عنوان مقاله [English]
Strength is necessary for upper body normal function. Many women with breast cancer report impairments in upper extremity function after the time required for improvement after breast cancer treatment. It is not possible to know precisely if cancer adjuvant therapies such as radiation and chemotherapy have any effects on the unaffected arm. The aim of this study was subjective report on strength of women with breast cancer. Therefore, 33 postmenopausal women (51±6.46 yr) with breast cancer who completed the surgery, received chemotherapy and radiation therapy on average five years ago and 30 healthy postmenopausal women (53.26±5.05 yr) were selected. Strength was measured using a hand held dynamometer for flexion, horizontal adduction, internal and external rotations of shoulder, scapular abduction and upward rotation, scapular depression and adduction. Data were analyzed by MANOVA (P≤ 0.05). The findings indicated significant differences between the groups in six variables of shoulder girdle strength (shoulder flexion, internal rotation, external rotation, shoulder horizontal adduction, scapular abduction and upward rotation, scapular depression and adduction) and the strength reduction was respectively %74.1, %65.3, %75.5, % 63.9, %61.3, %74.8 in patients compared to healthy subjects. The results indicated the importance of evaluating the shoulder girdle strength in women with breast cancer. Based on these findings, years after treatment, decreased shoulder girdle strength is found in these patients, health care professionals need to focus on these special shoulder girdle strength factors during the treatment and designing training and rehabilitation programs for women with breast cancer.
1- Andrews, A. W., Thomas, M. W., & Bohannon, R. W. (1996). Normative values for isometric muscle force measurements obtained with hand-held dynamometers. Physical therapy, 76(3), 248-259.
2- Blomqvist, L., Stark, B., Engler, N., & Malm, M. (2004). Evaluationof arm and shoulder mobility and strength after modified radical mastectomy and radiotherapy. Acta Oncologica, 43(3), 280-283.
3- Bohannon, R. W. (1997). Reference values for extremity muscle strength obtained by hand-held dynamometry from adults aged 20 to79 years. Archives of physical medicine and rehabilitation, 78(1), 26-32.
4- Crosbie, J., Kilbreath, S. L., Dylke, E., Refshauge, K. M., Nicholson, L. L., Beith, J. M., . . . White, K. (2010). Effects of mastectomy on shoulder and spinal kinematics duringbilateral upper-limb movement. Physical therapy, 90(5), 679-692.
5- Ebaugh, D., Spinelli, B., & Schmitz, K. H. (2011). Shoulder impairments and their association with symptomatic rotator cuff disease in breast cancer survivors. Medical hypotheses, 77(4), 481-487.
6- Fisher, M. I. (2013). A comparison of upper extremity function between female breast cancer survivors and healthy controls: typical self-report of function, motion, strength and muscular endurance.(Doctor of Philosophy in Rehabilitation Sciences), University of Kentucky, Lexington, Kentucky.
7- Gyedu, A., Kepenekci, I., Alic, B., & Akyar, S. (2009). Evaluation of muscle atrophy after axillary lymph node dissection. Acta Chir Belg, 109(2), 209-215.
8- Harirchi, I., Kolahdoozan, S., Karbakhsh, M., Chegini, N., Mohseni, S., Montazeri, A., . . . Ebrahimi, M. (2011). Twenty years of breast cancer in Iran: downstaging without a formal screening program. Annals of oncology, 22(1), 93-97.
9- Harmer, V. (2011). Breast Cancer Nursing Care and Management: JohnWiley & Sons PP:113.
10- Harrington, S., Padua, D., Battaglini, C., Michener, L. A., Giuliani, C., Myers, J., & Groff, D. (2011). Comparison of shoulder flexibility, strength, and function between breast cancer survivors and healthy participants. Journal of Cancer Survivorship, 5(2), 167-174.
11- Harris, S. R., Campbell, K. L., & Mcneely, M. L. (2004). Upper extremity rehabilitation for women who have been treated for breast cancer. Physiotherapy Canada, 56(4), 202-214.
12- Harrison, S. (2008). Physical activity among breast cancer survivors. (Master of Applied Science (Research)), Queensland University of Technology, pp:7-8.
13- Hayes, S., Battistutta, D., & Newman, B. (2005). Objective and subjective upper body function six months following diagnosis of breast cancer. Breast Cancer Research and Treatment, 94(1), 1-10.
14- Hayes, S. C., Rye, S., Battistutta, D., DiSipio, T., & Newman, B. (2010). Upper-body morbidity following breast cancer treatment is common, may persist longer-term and adversely influences quality of life. HealthQual Life Outcomes, 8(1), 92.
15- Hislop, H. J., & Montgomery, J. (2002). Muscle testing, techniques of manual examination (7th ed.). Philadelphia: Saunders pp:3-7.
16- Hughes, R., Sharrack, B., & Rubens, R. (1996). Carcinoma and the peripheral nervous system. Journalof neurology, 243(5), 371-376.
17- iSource National Breast Cancer Centre. (2001). Clinical practice guidlines: Management of early breast cancer pp:9-148.
18- Johansen, J., Overgaard, J., Blichert-Toft, M., & Overgaard, M. (2000). Treatment morbidity associated with the management of the axilla in breast-conserving therapy. Acta Oncologica, 39(3), 349-354.
19- Johansson, K., Ingvar, C., Albertsson, M., & Ekdahl, C. (2001). Arm Lymphoedema, Shoulder Mobility and Muscle Strength after Breast Cancer Treatment?A Prospective 2-year Study. Advances in Physiotherapy, 3(2), 55-66.
20- Karki, A., Simonen, R., Malkia, E., & Selfe, J. (2005). Impairments, activity limitations and participation restrictions 6 and 12 months after breast cancer operation. Journal of Rehabilitation Medicine, 37(3), 180-188.
21- Kendall, F., McCreary, E., & Provance, P. (1993). Muscles testing and function(e. Bultler JP Ed. 4th ed.). Baltimore: Williams & Wilkins, pp:315-330.
22- Kern, K., & Norton, J. (1988). Cancer cachexia. Journal of Parenteral and Enteral Nutrition, 12(3), 286-298.
23- Kilbreath, S. L., Refshauge, K. M., Beith, J. M., Ward, L. C., Simpson, J. M., & Hansen, R. D. (2006). Progressive resistance training and stretching following surgery for breast cancer: study protocol for a randomised controlled trial. BMC cancer, 6(1), 273.
24- Kilgour, R. D., Jones, D. H., & Keyserlingk, J. R. (2008). Effectiveness of a self-administered, home-based exercise rehabilitation program for women following a modified radical mastectomy and axillarynode dissection: a preliminary study. Breast Cancer Research and Treatment, 109(2), 285-295.
25- KOLBER, M. J., & CLELAND, J. A. (2005). Strength testing using hand-held dynamometry. Physical therapy reviews, 10(2), 99-112.
26- Lee, T., Kilbreath, S., Refshauge, K., Pendlebury, S., Beith, J., & Lee, M. (2007). Pectoral stretching program for women undergoing radiotherapy for breast cancer. Breast Cancer Research and Treatment, 102(3), 313-321.
27- Lin, J. C., Weintraub, N., & Aragaki, D. R. (2008). Nonsurgical treatment for rotator cuff injury in the elderly. Journal of the American Medical Directors Association, 9(9), 626-632.
28- Merchant, C., Chapman, T., Kilbreath, S., Refshauge, K., & Krupa, K. (2008). Decreased muscle strength following management of breast cancer. Disability & Rehabilitation, 30(15), 1098-1105.
29- Rebbeck, T. R., Friebel, T., Lynch, H. T., Neuhausen, S. L., van’t Veer, L., Garber, J. E., . . . Matloff, E. (2004). Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: the PROSE Study Group. Journal of clinical oncology, 22(6), 1055-1062.
30- Rietman, J. S., Dijkstra, P. U., Debreczeni, R., Geertzen, J. H., Robinson, D. P., & de Vries, J. (2004). Impairments, disabilities and health related quality of lifeafter treatment for breast cancer: a follow-up study 2.7 years after surgery. Disability & Rehabilitation, 26(2), 78-84.
31- Rietman, M. (2006). Efficacy of comprehensive group Rehabilitation for women with early breast cancer. Nursing and Health Science, 8, 140-146.
32- Roy, J.-S., MacDermid, J. C., Orton, B., Tran, T., Faber, K. J., Drosdowech, D., & Athwal, G. S. (2009). The concurrent validity of a hand-held versus a stationary dynamometer in testing isometric shoulder strength. Journal of Hand Therapy, 22(4), 320-327.
33- Schmitz, K. H., Speck, R. M., Rye, S. A., DiSipio, T., & Hayes, S. C. (2012). Prevalence of breast cancer treatment sequelae over 6 years of follow‐up. Cancer, 118(S8), 2217-2225.
34- Shamley, D. R., Srinanaganathan, R., Weatherall, R., Oskrochi, R., Watson, M., Ostlere, S., & Sugden, E. (2007). Changes in shoulder muscle size and activity following treatment for breast cancer. Breast Cancer Research and Treatment, 106(1), 19-27.
35- Springer, B. A., Levy, E., McGarvey, C., Pfalzer, L. A., Stout, N. L., Gerber, L. H., . . . Danoff, J. (2010). Pre-operative assessment enables early diagnosis and recovery of shoulder function in patients with breast cancer. Breast Cancer Research and Treatment, 120(1), 135-147.
36- Sugden, E., Rezvani, M., Harrison, J., &Hughes, L. (1998). Shoulder movement after the treatment of early stage breast cancer.Clinical Oncology, 10(3), 173-181.
37- Wong, V. (2014). A Cross-Sectional Study of Chronic Impairments and Activity Limitations in Women at Least Six Months Post-Operative for Breast Cancer: An Exploratory Study. (degree of MSc. in Human Kinetics), University of Ottawa, pp:14-15.