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Oncu H, Calik-Kutukcu E, Vardar Yagli N, Inal-Ince D, Saglam M, Unal F, Aksoy S. Reliability and validity of the 6-minute pegboard and ring test for functional exercise capacity in patients with breast cancer. Physiother Theory Pract 2024:1-13. [PMID: 38739486 DOI: 10.1080/09593985.2024.2353260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 05/05/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Chronic pain, sensory disturbances, and lymphedema are frequent after breast cancer, leading to arm dysfunction. There is a need for objective performance-based clinical exercise tests for the upper extremity in patients with breast cancer. OBJECTIVE The aim of this study was to evaluate the validity and reliability of the 6-minute pegboard and ring test (6PBRT) in breast cancer survivors. METHODS Forty-eight women with breast cancer (mean age = 55.40 ± 10.40 years) were included. All patients performed 6PBRT on the first day and one week later to investigate the test-retest reliability of the 6PBRT, and intraclass correlation coefficients (ICC) were calculated. The peak workload (Wpeak) and oxygen consumption level (VO2peak) during the arm ergometer test were used as outcomes for the criterion validity of the 6PBRT. RESULTS The 6PBRT showed good test - retest reliability with an ICC1,2 value of 0.871 [95% confidence interval (CI) 0.769-0.928]. The first 6PBRT score was very strongly correlated with the second test score (r = 0.866, p < .001). The 6PBRT score was significantly correlated with VO2peak (r = 0.634, p < .001), and Wpeak (r = 0.546, p < .001). While the 6PBRT score had less effect on VO2peak, the determination of VO2peak in the model was very good (R2 = 0.832). CONCLUSION The 6PBRT has good test-retest reliability and is a valid test in individuals with breast cancer. These findings suggest that 6PBRT is a practical, useful, valid and reliable assessment tool for determining functional arm exercise capacity in patients with breast cancer.
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Affiliation(s)
- Hacer Oncu
- Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ebru Calik-Kutukcu
- Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Naciye Vardar Yagli
- Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Deniz Inal-Ince
- Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Melda Saglam
- Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ferhat Unal
- Data Management Unit, Middle East Technical University, Ankara, Turkey
| | - Sercan Aksoy
- Institute of Oncology, Department of Medical Oncology, Hacettepe University, Ankara, Turkey
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2
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Austin PD, Lee W, Costa DSJ, Ritchie A, Lovell MR. Efficacy of aerobic and resistance exercises on cancer pain: A meta-analysis of randomised controlled trials. Heliyon 2024; 10:e29193. [PMID: 38623224 PMCID: PMC11016720 DOI: 10.1016/j.heliyon.2024.e29193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 02/19/2024] [Accepted: 04/02/2024] [Indexed: 04/17/2024] Open
Abstract
Purpose To evaluate effects of aerobic and resistance exercises for cancer-related pain in adults with and surviving cancer. Secondary objectives were to a) evaluate the effect of exercise on fatigue, psychological function, physical function, b) assess fidelity to exercise. Design A systematic search of MEDLINE, EMBASE, AMED, CINAHL and Cochrane Central Register of Controlled Trials was conducted to identify randomised controlled trials (RCTs) comparing aerobic and/or resistance exercise to control groups. The primary endpoint were changes in cancer-related pain intensity from baseline to post intervention. Meta-regression analysis evaluated predictors for heterogeneity between study findings. Tolerability was defined as reporting of exercise-induced adverse events while fidelity evaluated by reported intervention dropout. Results Twenty-three RCTs including 1954 patients (age 58 ± 8.5 years; 78 % women); 1087 (56 %) and 867 (44 %) allocated to aerobic/resistance exercise therapy and control group, respectively. Exercise therapy was associated with small to moderate decreases in cancer-related pain compared to controls (SMD = 0.38, 95 % CI: 0.17, 0.58). Although there was significant heterogeneity between individual and pooled study effects (Q = 205.25, p < 0.0001), there was no publication bias. Meta-regression including supervision, age, duration and exercise type as moderators showed no significant differences in reported outcomes. Analysis of secondary outcomes revealed a moderate effect for improvements in physical function, fatigue and psychological symptoms. Conclusions Aerobic and resistance exercises are tolerable and effective adjunct therapies to reduce cancer-related pain while also improving physical function, fatigue and mood. Future RCTs of dose, frequency, compliance and exercise type in specific cancer settings are required.
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Affiliation(s)
- Philip D. Austin
- Department of Palliative Care, HammondCare, Greenwich Hospital, Sydney, New South Wales, Australia
| | - Wei Lee
- Department of Palliative Care, HammondCare, Greenwich Hospital, Sydney, New South Wales, Australia
- Improving Care for Palliative Aged, and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Daniel SJ. Costa
- Sydney Medical School-Northern, University of Sydney, Sydney, New South Wales, Australia
- Kolling Institute, Northern Sydney Local Health District, Sydney, NSW, Australia
- School of Psychology, University of Sydney, Sydney, NSW, Australia
- The University of Sydney, Sydney, NSW, Australia
| | - Alison Ritchie
- Department of Palliative Care, HammondCare, Greenwich Hospital, Sydney, New South Wales, Australia
| | - Melanie R. Lovell
- Department of Palliative Care, HammondCare, Greenwich Hospital, Sydney, New South Wales, Australia
- Sydney Medical School-Northern, University of Sydney, Sydney, New South Wales, Australia
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3
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Rasmussen GHF, Kristiansen M, Arroyo-Morales M, Voigt M, Madeleine P. The Analgesic Effect of Resistance Training after Breast Cancer (ANTRAC): A Randomized Controlled Trial. Med Sci Sports Exerc 2023; 55:167-176. [PMID: 36084228 DOI: 10.1249/mss.0000000000003034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The objective of this blinded parallel-arm randomized controlled trial was to investigate the effect of resistance training (RT) on pain, maximal strength, and shoulder function in breast cancer survivors (BCS) with persistent pain after treatment. METHODS Twenty BCS with self-reported pain ≥1.5 yr after treatment were randomized to an experimental group (EXP, n = 10), who performed a supervised progressive total body heavy RT program 2 times per week for 12 wk, or a control group (CON, n = 10), who was instructed to continue their everyday life. Perceived pain intensity, pressure pain threshold (PPT) levels, one-repetition maximum (1RM), and active range of motion were collected pre- and postintervention and at 3 months follow-up. RESULTS There was a significant 11% decrease in peak pain intensity ( P < 0.05) for both groups, a significant 48% increase in 1RM ( P < 0.05), and a significant 35% increase in PPT levels ( P < 0.001) for EXP, but not for CON. For EXP, maximal strength at follow-up was still significantly greater than at preintervention ( P < 0.05), whereas PPT levels had reverted to baseline levels. There was no change in active range of motion ( P < 0.05) and no change in arm circumference ( P < 0.05). CONCLUSIONS RT had a significant effect on 1RM and PPT of BCS with persistent pain after treatment, demonstrating both a functional and analgesic effect of progressive RT in this population. Strength was largely maintained after detraining, whereas PPT levels were not, indicating that the process of RT rather than the gain in strength may be associated with analgesia.
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Affiliation(s)
- Gorm Henrik Fogh Rasmussen
- Sport Sciences-Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, DENMARK
| | - Mathias Kristiansen
- Sport Sciences-Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, DENMARK
| | | | - Michael Voigt
- Sport Sciences-Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, DENMARK
| | - Pascal Madeleine
- Sport Sciences-Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, DENMARK
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4
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Guloglu S, Basim P, Algun ZC. Efficacy of proprioceptive neuromuscular facilitation in improving shoulder biomechanical parameters, functionality, and pain after axillary lymph node dissection for breast cancer: A randomized controlled study. Complement Ther Clin Pract 2023; 50:101692. [PMID: 36528984 DOI: 10.1016/j.ctcp.2022.101692] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/02/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE Axillary lymph node dissection and radiotherapy have been associated with pain, physical symptoms, and decreased functional abilities in the upper extremity. This study aimed to evaluate the potential effects of the proprioceptive neuromuscular facilitation (PNF) technique on muscle strength, pain and functionality in this patient group in comparison with progressive resistance training (PRT). METHODS The study was conducted with a randomized clinical trial design. Sixty-six women were included in the study and randomly divided into three groups: the PNF group (n = 22), the PRT group (n = 22), and the control group (n = 22). The participants were evaluated at the baseline and after eight weeks of treatment. Outcome measures were determined as pain (the Visual Analog Scale), upper extremity strength (isokinetic dynamometer), functionality (the Disabilities of the Arm, Shoulder and Hand questionnaire), and perception of change (the Global Rating of Change Scale). TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT05288036. RESULTS The results showed statistically significant changes in both treatment groups in terms of shoulder flexors/extensors, abductor/adductors, internal/external rotators strength/power/endurance measurement, pain, and functionality (p < 0.05). Concerning functionality and perception of change, the PNF group had a statistically significantly higher improvement compared to the remaining two groups (p < 0.05). CONCLUSION PNF is an effective technique in increasing upper extremity muscle strength, reducing pain during rest and activity, and improving functionality in patients receiving breast cancer treatment.
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Affiliation(s)
- Selen Guloglu
- Istanbul Medipol University, Institute of Health Sciences, Department of Physical Therapy and Rehabilitation, Istanbul, Turkey.
| | - Pelin Basim
- Istanbul Medipol University, Faculty of Medicine, Department of General Surgery, Istanbul, Turkey.
| | - Z Candan Algun
- Istanbul Medipol University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.
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5
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Rasmussen GHF, Madeleine P, Arroyo-Morales M, Voigt M, Kristiansen M. Pain sensitivity and shoulder function among breast cancer survivors compared to matched controls: a case-control study. J Cancer Surviv 2023; 17:150-159. [PMID: 33495914 PMCID: PMC9970942 DOI: 10.1007/s11764-021-00995-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Persistent pain and loss of shoulder function are common adverse effects to breast cancer treatment, but the extent of these issues in comparison with healthy controls is unclear for survivors beyond 1.5 years after treatment. The purpose of this study was to benchmark differences in pressure pain thresholds (PPT), maximal isokinetic muscle strength (MIMS), and active range of motion (ROM) of females with persistent pain ≥1.5 years after breast cancer treatment (BCS) compared with pain-free matched controls (CON), and examine the presence of movement-evoked pain (MEP) during assessment of MIMS. METHODS The PPTs of 18 locations were assessed using a pressure algometer and a numeric rating scale was used to assess intensity of MEP. Active ROM and MIMS were measured using a universal goniometer and an isokinetic dynamometer, respectively. RESULTS A two-way analysis of variance revealed that PPTs across all locations, MIMS for horizontal shoulder extension/flexion and shoulder adduction, active ROM for shoulder flexion, horizontal shoulder extension, shoulder abduction, and external shoulder rotation were significantly lower for BCS compared with CON (P < 0.05). MEP was significantly higher for BCS and MEP intensity had a significant, negative correlation with PPTs (P < 0.01). DISCUSSION/CONCLUSION BCS with persistent pain ≥1.5 years after treatment demonstrates widespread reductions in PPTs and movement-specific reductions in MIMS and active ROM of the affected shoulder, along with MEP during physical performance assessment. IMPLICATIONS FOR CANCER SURVIVORS BCS with persistent pain ≥1.5 years after treatment shows signs of central sensitization and may benefit from individualized rehabilitation.
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Affiliation(s)
- G H F Rasmussen
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
| | - P Madeleine
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - M Arroyo-Morales
- Department of Physical Therapy, Faculty of Health Sciences, Sport and Health Research Institute, Biohealth Research Institute Granada, University of Granada, Granada, Spain
| | - M Voigt
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - M Kristiansen
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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6
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Pajero Otero V, García Delgado E, Martín Cortijo C, Rodríguez Ramos ML, De Carlos Iriarte E, Gil García A, Romay-Barrero H, Avendaño-Coy J. Intensive complex physical therapy combined with intermittent pneumatic compression versus Kinesio taping for treating breast cancer-related lymphedema of the upper limb: A randomised cross-over clinical trial. Eur J Cancer Care (Engl) 2022; 31:e13625. [PMID: 35642305 PMCID: PMC9540766 DOI: 10.1111/ecc.13625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/01/2022] [Accepted: 05/11/2022] [Indexed: 11/26/2022]
Abstract
Objective The objective of this study is to compare the effectiveness of complex physical therapy combined with intermittent pneumatic compression (CPT + IPC) versus Kinesio taping (KT) for breast cancer‐related lymphedema. Methods A cross‐over clinical trial was conducted in 43 women with lymphedema. All participants received two interventions: CPT + IPC and KT, both lasting 3 weeks and a washout period. The main outcome variable was the relative volume change (RVC). The secondary variables were Satisfaction Questionnaire about Textile Therapeutic Devices used for Breast Cancer‐Related Lymphedema, Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, motion range of upper limb and lymphedema‐related symptoms. Results The RVC reduction was greater with CPT + IPC (−2.2%, SD = 4.7) versus KT (−0.9%, SD = 1.7) (P = 0.002). KT was more satisfactory than multilayer bandaging (8.9 points difference, P < 0.001) and improved DASH score more than CPT + IPC (14.3 points difference, P = 0.002). Regarding motion ranges, only shoulder movements showed significant improvement with CPT + IPC compared with KT (differences between 5.6° and 11.4°). Of the symptoms assessed, only pain reduction showed a significant improvement with KT versus CPT + IPC (0.5 points, P = 0.035). Conclusions CPT + IPC achieved higher RVC and greater improvement in th shoulder motion range than KT. Conversely, KT was more satisfactory than multilayer bandaging, obtained better DASH scores and relieved pain more than CPT + IPC. Clinical Registration ClinicalTrial registration number: NCT03051750 (date of registration 14 February 2017).
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Affiliation(s)
- Violeta Pajero Otero
- University Hospital Infanta Sofía, San Sebastián de los Reyes, Spain.,Foundation for Biomedical Research and Innovation of the University Hospital Infanta Sofía and University Hospital de Henares (FIIB HUIS HHEN), Madrid, Spain.,Faculty of Nursing, Physiotherapy and Podiatry of the Complutense University, Madrid, Spain.,Research Institute i + 12 of Hospital October 12, Madrid, Spain
| | - Esther García Delgado
- University Hospital 12 de Octubre, Madrid, Spain.,Faculty of Nursing, Physical Therapy and Chiropody, Complutense University of Madrid, Madrid, Spain
| | - Concepción Martín Cortijo
- University Hospital 12 de Octubre, Madrid, Spain.,Faculty of Nursing, Physical Therapy and Chiropody, Complutense University of Madrid, Madrid, Spain
| | | | | | | | - Helena Romay-Barrero
- Faculty of Physical Therapy and Nursing, Castilla-La Mancha University, Toledo, Spain
| | - Juan Avendaño-Coy
- Faculty of Physical Therapy and Nursing, Castilla-La Mancha University, Toledo, Spain.,Toledo Physiotherapy Research Group (GIFTO), Toledo, Spain
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7
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Akiyama K, Takeuchi S, Makihara Y, Nishida Y. Minimum detectable change in reaction time to the Posner task due to change in sustained attention. J Phys Ther Sci 2022; 34:257-261. [PMID: 35400833 PMCID: PMC8989487 DOI: 10.1589/jpts.34.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/01/2022] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Spatial attention evaluations are beneficial for patients with unilateral
spatial neglect or dementia. Thus, such evaluations are crucial among these patients for
determining functional disorder extents. The study aimed to determine minimal detectable
changes in reaction time to the Posner task among healthy young participants for
establishing spatial attention evaluation protocols. [Participants and Methods] The study
recruited 10 healthy young adults (five males and five females; mean age: 28.9 ±
4.0 years). Each participant completed two sessions of the Posner task with 160 trials per
session. The reaction time for each trial was measured. Data obtained by the two blocks
were analyzed by Bland–Altman analysis, and intraclass correlation coefficient case 1 and
minimal detectable changes at the 95% confidence interval were calculated. [Results]
Bland–Altman analysis indicated no systematic bias. The intraclass correlation coefficient
case 1 exceeded 0.80 under all conditions of the Posner task, whereas the minimal
detectable changes at the 95% confidence interval spanned 23–34 ms. [Conclusion] The
results exhibited high reliability for reaction time to the Posner task. The minimal
detectable changes as the 95% confidence interval values determined in this study based on
reaction time can be applied to establish spatial attention evaluation protocols.
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Affiliation(s)
- Kazuya Akiyama
- Department of Rehabilitation Medicine, International University of Health and Welfare Narita Hospital: 852 Hatakeda, Narita, Chiba 286-8520, Japan
| | - Shinta Takeuchi
- Department of Physical Therapy, School of Health Sciences at Narita, International University of Health and Welfare, Japan
| | - Yukiko Makihara
- Department of Physical Therapy, School of Health Sciences at Narita, International University of Health and Welfare, Japan
| | - Yusuke Nishida
- Department of Rehabilitation Medicine, International University of Health and Welfare Narita Hospital: 852 Hatakeda, Narita, Chiba 286-8520, Japan.,Department of Physical Therapy, School of Health Sciences at Narita, International University of Health and Welfare, Japan
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8
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Torres-Lacomba M, Prieto-Gómez V, Arranz-Martín B, Ferrandez JC, Yuste-Sánchez MJ, Navarro-Brazález B, Romay-Barrero H. Manual Lymph Drainage With Progressive Arm Exercises for Axillary Web Syndrome After Breast Cancer Surgery: A Randomized Controlled Trial. Phys Ther 2022; 102:6497842. [PMID: 35079831 DOI: 10.1093/ptj/pzab314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/22/2021] [Accepted: 12/22/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study aimed to determine the effectiveness of a physical therapist-designed program tailored to axillary web syndrome (AWS) in women after breast cancer surgery. METHODS A prospective, single-center, assessor-blinded, randomized controlled trial was conducted at the Physiotherapy in Women's Health Research Unit of the Alcalá University (Madrid, Spain). Ninety-six women with AWS were assigned to the physical therapy group (manual lymph drainage [MLD] using resorption strokes and arm exercises as if performing median nerve neurodynamic glide exercises with no neural loading; n = 48) or the control group (standard arm exercises; n = 48), with both groups receiving treatment 3 times a week for 3 weeks. Both interventions included an educational component. RESULTS Compared with the control group, the physical therapy group showed significant and clinically relevant improvements in the primary outcome (self-reported pain intensity) at the primary and 3-month follow-ups. Significant and clinically relevant differences between groups were also found in the secondary outcomes (shoulder active range of motion, shoulder disability, and physical and functional aspects of health-related quality of life) at the primary follow-up and in the secondary outcomes as well as the trial outcome index at the 3-month follow-up. No significant differences were found at the 6-month follow-up in either primary or secondary outcomes. CONCLUSION The physical therapy program tailored to AWS was found to be effective for AWS symptoms in women after breast cancer surgery, both immediately after the program and after 3 months. IMPACT To our knowledge, this is the first appropriately designed study to demonstrate the effectiveness of MLD with progressive arm exercises for AWS. Clinicians and health service providers should consider how to provide survivors of breast cancer with AWS the opportunity to participate in physical therapy programs, including MLD with progressive arm exercises. LAY SUMMARY For axillary web syndrome following breast cancer surgery, a physical therapist can design a treatment program including manual lymph drainage and progressive arm exercises, which has been shown to result in reduced pain and improved motion compared with standard arm exercises.
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Affiliation(s)
- María Torres-Lacomba
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Virginia Prieto-Gómez
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Beatriz Arranz-Martín
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Jean Claude Ferrandez
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.,Lymphology Consultation, Sainte-Catherine Institute, Avignon, France
| | - María José Yuste-Sánchez
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Beatriz Navarro-Brazález
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Helena Romay-Barrero
- Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, Spain
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9
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Dams L, Haenen V, Van der Gucht E, Devoogdt N, Smeets A, Bernar K, De Vrieze T, De Groef A, Meeus M. Absolute and relative reliability of a comprehensive quantitative sensory testing protocol in women treated for breast cancer. PAIN MEDICINE 2021; 23:1162-1175. [PMID: 34908144 DOI: 10.1093/pm/pnab343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Quantitative sensory testing (QST) are non-invasive psychophysical assessment techniques to evaluate functioning of the somatosensory nervous system. Despite the importance of reliability for correct use of QST results in research and clinical practice, the relative and absolute intra-and inter-rater reliability of a comprehensive QST protocol to evaluate the functioning of both peripheral and central somatosensory nervous system in a breast cancer population, has not yet been investigated. SETTING University Hospitals, Leuven, Belgium. SUBJECTS Thirty women at least six months after unilateral breast cancer surgery. METHODS The protocol included nine static and dynamic QST methods (mechanical detection-pain thresholds, pressure pain thresholds, thermal detection-pain thresholds for heat and cold, temporal summation and conditioned pain modulation (CPM)) performed in the surgical area and more distant regions. Absolute and relative intra (60-minutes interval) and inter-rater (one-week interval) reliability was evaluated using intraclass correlation coefficients, standard error of measurement and Bland-Altman plots. RESULTS A moderate to excellent relative intra- and inter-rater reliability was found for the evaluation of mechanical thresholds, pressure pain thresholds and temporal summation. Reliability of the CPM paradigm was considered weak. Systematic bias between raters was noticed for detection of mechanical and cold stimuli at the non-affected trunk and CPM. CONCLUSIONS Except for the evaluation of CPM, the QST protocol was found suitable for identifying differences between subjects (relative reliability) and individual follow-up after breast cancer surgery (limited systematic bias) during a one-week timeframe. Additional research is required to determine measurement properties that influence CPM test stability in order to establish a more reliable CPM test paradigm.
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Affiliation(s)
- Lore Dams
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, MOVANT, Antwerp, Belgium.,KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.,Pain In Motion International research group, www.paininmotion.be
| | - Vincent Haenen
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, MOVANT, Antwerp, Belgium.,KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Elien Van der Gucht
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, MOVANT, Antwerp, Belgium.,KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.,Pain In Motion International research group, www.paininmotion.be
| | - Nele Devoogdt
- KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.,Department of Vascular Surgery and Department of Physical Medicine and Rehabilitation, Center for Lymphedema, UZ Leuven-University Hospitals Leuven, Leuven, Belgium
| | - Ann Smeets
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Koen Bernar
- The Leuven Centre for Algology and Pain Management, University Hospitals Leuven, Leuven, Belgium
| | - Tessa De Vrieze
- KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - An De Groef
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, MOVANT, Antwerp, Belgium.,KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.,Pain In Motion International research group, www.paininmotion.be
| | - Mira Meeus
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, MOVANT, Antwerp, Belgium.,Pain In Motion International research group, www.paininmotion.be.,Ghent University, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Ghent, Belgium
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10
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Gala-Alarcón P, Prieto-Gómez V, Bailón-Cerezo J, Yuste-Sánchez MJ, Arranz-Martín B, Torres-Lacomba M. Changes in shoulder outcomes using ultrasonographic assessment of breast cancer survivors: a prospective longitudinal study with 6-month follow-up. Sci Rep 2021; 11:23016. [PMID: 34837018 PMCID: PMC8626448 DOI: 10.1038/s41598-021-02379-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/15/2021] [Indexed: 11/08/2022] Open
Abstract
This study aimed to describe changes in supraspinatus tendon thickness, acromiohumeral distance, and the presence of fluid in the subacromial bursa as measured by ultrasound, as well as shoulder range of motion and strength, perceived shoulder disability, and health-related quality of life in women before and after breast cancer treatment. Women who underwent surgery for unilateral breast cancer who did not suffer from shoulder pain or difficulty performing activities of daily living in the 6 months prior to surgery were included. One pre-surgical (A0) and three post-surgical assessments at 7-10 days (A1), 3 months (A2), and 6 months (A3) after surgery were carried out. The thickness of the supraspinatus tendon on the affected side decreased between post-surgical (A1) and 6-month (A3) follow-up assessments (p = 0.029), although the minimal detectable change was not reached. The active range of motion of the affected shoulder decreased after surgery. Strength changes were observed in both shoulders after surgery. The intensity of shoulder pain increased between post-surgical and 6-month follow-up assessments. Shoulder function was decreased at the post-surgical assessment and increased throughout the follow-ups. Health-related quality of life declined after surgery. A trend of decreasing thickness of the supraspinatus tendon of the affected shoulder was observed. Detecting these possible structural changes early would allow for early or preventive treatment.
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Affiliation(s)
- Paula Gala-Alarcón
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805, Madrid, Spain
| | - Virginia Prieto-Gómez
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805, Madrid, Spain
| | - Javier Bailón-Cerezo
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805, Madrid, Spain
| | - María José Yuste-Sánchez
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805, Madrid, Spain
| | - Beatriz Arranz-Martín
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805, Madrid, Spain.
| | - María Torres-Lacomba
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805, Madrid, Spain
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Signs of Central Hypersensitivity, Stress, and Anxiety following Treatment for Breast Cancer: A Case Control Study. Int J Breast Cancer 2021; 2021:5691584. [PMID: 34707910 PMCID: PMC8545580 DOI: 10.1155/2021/5691584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 09/15/2021] [Accepted: 10/01/2021] [Indexed: 12/24/2022] Open
Abstract
Background With treatment for breast cancer, women treated may present significant sensory abnormalities in the upper extremity. However, there are no conclusive studies that have evaluated pressure pain thresholds (PPT) in the shoulder of postoperated women for breast cancer. The aim of this study was to compare PPT in the shoulder, stress, anxiety, depression symptoms, and quality of sleep among postoperated women for breast cancer (PO group) and asymptomatic women of shoulder pain (control group). Methods 40 women participated (n = 20, PO group, age: average ± standard deviation, 49.2 ± 8.3 years; body mass index (BMI): 27.5 ± 3.0 kg/cm2; surgery time: 22.2 ± 34.4 months; n = 20, control group, 46.9 ± 8.1 years; BMI: 26.8 ± 3.5 kg/cm2). The PPT was evaluated with a digital algometer at 32 points in the shoulder region and one control point in the tibialis anterior. Stress, anxiety, and depression were evaluated with the Depression, Anxiety and Stress Scale 21 (DASS-21) and the quality of sleep by the Pittsburgh Sleep Quality Index. Results Significant differences were observed over 1.5 kgf/cm2 in 33 points evaluated (p < 0.01) with a small to high effect size (Cliff's delta range = 0.16; 0.92) and higher levels of anxiety and stress in the PO group (anxiety: median [first; third quartile], 5[3; 12.5]; stress: 9.7 ± 4.7 (7.8; 11.8)) in comparison with the control group (anxiety: 2.5[1; 4.8]; stress: 6.7 ± 3.31 (5.2; 8.3), (p < 0.05)). No significant differences were found between the groups in depression and sleep quality (p > 0.05). Conclusion Postoperated women for breast cancer present hyperalgesia in the shoulder anterior and posterior region, low PPT in the tibialis anterior, and higher levels of stress and anxiety compared to the control group.
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