Comparison of Spinal Alignment and Mobility in Women With and Without Post Modified Radical Mastectomy Unilateral Lymphoedema

Postural stability, spinal alignment, mobility, and postural competency in women with unilateral lower extremity lymphedema after radical hysterectomy following gynecologic cancer: A case-control study

PURPOSE

To compare postural stability, spinal alignment, mobility, and postural competency in women with unilateral lower extremity lymphedema after radical hysterectomy following gynecologic cancer with a matched control group.

METHODS

Twenty-seven women with unilateral lower extremity lymphedema (lymphedema group, age: 54.14 ± 5.80 years) and 30 healthy women (control group, age: 51.90 ± 6.54 years) were included. The lymphedema severity was evaluated with circumferential measurements. Postural stability with the Biodex Balance System SD and the spinal alignment, mobility, and postural competency with the Spinal Mouse device were assessed.

RESULTS

In the lymphedema group, it was found that 3.7% of the women had mild lymphedema, 7.4% had moderate lymphedema, and 88.9% had severe lymphedema. Static eyes open (EO) (overall, medio-lateral and antero-posterior) and eyes closed (EC) (antero-posterior) stability scores and dynamic EO and EC stability scores (overall and antero-posterior) were detected to be higher in the lymphedema group than in the controls (p < 0.05). Spinal mobility and postural competency scores were lower in the lymphedema group than in the control group (p < 0.05). In other parameters, there were no significant differences between the groups (p > 0.05).

CONCLUSION

Decreased postural stability, spinal mobility, and postural competency were detected in women with unilateral lower extremity lymphedema; however, no difference was seen in spinal alignment. These changes should be taken into account in the assessment and the treatment of unilateral lower extremity lymphedema.

Investigation of the relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions in unilateral breast cancer surgery survivors: a cross-sectional study

PURPOSE

Despite the research on structural and functional changes that may occur in breast cancer survivors, no study has investigated the relationship between spinal characteristics and the respiratory system. Therefore, we aimed to investigate the relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions in breast cancer patients who have completed their treatment METHODS: This cross-sectional study included 38 female breast cancer surgery survivors. Participants underwent the following evaluations: Chest wall mobility with a tapeline; postural assessments (spinal curvature, spinal mobility, and spinal inclination) with a non-invasive, computer-assisted electromechanical device; and pulmonary function test and respiratory muscle strength with a portable digital spirometer device. The relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions was analyzed by the bivariate correlation analysis.

RESULTS

Increased thoracic curvature angle was associated with decreased FEV1 (r=-0.360, p=0.026) and decreased subcostal mobility (r=-0.385, p=0.017), and the increase in thoracic frontal mobility was associated with decrease in PEF (r=-0.342, p=0.036). Increased lumbar mobility was associated with increased FVC (r=0.324, p=0.047), and increased total spinal inclination mobility was associated with decreased MIP (r=-0.396, p=0.017). Chest wall mobility was associated with postural assessments at varying rates (the r value ranged from -0.357 to 0.661, p<0.05).

CONCLUSION

The changes in spinal posture and mobility of women who have undergone unilateral breast cancer surgery were associated with respiratory parameters and thoracic cage mobility. These patients' spinal posture and mobility should be taken into account in conjunction with respiratory functions for a comprehensive assessment.

Health-related physical fitness parameters in women with breast cancer-related lymphedema: a case-control study

PURPOSE

This study aimed to compare health-related physical fitness parameters of women with breast cancer-related lymphedema (BCRL) to a matched control group.

METHODS

Thirty women with unilateral BCRL (lymphedema group, age = 55.00 (40.00-65.00) years) and 32 healthy women (control group, age = 49.00 (44.00-64.00) years) were included. Cardiorespiratory fitness with the UKK 2-km walk test, grip strength with a hand dynamometer, trunk muscle endurance with the McGill trunk muscle endurance tests, flexibility with the sit and reach test, body composition with a body composition analyzer, and waist-to-hip ratio were assessed.

RESULTS

In the lymphedema group, 36.7% of women had mild lymphedema, 36.7% had moderate, and 26.7% had severe lymphedema. It was found that maximal oxygen consumption, physical fitness index, grip strength, trunk extensor and lateral flexor muscle endurance, and flexibility scores were higher in the control group than in the lymphedema group (p < 0.05). In addition, body mass index, body fat percentage, and waist-to-hip ratio were found to be lower in the control group compared to the lymphedema group (p < 0.05). There was no significant difference between the trunk flexor muscle endurance scores (p > 0.05).

CONCLUSIONS

It was found that the health-related physical fitness parameters were adversely affected in women with BCRL compared to healthy women. The changes of physical fitness may be important for the assessment and the treatment of BCRL.

The Influence of External Breast Prostheses on the Body Postures of Women Who Have Undergone Mastectomies

Most women who have had a mastectomy and have not opted for breast reconstruction choose to use an external breast prosthesis. This study aimed to assess the impacts of external breast prostheses on the body postures of women after unilateral mastectomies. An additional aim was to identify whether postural asymmetry depended on the side of mastectomy. This study involved 52 women after unilateral mastectomy and consisted of two parts: (1) anthropometric measurement and (2) assessment of body posture using the moiré topography method. The posturometric indices showed that the body posture of the subjects in the sagittal plane is characterized by forward trunk inclination and a tendency to excessive kyphosis. There were no significant differences between parameters characterizing body posture with and without external breast prosthesis. The lack of external breast prosthesis had a significant effect only on excessive forward trunk inclination. Significant differences were found in the posturometric parameters in the transverse plane between the groups of patients after left- and right-sided mastectomy. The obtained results did not fully confirm the hypothesis that the external breast prosthesis affects the body posture of women after unilateral mastectomy.

Effects of scapulothoracic stabilization exercises on scapular function, posture, and balance in lymphedema after mastectomy: a randomized controlled trial

This study aimed to investigate the effects of scapulothoracic stabilization exercises (SSE) on scapular function, posture, and balance in women with lymphedema after mastectomy. The patients were randomly divided into two groups as complex decongestive physiotherapy (CDP) (n: 12; age: 55.25 ± 8.17 years) and CDP+SSE (n: 13; age: 54.38 ± 9.08 years). While only CDP was applied in the CDP group, CDP and SSE were applied in the CDP+SSE group. Scapulothoracic muscle strength with dynamometer, scapular endurance with Scapular Isometric Compression Test, scapular dyskinesia with Lateral Scapular Slide Test, thoracic posture with inclinometer, general posture with New York Posture Scale, and balance with Mini-BESTest were evaluated before the 3-week treatment phase (TP), after the TP, and after the fifth week of the maintenance phase (MP). Improvements in the lower trapezius muscle strength were found in both groups after the TP (p < .05). In addition, the middle trapezius muscle strength and general posture improved more in the CDP+SSE group than in the CDP group after the TP (p < .05). In the MP, scapulothoracic muscle strength, scapular endurance, and general posture improved more in CDP+SSE group compared to the CDP group (p < .05). In upper extremity lymphedema patients, incorporating additional SSE in CDP may contribute to the improvement of posture and scapular functions.

Risk factors of recurrent erysipelas in adult Chinese patients: a prospective cohort study

BACKGROUND

Erysipelas is a common skin infection that is prone to recur. Recurrent erysipelas has a severe effect on the quality of life of patients. The present study aimed to investigate the risk factors of recurrent erysipelas in adult Chinese patients.

METHODS

A total of 428 Chinese patients with erysipelas who met the inclusion criteria were studied. The patients were divided into the nonrecurrent erysipelas group and the recurrent erysipelas group. Clinical data were collected on the first episode and relapse of erysipelas. The patients were followed up every 3 months. Statistical analysis was performed to analyze and determine the risk factors of erysipelas relapse.

RESULTS

Univariate analysis was performed to analyze the data, including surgery, types of antibiotics administered in the first episode, obesity, diabetes mellitus, venous insufficiency, lymphedema, and malignancy. The differences between the groups were statistically significant (p < 0.05). The Cox proportional hazards regression model analysis showed that the final risk factors included surgery, obesity, diabetes mellitus, venous insufficiency, and lymphedema.

CONCLUSIONS

Surgery, obesity, diabetes mellitus, venous insufficiency, and lymphedema are considered as risk factors for recurrent erysipelas.

Comparison of Shoulder-Arm Complex Pain, Function, and Scapular Dyskinesia in Women With and Without Unilateral Lymphedema After Breast Cancer Surgery

INTRODUCTION

Lymphedema is the most important complication seen after breast cancer surgery. The study aimed to evaluate pain, shoulder-arm complex function, and scapular function in women who developed lymphedema after breast cancer surgery and to compare these with women without lymphedema.

MATERIALS AND METHODS

Fifty women with lymphedema (age, 54.34 ± 9.08 years; body mass index, 30.10 ± 4.03 kg/cm²) and 57 women without lymphedema (age, 53.68 ± 9.41 years; body mass index, 29.0 ± 5.44 kg/cm²) after unilateral surgery for breast cancer were included. Clinical and demographic information was noted. The severity of lymphedema with perimeter measurements (Frustum model), level of heaviness discomfort sensation with a visual analog scale, pain threshold with a digital algometer, shoulder-arm complex functionality with the Disabilities of the Arm, Shoulder, Hand Problems Survey (DASH), and scapular function with observational scapular dyskinesia and lateral scapular sliding tests were assessed. The t test, χ² test, and Mann-Whitney U test were used for analyses.

RESULTS

The follow-up duration after the surgery was 4.24 ± 2.97 years and 3.19 ± 1.76 years, and the upper extremity volume was 2106.65 ± 510.82 cm³ and 1725.92 ± 342.49 cm³ in the lymphedema group and in the no-lymphedema group, respectively. In the lymphedema group, arm-heaviness discomfort, pain threshold levels in the trapezius and deltoid muscles, and DASH scores were worse (P < .05). The rate of scapular dyskinesia (70.0%) and type 2 scapula (32%) in the surgical side was higher in patients with lymphedema.

CONCLUSION

The pain pressure threshold in the trapezius and deltoid muscles, heaviness sensation level, and inadequate upper extremity function are significantly higher in patients with lymphedema, and the scapular dyskinesia rate was higher.

Modified radical mastectomy for anterior thoracic nerve and intercostobrachial nerve protection (case report)

Modified breast cancer radical mastectomy is a more common operating method in breast surgery. Traditional modified radical mastectomy focuses on protecting the long thoracic nerve and thoracodorsal nerve while ignoring the protection of the anterior thoracic nerve and intercostobrachial nerve protection, which leads often to patients with upper medial arm numbness, acid swelling, pain, chest atrophy, and other problems. In the modified radical mastectomy of breast cancer, in this case, the author used an elaborative operation to protect the anterior thoracic nerve and intercostobrachial nerve and thoroughly dissected the third-level lymph nodes through the axillary approach.