome measures showed moderate to large ES improvements after participants completed the 12-week multimodal exercise program for breast cancer survivors.
Collapse
|
30
|
De Groef A, Van Kampen M, Tieto E, Schönweger P, Christiaens MR, Neven P, Geraerts I, Gebruers N, Devoogdt N. Arm lymphoedema and upper limb impairments in sentinel node-negative breast cancer patients: A one year follow-up study. Breast 2016; 29:102-8. [PMID: 27479040 DOI: 10.1016/j.breast.2016.07.021] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/24/2016] [Accepted: 07/18/2016] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this study is (1) to investigate the prevalence rate of arm lymphedema, pain, impaired shoulder range of motion, strength and shoulder function one year after a sentinel lymph node biopsy (SLNB) for breast cancer and (2) to determine predictive factors for these complications. METHODS A longitudinal study was performed. One hundred patients with a sentinel-lymph node negative breast cancer were included. All patients were measured before surgery and one year after. Arm lymphedema was measured with the perimeter, pain with the Visual Analogue Scale, shoulder range of motion with an inclinometer, strength with a handheld dynamometer and shoulder function with the Disability of Arm, Shoulder and Hand questionnaire. Patient-, breast cancer- and treatment-related variables were recorded. RESULTS One year after surgery 8% of sentinel node-negative breast cancer patients had developed arm lymphedema. Fifty percent of patients had pain, 30% had an impaired shoulder range of motion, 8% had a decreased handgrip strength and 49% had an impaired shoulder function. Pain, shoulder range of motion, strength and shoulder dysfunctions changed significantly over one year (p < 0.001). Higher Body Mass Index is a predictive variable for shoulder dysfunctions one year post-SLNB. CONCLUSIONS Prevalence rate of lymphedema and other upper limb impairments may not be underestimated after SLNB. Pain, shoulder range of motion, handgrip strength and shoulder function change significantly up to one year compared to preoperative values in sentinel node-negative breast cancer patients.
Collapse
Affiliation(s)
- An De Groef
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium.
| | - Marijke Van Kampen
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium
| | - Elena Tieto
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium
| | - Petra Schönweger
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium
| | - Marie-Rose Christiaens
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium; KU Leuven - University of Leuven, Oncology Department, Department of Surgical Oncology, Belgium
| | - Patrick Neven
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium; Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | - Inge Geraerts
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium
| | - Nick Gebruers
- Univeristy of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Antwerp, Belgium
| | - Nele Devoogdt
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences and University Hospitals Leuven, Department of Physical Medicine and Rehabilitation, Belgium
| |
Collapse
|
31
|
Rufa'i AA, Muda WAMW, Yen SH, Abd Shatar AK, Murali BVK, Tan SW. Design of a randomised intervention study: the effect of dumbbell exercise therapy on physical activity and quality of life among breast cancer survivors in Malaysia. BMJ Glob Health 2016; 1:e000015. [PMID: 28588911 PMCID: PMC5321396 DOI: 10.1136/bmjgh-2015-000015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 06/24/2016] [Accepted: 07/01/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Participation in physical activity has a positive impact on the overall health and quality of life, whereas physical inactivity is associated with a poor prognosis among breast cancer survivors. Despite the health-enhancing benefits of physical activity, the majority of Malaysian breast cancer survivors are not physically active. This paper presents the design of a randomised study to evaluate the feasibility and effect of exercise therapy intervention using light resistance dumbbell exercise to promote active lifestyle and improve the quality of life of breast cancer survivors in Malaysia. METHODS/DESIGN This is an intervention study of a 12-week exercise therapy that will explore and compare the effects of light resistance and aerobic exercise on physical activity level and quality of life components in 102 female breast cancer survivors. Major eligibility criteria include histologically confirmed diagnosis of breast cancer stages I-III, 3-12 months post-diagnosis, and absence of any disorder contraindicating exercise. Participants will be stratified based on menopausal status (pre-menopause vs post-menopause) and then assigned randomly to one of three groups. Participants in group A will participate in a three-times weekly supervised resistance exercise using light resistance dumbbells; participants in group B will participate in a three-times weekly supervised aerobic exercise; while participants in group C (control group) will be given aerobic exercise after completion of the intervention. The primary end points include physical activity level and quality of life components. The secondary end points are body mass index, body composition, total caloric intake, and waist-to-hip ratio. DISCUSSION Although there have been many studies of resistance exercise in breast cancer survivors, this is the first study using this specific mode of resistance. Findings will contribute data on the feasibility and effects of light resistance dumbbell exercises, and provide knowledge on the physical activity intervention programme that will maximally promote better overall health and well-being of survivors.
Collapse
Affiliation(s)
- Adamu Ahmad Rufa'i
- School of Health Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
- Department of Physiotherapy, College of Medical Sciences, University of Maiduguri, Borno, Nigeria
| | | | - Siew Hwa Yen
- School of Distance Education, Universiti Sains Malaysia, Pinang, Malaysia
| | - Aishah Knight Abd Shatar
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
| | | | - Shu Wen Tan
- School of Health Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| |
Collapse
|
32
|
Breast Cancer Rehabilitation. TOPICS IN GERIATRIC REHABILITATION 2015. [DOI: 10.1097/tgr.0000000000000082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
33
|
O'Toole JA, Ferguson CM, Swaroop MN, Horick N, Skolny MN, Brunelle CL, Miller CL, Jammallo LS, Specht MC, Taghian AG. The impact of breast cancer-related lymphedema on the ability to perform upper extremity activities of daily living. Breast Cancer Res Treat 2015; 150:381-8. [PMID: 25749734 DOI: 10.1007/s10549-015-3325-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 02/24/2015] [Indexed: 01/15/2023]
Abstract
We sought to assess the association of breast cancer-related lymphedema (BCRL) with the ability to perform upper extremity activities of daily living (ADL) in our patient population. 324 breast cancer patients who had received treatment for unilateral breast cancer at our institution between 2005 and 2014 were prospectively screened for lymphedema. Bilateral arm measurements were performed pre-operatively and during post-operative follow-up using a Perometer. Patients completed an extensive quality of life (QOL) questionnaire at the time of each study assessment. Lymphedema was defined as a relative volume change (RVC) of ≥10% from the patient's pre-operative baseline measurement. Linear regression models were used to evaluate the relationship between post-operative arm function score (as a continuous variable) and RVC, demographic, clinical, and QOL factors. By multivariate analysis, greater fear of lymphedema (p < 0.0001), more pain (p < 0.0001), body mass index >25 (p = 0.0015), mastectomy (p = 0.0001), and having an axillary node dissection (p = 0.0045) were all associated with lower functional scores. Higher emotional well-being score (p < 0.0001) and adjuvant chemotherapy (p = 0.0005) were associated with higher post-operative functional score. Neither low-level volume changes (5-10 % RVC) nor BCRL (RVC ≥10 %) were associated with ability to perform upper extremity ADL as measured by self-report (p = 0.99, p = 0.79). This prospective study demonstrates that low-level changes in arm volume (RVC 5-10 %) as well as clinically significant BCRL (RVC ≥10 %) did not impact the self-reported ability to use the affected extremity for ADL. These findings may help to inform clinicians and patients on the importance of prospective screening for lymphedema and QOL which enables early detection and intervention.
Collapse
Affiliation(s)
- Jean A O'Toole
- Department of Physical & Occupational Therapy, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Cantarero-Villanueva I, Galiano-Castillo N, Fernández-Lao C, Diaz-Rodríguez L, Fernández-Pérez AM, Sánchez MJ, Arroyo-Morales M. The influence of body mass index on survival in breast cancer patients. Clin Breast Cancer 2014; 15:e117-23. [PMID: 25499695 DOI: 10.1016/j.clbc.2014.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 11/12/2014] [Indexed: 11/28/2022]
Abstract
INTRODUCTION More than half of breast cancer survivors (BCSs) are obese at diagnosis and experience approximately 50% to 96% of weight gain during treatment that could physically affect their survival. The aim of the study was to evaluate the influence of body mass index (BMI) on physical, anthropometric, and physiological parameters in BCSs. PATIENTS AND METHODS A cross-sectional study was conducted with 147 BCSs. Health-related fitness, anthropometric measures, cardiovascular state, and cancer-related fatigue (CRF) were assessed for our analysis and 3 groups were formed. RESULTS Tests of force handgrip (affected side: F = 3.44; P < .05; nonaffected side: F = 3.067; P < .05), functional capacity (F = 3.239; P = .043), and endurance of trunk flexors (×2 = 8.264; P = .016) were significantly lower in obese BCSs compared with the normal-weight group, whereas systolic (F = 5.839; P = .004) and diastolic blood pressure (F = 8.794; P < .001), waist circumference (F = 85.81; P < .001), and arm circumference at 10 cm (affected side: F = 23.530; P < .001; nonaffected side: F = 17.095; P < .001) and 5 cm (affected side: F = 21.751; P < .001; nonaffected side: F = 22.490; P < .001) were significantly greater in BCSs with higher BMI compared with other groups. No significant differences were observed between groups regarding lower limb endurance, resting heart rate or CRF. CONCLUSION This study demonstrated the influence of obesity on health-related fitness, anthropometric measures, and cardiovascular state.
Collapse
Affiliation(s)
| | - Noelia Galiano-Castillo
- Department of Physiotherapy, Faculty of Health Sciencies, University of Granada, Granada, Spain
| | - Carolina Fernández-Lao
- Department of Physiotherapy, Faculty of Health Sciencies, University of Granada, Granada, Spain
| | - Lourdes Diaz-Rodríguez
- Department of Physiotherapy, Faculty of Health Sciencies, University of Granada, Granada, Spain
| | | | - María J Sánchez
- Department of Physiotherapy, Faculty of Health Sciencies, University of Granada, Granada, Spain
| | - Manuel Arroyo-Morales
- Department of Physiotherapy, Faculty of Health Sciencies, University of Granada, Granada, Spain
| |
Collapse
|
35
|
Cheema BS, Kilbreath SL, Fahey PP, Delaney GP, Atlantis E. Safety and efficacy of progressive resistance training in breast cancer: a systematic review and meta-analysis. Breast Cancer Res Treat 2014; 148:249-68. [DOI: 10.1007/s10549-014-3162-9] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 10/01/2014] [Indexed: 01/24/2023]
|
36
|
Dieli-Conwright CM, Mortimer JE, Schroeder ET, Courneya K, Demark-Wahnefried W, Buchanan TA, Tripathy D, Bernstein L. Randomized controlled trial to evaluate the effects of combined progressive exercise on metabolic syndrome in breast cancer survivors: rationale, design, and methods. BMC Cancer 2014; 14:238. [PMID: 24708832 PMCID: PMC3985576 DOI: 10.1186/1471-2407-14-238] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 03/21/2014] [Indexed: 12/18/2022] Open
Abstract
Background Metabolic syndrome (MetS) is increasingly present in breast cancer survivors, possibly worsened by cancer-related treatments, such as chemotherapy. MetS greatly increases risk of cardiovascular disease and diabetes, co-morbidities that could impair the survivorship experience, and possibly lead to cancer recurrence. Exercise has been shown to positively influence quality of life (QOL), physical function, muscular strength and endurance, reduce fatigue, and improve emotional well-being; however, the impact on MetS components (visceral adiposity, hyperglycemia, low serum high-density lipoprotein cholesterol, hypertriglyceridemia, and hypertension) remains largely unknown. In this trial, we aim to assess the effects of combined (aerobic and resistance) exercise on components of MetS, as well as on physical fitness and QOL, in breast cancer survivors soon after completing cancer-related treatments. Methods/Design This study is a prospective randomized controlled trial (RCT) investigating the effects of a 16-week supervised progressive aerobic and resistance exercise training intervention on MetS in 100 breast cancer survivors. Main inclusion criteria are histologically-confirmed breast cancer stage I-III, completion of chemotherapy and/or radiation within 6 months prior to initiation of the study, sedentary, and free from musculoskeletal disorders. The primary endpoint is MetS; secondary endpoints include: muscle strength, shoulder function, cardiorespiratory fitness, body composition, bone mineral density, and QOL. Participants randomized to the Exercise group participate in 3 supervised weekly exercise sessions for 16 weeks. Participants randomized to the Control group are offered the same intervention after the 16-week period of observation. Discussion This is the one of few RCTs examining the effects of exercise on MetS in breast cancer survivors. Results will contribute a better understanding of metabolic disease-related effects of resistance and aerobic exercise training and inform intervention programs that will optimally improve physiological and psychosocial health during cancer survivorship, and that are ultimately aimed at improving prognosis. Trial registration NCT01140282; Registration: June 10, 2010
Collapse
Affiliation(s)
- Christina M Dieli-Conwright
- Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 E, Alcazar St, CHP 155, 90089 Los Angeles, CA, USA.
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Sudarshan M, Petrucci A, Dumitra S, Duplisea J, Wexler S, Meterissian S. Yoga therapy for breast cancer patients: a prospective cohort study. Complement Ther Clin Pract 2013; 19:227-9. [PMID: 24199978 DOI: 10.1016/j.ctcp.2013.06.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 05/27/2013] [Accepted: 06/06/2013] [Indexed: 01/12/2023]
Abstract
We sought to study the impact of yoga therapy on anxiety, depression and physical health in breast cancer patients. Stage I-III post-operative breast cancer patients were recruited with twelve 1-h weekly yoga sessions completed with an experienced yoga instructor. Before and after each module completion, assessments were obtained with the Hospital Anxiety and Depression scale (HADS), the Dallas pain scale and shoulder flexibility measurements. Fourteen patients completed the entire yoga session with 42.8% having a total mastectomy and 15.4% having breast reconstruction. Both right and left shoulder abduction flexibility significantly improved (p = 0.004; p = 0.015 respectively) as well as left shoulder flexion (p = 0.046). An improvement trend in scores for the HADS and Dallas questionnaires pre- and post-intervention was found, although it was not statistically significant. Our data indicates an improvement in physical function in addition to a consistent amelioration in anxiety, depression and pain symptoms after a yoga intervention.
Collapse
Affiliation(s)
- Monisha Sudarshan
- Division of General Surgery and the Cedars Breast Clinic, The McGill University Health Center, 687 Pine Avenue West, Montreal, Quebec H3A 1A1, Canada
| | | | | | | | | | | |
Collapse
|