scholarly journals Quality of Life and Recovery of Arm Function Applying Physiotherapy After Breast Cancer Surgery

Author(s):  
Jūratė Nagytė ◽  
Vilma Dudonienė

Research background. Breast cancer is the most common female malignancy. Different types of surgery are performed after assessing stage of the disease, tumour morphology, and other dimensions. Dysfunction of hand after surgery may affect physical, emotional and sexual function and quality of life more than body shape changes (Guan et al., 2012). The aim of this study was to evaluate the quality of life, shoulder range of motion, arm pain, circumference of arm, and hand muscle strength after breastconserving surgery after mastectomy. Methods. The study included 30 women, 15 of them were after breast conserving surgery, and 15 – after mastectomy. All subjects participated in the same physiotherapy program ‒ stretching and muscle strengthening exercises, shoulder girdle, neck and hand massage, lymph drainage massage (sleeve), transcutaneous electrical nerve stimulation (TENS). Duration of rehabilitation was two weeks. Quality of life, shoulder range of motion, arm pain and circumference, hand muscle strength of the affected side were measured before and after rehabilitation. Results. Regardless of the type of surgical intervention, the range of motion of shoulder flexion, extension and abduction in both groups after physiotherapy increased signifcantly, but for the patients who had undergone breast conserving surgery the ranges of motion were signifcantly higher (flexion – 163.20 ± 11,7°; extension – 48.53 ± 5.5°; abduction – 145.27 ± 13.6°) than for those who undergone mastectomy (flexion – 141.20 ± 13.2°; extension – 33.13 ± 4.9°; abduction – 130.33 ± 14.9°). It was found that circumference of the arm reduced significantly  in both groups, but comparing one group to another no signifcant differences were found. Pain intensity after physiotherapy in patients with mastectomy and patients who had undergone breast conserving surgery signifcantly decreased, but pain reduction was signifcantly higher in patients after breast conserving surgery (6.00 ± 1.1 points) compared to mastectomy group (3.67 ± 1.5 points). Muscle strength of hand of the affected side after physiotherapy increased signifcantly in both groups, but signifcantly more (up to 15.03 ± 2.1 kg) in patients after the breast conserving surgery compared to patients who had undergone mastectomy (up to 12.77 ± 2.0 kg). In addition, most of the functions of quality of life in patients who had undergone breast conserving surgery were signifcantly better than those in patients who had undergone mastectomy. Conclusions: 1. Regardless of the surgery type, shoulder range of motion and hand muscle strength increased signifcantly, and arm circumference and the pain reduced signifcantly after physiotherapy. 2. Shoulder range of motion and hand strength of the affected side were signifcantly higher while pain was signifcantly lower in patients who had undergone breast-conserving surgery compared to patients who had undergone mastectomy. 3. three components of the quality of life ‒ role, emotional and social functions – were signifcantly higher, but symptom scale scores were better in patients who had undergone breast-conserving surgery compared to those who had undergone mastectomy.Keywords: physiotherapy, breast cancer, mastectomy, breast-conserving surgery

Author(s):  
Aušra Tvarijonavičienė

Breast cancer is the most common oncological disease among women. After breast cancer surgery women face various physical and psychosocial problems. They often suffer from arm lymphedema, poor posture, and pain. Side effects of breast cancer surgery can greatly affect general physical health and quality of life. To manage the problems it is necessary to apply rehabilitation. The most important part of rehabilitation is physiotherapy with the main aim of helping patients to recover and to achieve their maximum functional level (Hsieh et al., 2008). The aim of this study was to determine the impact of physiotherapy on differently aged women’s arm function after breast cancer surgery. The sample size of the survey was 40 women who were referred for post operative outpatient rehabilitation. The participants were divided into two age groups: I group – women aged 35–49 years (n = 20, average age 42 ± 4.30 yrs.); II group – women aged 50–64 years (n = 20, average age 56 ± 5.39 yrs.). Shoulder range of motion, arm circumference and pain were measured before and after 14 physiotherapy procedures, their general health state and quality of life were assessed as well. Shoulder range of motion increased, arm swelling and pain on the operated side decreased significantly in women of different age. General health status and quality of life after physiotherapy improved significantly both in younger and older women, but there were no significant differences between groups. After breast cancer surgery more than half of the women had psychological problems and were worried about their health in future, and less than half experienced body image problems and faced various social problems. Physical therapy was equally effective for both younger and older women.Keywords: physiotherapy, breast cancer, lymphedema, quality of life.


PM&R ◽  
2014 ◽  
Vol 6 (12) ◽  
pp. 1073-1080 ◽  
Author(s):  
Sarah M. Eickmeyer ◽  
Christine K. Walczak ◽  
Katherine B. Myers ◽  
D. Richard Lindstrom ◽  
Peter Layde ◽  
...  

2020 ◽  
Vol 19 ◽  
pp. 153473541989376 ◽  
Author(s):  
Kamila Osypiuk ◽  
Jennifer Ligibel ◽  
Anita Giobbie-Hurder ◽  
Gloria Vergara-Diaz ◽  
Paolo Bonato ◽  
...  

Purpose: To assess the feasibility, safety, and preliminary effectiveness of a 12-week multimodal Qigong Mind-Body Exercise (QMBE) program for breast cancer survivors with persistent post-surgical pain (PPSP). Methods: This was a single-arm mixed-methods pilot study. Primary outcome measures were feasibility (recruitment, adherence) and safety. Validated self-report questionnaires were used to evaluate a constellation of interdependent symptoms, including pain, fatigue, mood, exercise, interoceptive awareness, and health-related quality of life at baseline and 12 weeks. A subset of the instruments was administered 6 months postintervention. Shoulder range of motion and grip strength were objectively assessed at baseline and 12 weeks. Qualitative interviews were conducted at baseline and 12 weeks. Results: Twenty-one participants were enrolled; 18 and 17 participants, respectively, completed the 12-week and 6-month outcome assessment. No serious adverse events were reported. Statistically significant improvements were observed at 12 weeks in pain severity and interference, fatigue, anxiety, depression, perceived stress, self-esteem, pain catastrophizing, and several subdomains of quality of life, interoceptive awareness, and shoulder range of motion. Changes in pain, fatigue, pain catastrophizing, anxiety, depression, and quality of life were clinically meaningful. Postintervention effects were sustained at 6 months. Conclusions: QMBE is a safe and gentle multimodal intervention that shows promise in conferring a broad range of psychosocial and physical benefits for breast cancer survivors with PPSP. Results support the value of future studies evaluating the impact of QMBE on multiple outcomes relevant to breast cancer survivors with PPSP.


2020 ◽  
Vol 19 ◽  
pp. 153473542096285
Author(s):  
Kyungsun Han ◽  
Ojin Kwon ◽  
Hyo-Ju Park ◽  
Ae-Ran Kim ◽  
Boram Lee ◽  
...  

This is a preliminary study to investigate the feasibility of electronic moxibustion in breast cancer patients with upper limb lymphedema. As current treatment options for lymphedema are unsatisfactory and time consuming, there have been attempts to manage symptoms using integrative treatments. Electronic moxibustion was developed to compensate for the shortcomings of conventional moxibustion and is widely used in clinical practice. However, there have been no studies on using electronic moxibustion in breast cancer-related lymphedema. To investigate the feasibility of electronic moxibustion in treating breast cancer-related lymphedema, this study included subjects who completed primary cancer treatment at least 6 months ago and had more than 10 mm difference in arm circumference of upper limbs. All subjects were assigned to the treatment group. Subjects were treated with 16 sessions (30 minutes/session) of electronic moxibustion for 8 weeks followed by 4 weeks of follow-up. For outcome measures, upper limb circumferences, shoulder range of motion, bioimpedance analysis, and quality of life questionnaire were assessed. All 10 subjects completed the study. The effective index showed 38.21% reduction after treatment ( P = .0098) and 29.35% ( P = .0039) after 4 weeks of follow-up compared to the baseline. The reduction of lymphedema was most prominent at 10 cm above the elbow crease, where the mean reduction of circumference difference was 7.5 mm ( P = .0430) and continued to improve after treatment (mean reduction of 8.3 mm, P = .0156). There was significant improvement in shoulder range of motion only in flexion and internal rotation at week 9. There were 7 adverse events, and most were irrelevant to the treatment. Only 1 participant had a mild burn on the acupuncture point. Here, we demonstrate for the first time that electronic moxibustion treatment is a feasible treatment for breast cancer-related lymphedema. Electronic moxibustion may reduce differences in upper limb circumference and improve shoulder range of motion. A future comparative clinical trial is needed to confirm the clinical efficacy of this treatment.


2015 ◽  
Vol 112 (4) ◽  
pp. 636-643 ◽  
Author(s):  
E J Bantema-Joppe ◽  
G H de Bock ◽  
M Woltman-van Iersel ◽  
D M Busz ◽  
A V Ranchor ◽  
...  

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Samantha K.L.A. Rizzi ◽  
Cinira A.S. Haddad ◽  
Patrícia S. Giron ◽  
Patrícia V.G. Figueira ◽  
Amanda Estevão ◽  
...  

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