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Journal of Cancer Survivorship
Erschienen in: Journal of Cancer Survivorship 2/2011

01.06.2011

Comparison of shoulder flexibility, strength, and function between breast cancer survivors and healthy participants

verfasst von: Shana Harrington, Darin Padua, Claudio Battaglini, Lori A. Michener, Carol Giuliani, Joseph Myers, Diane Groff

Erschienen in: Journal of Cancer Survivorship | Ausgabe 2/2011

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Abstract

Introduction

Deficits after breast cancer treatment have been examined by comparing the surgically affected upper extremity to the unaffected extremity. It is not possible to know precisely if anti-cancer treatment such as radiation and chemotherapy had any effect on the unaffected arm. The purpose of this study was to compare ROM, strength, and shoulder function between breast cancer survivors and healthy, matched controls.

Methods

Shoulder pain and function was assessed using the Disabilities of the Arm Shoulder Hand (DASH) and the Pennsylvania Shoulder Score (PSS). Active and passive range of motion (ROM) for shoulder flexion, extension, external rotation (ER) at 0° and 90° of abduction, internal rotation (IR) at 90° of abduction were measured on the affected side using a digital inclinometer. Strength was measured using a hand held dynamometer for scapular abduction and upward rotation, scapular depression and adduction, flexion, internal rotation, ER, scaption, and horizontal adduction.

Results

Significant differences were found between the two groups for the DASH (p < 0.001) and PSS (p < 0.001), active flexion (p < 0.001), 90° ER (p = 0.020), extension (p = 0.004) and passive flexion (p < 0.001) and 90° ER (p = 0.012). All 7 of the shoulder girdle strength measures were significantly different between groups for abduction and upward rotation (p = 0.006), depression and adduction (p = 0.001), flexion (p < 0.001), ER (p = 0.004), IR (p = 0.001), scaption (p < 0.001), and adduction (p < 0.001).

Discussion/Conclusions

These results provide preliminary evidence to suggest clinicians focus on these particular ROM, strength, and shoulder function measures when treating a breast cancer survivors.

Implications for Cancer Survivors

Shoulder ROM, strength, and function are important to assess in BCS.
Literatur
1.
2.
Gordon LG et al. The impact of rehabilitation support services on health-related quality of life for women with breast cancer. Breast Cancer Res Treat. 2005;93(3):217–26.PubMedCrossRef
3.
Battaglini C et al. The effects of an individualized exercise intervention on body composition in breast cancer patients undergoing treatment. São Paulo Med J. 2007;125(1):22–8.PubMed
4.
Yang EJ et al. Longitudinal change of treatment-related upper limb dysfunction and its impact on late dysfunction in breast cancer survivors: a prospective cohort study. J Surg Oncol. 2010;101(1):84–91.PubMedCrossRef
5.
Box RC et al. Shoulder movement after breast cancer surgery: results of a randomised controlled study of postoperative physiotherapy. Breast Cancer Res Treat. 2002;75(1):35–50.PubMedCrossRef
6.
Cho OH, Yoo YS, Kim NC. Efficacy of comprehensive group rehabilitation for women with early breast cancer in South Korea. Nurs Health Sci. 2006;8(3):140–6.PubMedCrossRef
7.
Cinar N et al. The effectiveness of early rehabilitation in patients with modified radical mastectomy. Cancer Nurs. 2008;31(2):160–5.PubMedCrossRef
8.
Crosbie J et al. Scapulohumeral rhythm and associated spinal motion. Clin Biomech (Bristol). 2008;23(2):184–92.CrossRef
9.
10.
Hayes S, Battistutta D, Newman B. Objective and subjective upper body function six months following diagnosis of breast cancer. Breast Cancer Res Treat. 2005;94(1):1–10.PubMedCrossRef
11.
Hwang JH et al. Effects of supervised exercise therapy in patients receiving radiotherapy for breast cancer. Yonsei Med J. 2008;49(3):443–50.PubMedCrossRef
12.
Isaksson G, Feuk B. Morbidity from axillary treatment in breast cancer–a follow-up study in a district hospital. Acta Oncol. 2000;39(3):335–6.PubMedCrossRef
13.
Kaya T et al. Disability and health-related quality of life after breast cancer surgery: relation to impairments. S Med J. 2010;103(1):37–41.CrossRef
14.
Kuehn T et al. Long-term morbidity following axillary dissection in breast cancer patients–clinical assessment, significance for life quality and the impact of demographic, oncologic and therapeutic factors. Breast Cancer Res Treat. 2000;64(3):275–86.PubMedCrossRef
15.
Nikkanen TA, Vanharanta H, Helenius-Reunanen H. Swelling of the upper extremity, function and muscle strength of shoulder joint following mastectomy combined with radiotherapy. Ann Clin Res. 1978;10(5):273–9.PubMed
16.
Ryttov N et al. Influence of adjuvant irradiation on the development of late arm lymphedema and impaired shoulder mobility after mastectomy for carcinoma of the breast. Acta Oncol. 1988;27(6A):667–70.PubMedCrossRef
17.
Springer BA et al. Pre-operative assessment enables early diagnosis and recovery of shoulder function in patients with breast cancer. Breast Cancer Res Treat. 2010;120(1):135–47.PubMedCrossRef
18.
Thomas-Maclean RL et al. Arm morbidity and disability after breast cancer: new directions for care. Oncol Nurs Forum. 2008;35(1):65–71.PubMedCrossRef
19.
Johansen J et al. Treatment of morbidity associated with the management of the axilla in breast-conserving therapy. Acta Oncol. 2000;39(3):349–54.PubMedCrossRef
20.
Kakuda JT et al. Objective assessment of axillary morbidity in breast cancer treatment. Am Surg. 1999;65(10):995–8.PubMed
21.
Lee TS et al. Pectoral stretching program for women undergoing radiotherapy for breast cancer. Breast Cancer Res Treat. 2007;102(3):313–21.PubMedCrossRef
22.
Merchant CR, Chapman T, Kilbreath SL, Refshaunge KM, Krupa, K. Decreased muscle strength following management of breast cancer. Disability Rehabiliation. 2008;30(15):1098–105.
23.
Shamley DR, Srinanaganathan R, Weatherall R, Oskrochi R, Watson M, Ostlere S, et al. Changes in shoulder muscle size and activity after treatment for breast cancer: a study using EMG and MRI scans. Breast Cancer Res Treat. 2007;106(1):19–27.
24.
Institute for Work & Health and the American Academy of Orthopaedic Surgery. The DASH outcome measure. 2006.
25.
Dowrick AS, Gabbe BJ, et al. Outcome Instruments For The Assessment Of The Upper Extremity Following Trauma: A Review. Int J Care Injured. 2004;36:468–76.
26.
Beaton DE et al. Measuring the whole or the parts? Validity, reliability, and responsiveness of the disabilities of the arm, shoulder and hand outcome measure in different regions of the upper extremity. J Hand Ther. 2001;14(2):128–46.PubMed
27.
Leggin BG et al. The Penn shoulder score: reliability and validity. J Orthop Sports Phys Ther. 2006;36(3):138–51.PubMed
28.
Norkin CC, White DJ. Measurement of joint motion: a guide to goniometry. 2nd ed. Philadelphia: F.A. Davis Company; 1985.
29.
Kendall FP, McCreary EK, Provance PG. In: Bultler JP, editor. Muscles testing and function. 4th ed. Baltimore: Williams & Wilkins; 1993.
30.
Hislop HJ, Montgomery J. Muscle testing: techniques of manual examination. 7th ed. Philadelphia: Saunders; 2002.
31.
Beaulac SM et al. Lymphedema and quality of life in survivors of early-stage breast cancer. Arch Surg. 2002;137(11):1253–7.PubMedCrossRef
32.
Rietman JS et al. Impairments, disabilities and health related quality of life after treatment for breast cancer: a follow-up study 2.7 years after surgery. Disabil Rehabil. 2004;26(2):78–84.PubMedCrossRef
33.
Michener LA, Leggin BG. A review of self-report scales for the assessment of functional limitation and disability of the shoulder. J Hand Ther. 2001;14(2):68–76.PubMed
34.
Schmitt JS, Di Fabio RP. Reliable change and minimum important difference (MID) proportions facilitated group responsiveness comparisons using individual threshold criteria. J Clin Epidemiol. 2004;57(10):1008–18.PubMedCrossRef
35.
Crosbie J et al. Effects of mastectomy on shoulder and spinal kinematics during bilateral upper-limb movement. Phys Ther. 2010;90(5):679–92.PubMedCrossRef
36.
Clarke M et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;366(9503):2087–106.PubMed
37.
Nesvold IL et al. Arm and shoulder morbidity in breast cancer patients after breast-conserving therapy versus mastectomy. Acta Oncol. 2008;47(5):835–42.PubMedCrossRef
38.
Sugden EM et al. Shoulder movement after the treatment of early stage breast cancer. Clin Oncol (R Coll Radiol). 1998;10(3):173–81.
39.
Wylie JD, Bershadsky B, Iannotti JP. The effect of medical comorbidity on self-reported shoulder-specific health related quality of life in patients with shoulder disease. J Shoulder Elbow Surg. 2010;19(6):823–8.PubMedCrossRef
40.
Barnes CJ, Van Steyn SJ, Fischer RA. The effects of age, sex, and shoulder dominance on range of motion of the shoulder. J Shoulder Elbow Surg. 2001;10(3):242–6.PubMedCrossRef
Metadaten
Titel
Comparison of shoulder flexibility, strength, and function between breast cancer survivors and healthy participants
verfasst von
Shana Harrington
Darin Padua
Claudio Battaglini
Lori A. Michener
Carol Giuliani
Joseph Myers
Diane Groff
Publikationsdatum
01.06.2011
Verlag
Springer US
Erschienen in
Journal of Cancer Survivorship / Ausgabe 2/2011
Print ISSN: 1932-2259
Elektronische ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-010-0168-0

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