Self-reported Upper Extremity Function, Active Range Of Motion And Shoulder Isometric Strength In Breast Cancer Survivors

Abstract Background Breast cancer treatments often result in upper extremity functional limitations in both the short and long term. Current evidence makes comparisons against a baseline or contralateral limb, but does not consider changes in function associated with aging. Objective The objective of this study was to compare upper extremity function between women treated for breast cancer more than 12 months in the past and women without cancer. Design This was an observational cross-sectional study. Methods Women who were diagnosed with breast cancer and had a mean post–surgical treatment time of 51 months (range = 12–336 months) were compared with women who did not have breast cancer (CTRL group). Self-reported upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and shoulder range of motion, strength, and muscular endurance were measured. Participants were divided into 3 groups: breast cancer involving the nondominant limb (BC-ND), breast cancer involving the dominant limb (BC-DOM), and CTRL. Results A total of 59 women in the CTRL group, 23 women in the BC-ND group, and 28 women in the BC-DOM group completed measures. Mean DASH scores in women with breast cancer were higher than those of women in the CTRL group, regardless of the limb on which cancer occurred (Cohen d = 1.13; 95% CI = 2.20 to 16.21) Range of motion for the BC-ND group was significantly less for flexion (Cohen d = 1.19, 95% CI = −13.08 to −0.11) and external rotation (Cohen d = 1.11, 95% CI = −18.62 to −1.98) compared with the CTRL group. Strength in the BC-ND group was 23% to 25% lower in the CTRL group for external (Cohen’s d = 0.89, 95% CI = 0.09 to 0.12) and internal rotation (Cohen d = 0.92, 95% CI = 0.10 to 0.13). Endurance was not significantly different in the 3 groups. Limitations Some participants had rehabilitation, which may have skewed results. The range of post–surgical treatment times was broad, making it difficult to determine when function returned. Muscular endurance measures demonstrated a ceiling effect and large variance, limiting the ability to distinguish differences among participants. These results may not be generalizable to the subset of women who were treated with lumpectomy, sentinel node biopsy, or chest wall radiation alone or who underwent a contralateral prophylactic mastectomy. Conclusion In the long term, women with breast cancer have lower self-reported shoulder function than women without breast cancer. Motion and strength are lower among women who have experienced cancer on the nondominant limb.

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Active Range of Motion Predicts Upper Extremity Function 3 Months After Stroke

Stroke ◽

10.1161/strokeaha.108.536763 ◽

2009 ◽

Vol 40 (5) ◽

pp. 1772-1779 ◽

Cited By ~ 80

Author(s):

Justin A. Beebe ◽

Catherine E. Lang

Keyword(s):

Range Of Motion ◽

Upper Extremity ◽

Extremity Function ◽

Active Range Of Motion ◽

Upper Extremity Function

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Ultrasound-Guided Block of the Suprascapular Nerve in Breast Cancer Survivors with Limited Shoulder Motion – Case Series

January 2018 - Pain Physician ◽

10.36076/ppj.2017.e239 ◽

2017 ◽

Vol 2 (20;2) ◽

pp. E233-E239

Author(s):

Ozden Ozyemisci-Taskiran

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Range Of Motion ◽

Upper Extremity ◽

Breast Cancer Survivors ◽

Radiation Treatment ◽

Suprascapular Nerve ◽

Ultrasound Guided ◽

Suprascapular Nerve Block ◽

Shoulder Motion

Background: Suprascapular nerve block is performed in the management of chronic shoulder pain and frozen shoulder. Objective: To investigate the effects of ultrasound-guided suprascapular nerve block in restoration of shoulder motion in breast cancer survivors. Study Design: A cohort study. Setting: A training and research hospital, outpatient setting. Methods: A total of 18 breast cancer survivors with limited shoulder motion, pain, and difficulty in positioning the upper extremity for radiation treatment following surgery were enrolled in this study. Ultrasound-guided suprascapular nerve blocks were performed while the patients were seated in a chair without a backrest. After visualization of the suprascapular nerve under the transverse suprascapular ligament, 20 mg of triamcinolone and 4 mL of 0.5% bupivacaine were injected. Shoulder range of motion, pain, disability, and upper extremity circumference measurements were assessed in all participants before and 10 days after the block. Results: A significant decrease was observed in severity of pain and disability 10 days after the block. The ranges of shoulder abduction, flexion, and external rotation were improved significantly. All patients were able to receive radiation therapy without delay. Limitations: Absence of a control group and absence of randomization reduces the strength of our findings. Small sample size and absence of long-term follow-up are other limitations of this study. Conclusions: This is the first study investigating the effect of ultrasound-guided suprascapular block on shoulder limitation in breast cancer survivors. The results demonstrate that it may be a promising treatment approach for rapid recovery of shoulder motion in women with breast cancer before radiation treatment. Key words: Breast cancer, upper extremity, shoulder pain, range of motion, disability, ultrasound, injection, triamcinolone, local anesthetics

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The association of breast cancer related lymphedema after unilateral mastectomy with shoulder girdle kinematics and upper extremity function

Journal of Biomechanics ◽

10.1016/j.jbiomech.2021.110432 ◽

2021 ◽

pp. 110432

Author(s):

Emine Baran ◽

Taha İbrahim Yildiz ◽

Ceren Gursen ◽

Esra Üzelpasaci ◽

Serap Özgül ◽

...

Keyword(s):

Breast Cancer ◽

Upper Extremity ◽

Shoulder Girdle ◽

Extremity Function ◽

Upper Extremity Function ◽

Breast Cancer Related Lymphedema ◽

Unilateral Mastectomy

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Effects of Mirror Therapy Combined With EMG-triggered Functional Electrical Stimulation to Improve on Upper Extremity Function in Patient with Chronic Stroke

Physikalische Medizin Rehabilitationsmedizin Kurortmedizin ◽

10.1055/a-1210-2930 ◽

2020 ◽

Author(s):

Joo Yeol Jung ◽

Pong Sub Youn ◽

Dong Hoon Kim

Keyword(s):

Electrical Stimulation ◽

Physical Therapy ◽

Muscle Strength ◽

Range Of Motion ◽

Upper Extremity ◽

Functional Electrical Stimulation ◽

Chronic Stroke ◽

Mirror Therapy ◽

Extremity Function ◽

Upper Extremity Function

AbstractThis study was performed to evaluate the effects of Mirror therapy combined with EMG-triggered Functional Electrical Stimulation on upper extremity function in patient with Chronic Stroke. A total of 24 chronic stroke patients were divided into 3 groups. Group I (n=8) was given with traditional physical therapy (TPT), group II (n=7) was given with traditional physical therapy and mirror therapy (MT), and group III (n=9) was given with traditional physical therapy and mirror therapy in conjunction with EMG-triggered Functional Electrical Stimulation (EMGFES-MT). Each group performed one hour a day 5 times a week for 6 weeks.We obtained the following result between before and after treatments about changes of elbow flexion muscle strength (EFMS), elbow extension muscle strength (EEMS), wrist flexion muscle strength (WFMS), wrist extension muscle strength (WEMS), elbow flexion range of motion (EFROM), elbow extension range of motion (EEROM), wrist flexion range of motion (WFROM), wrist extension range of motion (WEROM), grip strength (GS) and upper extremity function.Each group showed a significant difference in EFMS, EEMS, WFMS, WEMS, EFROM, EEROM, WFROM, WEROM, GS and upper extremity function (p<0.05) EMFES-MT group revealed significant differences in EEMS, WEROM, grip strength and upper extremity function as compared to the other groups (p<0.05). No difference was found in the change of spasticity among the 3 groups.Our results showed that EMFES-MT was more effective on elbow, WFMS, WEMS, AROM, grip strength and upper extremity function in patients with chronic stroke. We suggest that this study will be able to be used as an intervention data for recovering upper extremity function in chronic stroke patients

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