1
|
Lippi L, Turco A, Moalli S, Gallo M, Curci C, Maconi A, de Sire A, Invernizzi M. Role of Prehabilitation and Rehabilitation on Functional Recovery and Quality of Life in Thyroid Cancer Patients: A Comprehensive Review. Cancers (Basel) 2023; 15:4502. [PMID: 37760472 PMCID: PMC10526253 DOI: 10.3390/cancers15184502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND This narrative review aims to provide a comprehensive overview of the current prehabilitation and rehabilitation strategies for thyroid cancer survivors to optimize functional outcomes and enhance their quality of life. METHODS The review follows the SANRA quality criteria and includes an extensive literature search conducted in PubMed/Medline, Web of Science, and Scopus. RESULTS The review emphasizes the role of a comprehensive rehabilitation approach in targeting the different domains that generate disability in thyroid cancer patients. In this context, physical activity, range of motion exercises, myofascial release, joint mobilization, and postural exercises are crucial for improving functional outcomes and reducing treatment-related discomfort and disability. Moreover, tailored rehabilitative management addressing dysphonia and dysphagia might have a positive impact on the quality of life of these patients. Despite these considerations, several barriers still affect the implementation of a multimodal rehabilitative approach in common clinical practice. Thus, sustainable and effective strategies like digital innovation and patient-centered approaches are strongly needed in order to implement the rehabilitative treatment framework of these subjects. CONCLUSIONS This narrative review provides valuable insights into the current prehabilitation and rehabilitation strategies to treat thyroid cancer survivors, addressing physical, psychological, and vocational needs to optimize functional outcomes and enhance their quality of life.
Collapse
Affiliation(s)
- Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (S.M.)
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Alessio Turco
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (S.M.)
| | - Stefano Moalli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (S.M.)
| | - Marco Gallo
- Endocrinology and Metabolic Diseases Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Claudio Curci
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy;
| | - Antonio Maconi
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy;
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (S.M.)
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| |
Collapse
|
2
|
Dieterich AV, Yavuz UŞ, Petzke F, Nordez A. Assessment of Neck Muscle Shear Modulus Normalization in Women with and without Chronic Neck Pain. Diagnostics (Basel) 2022; 12:1791. [PMID: 35892502 PMCID: PMC9331943 DOI: 10.3390/diagnostics12081791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
Identifying the objective stiffness of the neck muscles facilitates the early and specific diagnosis of neck pain and targeted therapy. However, individual variation in the muscle shear modulus obscures differences between healthy and diseased individuals. Normalization may improve the comparability between individuals. The shear modulus at different functional tasks served as a reference for normalizing the neck muscles’ shear modulus of 38 women, 20 with chronic neck pain and 18 asymptomatic. Reference tasks were maximal voluntary contraction, relaxed sitting, prone head lift, balancing 1 kg on the head, and neck extension at 48 N. The effects of normalization on within-group variation and between-group differences were compared. Normalization with maximal voluntary contraction was discarded due to imaging problems. Normalization with relaxed sitting, prone head lift, balancing 1 kg, and neck extension at 48 N reduced within-group variation, by 23.2%, 26.8%, 11.6%, and 33.6%, respectively. All four normalization approaches reduced the p-values when testing for between-group differences. For the pain group, normalization with relaxed sitting and head lift indicated less normalized muscle stiffness, while normalization with balancing 1 kg and extension at 48 N indicated higher stiffness. The contradictory results are explainable by non-significant group differences in the reference tasks. Normalization of the muscle shear modulus is effective to reduce within-group variation, but a trustworthy normalization approach for group comparisons has yet to be identified.
Collapse
|
3
|
Kim Y, An SY, Park W, Hwang JH. Detection of early changes in the muscle properties of the pectoralis major in breast cancer patients treated with radiotherapy using a handheld myotonometer. Support Care Cancer 2020; 29:2581-2590. [PMID: 32959155 DOI: 10.1007/s00520-020-05751-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 09/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The primary aim was to investigate serial changes in the mechanical properties of the pectoralis major (PM), upper trapezius (UT), and sternoclavicular mastoid muscle (SCM) in breast cancer patients undergoing radiotherapy (RT) using a hand-held myotonometer. The secondary aims were to determine changes in subjective symptoms and to identify correlation with subjective results. DESIGN A total of 42 breast cancer patients were enrolled in this longitudinal prospective study. Muscle properties of the PM, UT, and SCM were evaluated before RT, immediately after RT, and 4 months post-RT. Subjective symptom scales of pain and stiffness at rest/stretch of each muscle were evaluated. RESULTS The PM showed significant side-to-side differences; the affected PM showed increased tone, stiffness, and decreased elasticity compared with the unaffected PM. The affected PM and UT showed significant time-dependent interactions. Stiffness of the affected PM at stretching was significantly higher 4 months post-RT than baseline. Only the tone and elasticity of the affected PM were correlated with subjective symptoms. CONCLUSION In breast cancer patients who received RT after surgery, increased tone, stiffness, and decreased elasticity were observed in the affected PM compared with the unaffected side, which sustained four months post-RT. Change in muscle properties immediately after RT preceded subjective stiffness, which worsened significantly 4 months post-RT compared with baseline.
Collapse
Affiliation(s)
- Yoon Kim
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of Korea
| | - So Yeon An
- Center for Clinical Medicine, Samsung Biomedical Research Institute, Seoul, Republic of Korea
| | - Won Park
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Hye Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
| |
Collapse
|
4
|
Paluch Ł, Pietruski P, Noszczyk B, Kwiek B, Ambroziak M. Intra-rater reproducibility of shear wave elastography in the evaluation of facial skin. Postepy Dermatol Alergol 2020; 37:371-6. [PMID: 32792878 DOI: 10.5114/ada.2018.81144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 11/05/2018] [Indexed: 11/25/2022] Open
Abstract
Introduction Recently, esthetic medicine has been gaining its momentum worldwide, mostly due to the development of minimally invasive techniques. In our opinion, elastography can be a candidate for an objective quantitative method to evaluate facial skin condition. The aim of this study was to determine intra-rater reproducibility of shear wave elastography (SWE) in the evaluation of facial skin in patients qualified for minimally invasive nonsurgical facial rejuvenation treatment. Aim To determine intra-rater reproducibility of shear wave elastography (SWE) in the evaluation of facial skin in patients qualified for minimally invasive nonsurgical facial rejuvenation treatment. Material and methods The study included 57 women between 40 and 67 years of age (mean: 51.5 ±7.3 years). Prior to the laser treatment, all participants were subjected to ultrasonographic examination and elastography of the skin. Upon visualization of the area of interest, the thickness of the dermis, subcutaneous tissue and superficial muscular aponeurotic system (SMAS) in millimeters was measured. Then, SWE was performed. Results No statistically significant differences were found in intraclass coefficient values (ICC) for elastographic parameters of the skin on the right and left side of the face (0.953 ±0.001 vs. 0.953 ±0.001, p = 0.992). Moreover, no significant differences were observed in the ICC values for the SWE parameters of various skin layers: dermis, subcutaneous tissue and SMAS (0.945 ±0.001 vs. 0.953 ±.001 vs. 0.961 ±0.001, p = 0.597). Women with normal body weight and overweight did not differ significantly in terms of their elastographic parameters of facial skin. Conclusions Shear wave elastography is a reliable method for the evaluation of facial skin elasticity, providing highly reproducible results in all patients, regardless of their age and body weight.
Collapse
|
5
|
Drakonaki EE, Sudoł-Szopińska I, Sinopidis C, Givissis P. High resolution ultrasound for imaging complications of muscle injury: Is there an additional role for elastography? J Ultrason 2019; 19:137-144. [PMID: 31355586 PMCID: PMC6750326 DOI: 10.15557/jou.2019.0020] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/30/2019] [Indexed: 01/01/2023] Open
Abstract
Muscle healing after injury occurs within a period of weeks following a three-phase physiological process. Disruption of the normal healing process may lead to a number of complications, including excessive scar formation, myositis ossificans, muscle atrophy, muscle cysts and hernias. Complications of muscle injury are important because they may be symptomatic, are associated with high risk of re-injury and compromise muscle performance, thus delaying return to sporting activity and requiring special treatment. High-resolution ultrasound imaging equipped with high-frequency probes and advanced B-mode and Doppler technology has emerged as a promising modality for the diagnosis, grading and follow-up of muscle injury. Ultrasound allows imaging of minimal scar formation, early detection of myositis ossificans and cysts, and dynamic evaluation of small muscle hernias. Ultrasound imaging combined with strain and shear wave elastography can also provide information on the mechanical properties of intact and diseased muscle tissue, thus allowing assessment of muscle biomechanics in the clinical setting. This article reviews the histology and ultrasound appearance of normal and abnormal muscle healing with an emphasis on the sonographic appearances of muscle injury complications. It also discusses pitfalls, provides tips for an less experienced sonographer and presents the possible role of strain elastography in the diagnosis of complications, such as scar tissue.
Collapse
Affiliation(s)
| | - Iwona Sudoł-Szopińska
- National Institute of Geriatrics , Rheumatology and Rehabilitation , Warsaw , Poland
| | - Christos Sinopidis
- 1st Department of Orthopaedic Surgery, Medical School , University of Thessaloniki , Papanikolaoy Hospital , Thessaloniki , Greece
| | - Panagiotis Givissis
- 1st Department of Orthopaedic Surgery, Medical School , University of Thessaloniki , Papanikolaoy Hospital , Thessaloniki , Greece
| |
Collapse
|
6
|
Ambroziak M, Noszczyk B, Pietruski P, Guz W, Paluch Ł. Elastography reference values of facial skin elasticity. Postepy Dermatol Alergol 2019; 36:626-34. [PMID: 31839782 DOI: 10.5114/ada.2018.77502] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 07/08/2018] [Indexed: 12/16/2022] Open
Abstract
Introduction With an introduction of new ultrasonographic transducers, skin elastography may find an application in dermatology and aesthetic medicine enabling direct evaluation of various pathological or natural processes. Aim To verify which elastographic technique, strain elastography (SE) or shear wave elastography (SWE), is a better candidate for the reference method of facial skin elasticity examination and to determine normal ranges for elastographic parameters in various facial regions. Material and methods The study included 71 female volunteers (age: 40–67 years, mean: 52 ±7.5 years). All participants were subjected to SE and SWE of the skin in five anatomical regions: the forehead, suborbital regions, cheeks, nasolabial folds and chin. Reference ranges for elastographic parameters were defined as 95% confidence intervals and ±2 standard deviations and estimated by means of ROC analysis. Results Shear wave elastography parameters, but not SE indices, showed strong inverse correlations with the patient age. No significant correlations were found between SE and SWE parameters of the facial skin. In contrast to SWE, no significant correlations were observed between bilateral SE parameters. Based on these findings, SWE was chosen as the reference method to determine age-specific normative values for the elasticity of the facial skin. Reference and cut-off values of SWE parameters were defined for three age groups. Conclusions Shear wave elastography is suitable for the determination of elastographic parameters of normal facial skin, and can be used to determine reference ranges thereof. Elasticity of the facial skin decreases considerably with age, and this factor should be considered during determination of reference values for the elastographic parameters.
Collapse
|
7
|
Ambroziak M, Pietruski P, Noszczyk B, Paluch Ł. Ultrasonographic elastography in the evaluation of normal and pathological skin - a review. Postepy Dermatol Alergol 2019; 36:667-72. [PMID: 31997992 DOI: 10.5114/ada.2018.77069] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 06/19/2018] [Indexed: 11/17/2022] Open
Abstract
The aim of this review article is to discuss the role of ultrasonographic elastography, a technique used to quantify tissue stiffness, in the evaluation of normal and pathological skin. A growing body of evidence suggests that elastography may be used for the diagnosis and monitoring of skin pathologies, in particular tumors, and fibrotic and sclerotic processes. Our knowledge about the elastographic parameters of normal skin is sparse, which together with the lack of reference values for cutaneous stiffness constitutes a serious limitation to the use of elastography in some medical disciplines, including aesthetic medicine.
Collapse
|
8
|
Luciani BD, Desmet DM, Alkayyali AA, Leonardis JM, Lipps DB. Identifying the mechanical and neural properties of the sternocleidomastoid muscles. J Appl Physiol (1985) 2018; 124:1297-1303. [PMID: 29420159 DOI: 10.1152/japplphysiol.00892.2017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Neck muscles are preferentially activated in specific force directions, but the constraints that the central nervous system considers when programming these preferred directions of muscle activity are unknown. The current study used ultrasound shear wave elastography (SWE) to investigate whether the material properties of the sternocleidomastoid (SCM) muscles exhibit preferred directions similar to their preferred direction of muscle activity during an isometric task. Twenty-four healthy participants matched isometric forces in 16 axial directions. All force targets were scaled to 20% of a maximum voluntary contraction. Muscle activity was recorded with surface electromyography (EMG) from six muscles (the bilateral SCMs, upper trapezius, and splenius capitis muscles), and shear wave velocities (SWVs) were recorded with SWE from both SCM muscles. We observed statistically significant differences between the preferred directions of muscle activity and SWVs for both the left SCM ( P = 0.002) and the right SCM ( P < 0.001), with the SWE data exhibiting a more lateral preferred direction. Significant differences in the spatial focus ( P < 0.001) were also observed, with the dispersion of SWV data covering a greater angular range than the EMG data during isometric tasks. The preferred directions of muscle activity and material properties for the SCM muscles were closer than previous comparisons of muscle activity and moment arms, suggesting muscle mechanics could play a more important role than anatomy in how the central nervous system spatially tunes muscle activation. NEW & NOTEWORTHY Our study used a novel combination of surface electromyography and ultrasound shear wave elastography to investigate the neuromuscular control of the neck. Our work highlights differences in how the activation and material properties of the sternocleidomastoid muscles are modulated as the central nervous system stabilizes the neck during isometric force production. These findings provide normative data for future studies to investigate pathologic changes to both the activation and material properties of the sternocleidomastoid muscles.
Collapse
Affiliation(s)
| | - David M Desmet
- School of Kinesiology, University of Michigan , Ann Arbor, Michigan
| | | | | | - David B Lipps
- School of Kinesiology, University of Michigan , Ann Arbor, Michigan.,Department of Biomedical Engineering, University of Michigan , Ann Arbor, Michigan
| |
Collapse
|
9
|
Abstract
Congenital muscular torticollis (CMT) is characterized by shortening or excessive contraction of the sternocleidomastoid muscle (SCM). The main purpose of this study was to evaluate the feasibility of quantifying SCM stiffness using acoustic radiation force impulse (ARFI) sonoelastography in infants with CMT. Twenty infants with an SCM thickness greater than 10 mm with or without involvement of the entire SCM length (limitation of neck rotation passive range of motion [PROM]: group 1S >30°, group 1M = 15°-30°) and 12 infants with an SCM thickness smaller than 10 mm with or without involvement of any part of SCM (group 2) were included. The SCM thickness was measured using real time B-mode ultrasound, and the local SCM shear wave velocity (SWV) and subcutaneous fat layer using ARFI sonoelastography. The neck rotation PROM was significantly greater in group 1S (36.5° ± 5.3°) than in group 1M (18.8° ± 4.9°; P < .01); the SWV of the SCM in the affected side (2.96 ± 0.99 m/s) was significantly higher than that in the unaffected side (1.50 ± 0.30 m/s; P < .01) in group 1. The SWV of the SCM was significantly higher in group 1S than in group 1M. There was significant correlation between the degree of PROM deficit of neck rotation and the SWV of the affected SCM (r = .75; P < .01) in all infants. This study revealed a difference in the SWV of the affected SCM in relationship to the limitation of neck rotation PROM in infants with CMT, if there was no difference in SCM thickness among infants.
Collapse
|