Angin Salih, Karadibak Didem, Yavuzşen Tuğba, Demirbüken Ilkşan
Dokuz Eylül University, School of Physical Therapy and Rehabilitation, Sağlık Kampusü, Izmir, Turkey.
Contemp Oncol (Pozn). 2014;18(4):279-84. doi: 10.5114/wo.2014.44120. Epub 2014 Jul 22.
There is little known about any change in postural balance caused by asymmetrical volume increase due to unilateral upper extremity lymphedema in patients who underwent breast surgery. The aim of this study was to determine whether there is a change in postural balance by measuring postural sway velocity (PSV), center of gravity (CoG) displacement and directional control (DCL) in patients with unilateral upper extremity lymphedema in breast cancer survivors.
Eighteen females 38-60 (M = 53) years old diagnosed with upper extremity lymphedema due to breast cancer surgery, and 18 healthy females with similar ages (M = 52.5) were assessed using the Balance Master system (Neuro Com, Clackamas, USA). Unilateral stance (US) and bilateral stance (BS) tests in eyes open and closed conditions and the limit of stability (LOS) test were applied to quantify postural sway velocity (PSV), CoG displacement, and directional control (DCL).
The lymphedema group showed a significant increase in PSV in the US test on the ipsilateral leg with eyes open (p = 0.02) and eyes closed (p = 0.005) as well as on the contralateral leg with eyes open (p = 0.004) and eyes closed (p = 0.0001). Average displacement and position of the CoG were 25% of LOS (p = 0.0001) towards the lymphedema side and 60.6 degrees respectively. DCL in the lymphedema group was significantly lower in forward (p = 0.0001), back (p = 0.003), ipsilateral (p = 0.002), and contralateral (p = 0.03) directions.
These findings suggest that unilateral upper extremity lymphedema may have challenging effects on postural balance.
对于接受乳房手术的患者，因单侧上肢淋巴水肿导致的不对称体积增加所引起的姿势平衡变化，人们了解甚少。本研究的目的是通过测量乳腺癌幸存者单侧上肢淋巴水肿患者的姿势摇摆速度（PSV）、重心（CoG）位移和方向控制（DCL），来确定姿势平衡是否发生变化。
使用平衡大师系统（美国克拉克马斯Neuro Com公司）对18名年龄在38 - 60岁（平均年龄53岁）、因乳腺癌手术诊断为上肢淋巴水肿的女性，以及18名年龄相仿（平均年龄52.5岁）的健康女性进行评估。应用睁眼和闭眼条件下的单侧站立（US）和双侧站立（BS）测试以及稳定性极限（LOS）测试，以量化姿势摇摆速度（PSV）、重心位移和方向控制（DCL）。
淋巴水肿组在睁眼（p = 0.02）和闭眼（p = 0.005）时，患侧腿在US测试中的PSV显著增加，在睁眼（p = 0.004）和闭眼（p = 0.0001）时，对侧腿的PSV也显著增加。重心的平均位移和位置分别为向淋巴水肿侧的LOS的25%（p = 0.0001）和60.6度。淋巴水肿组在向前（p = 0.0001）、向后（p = 0.003）、同侧（p = 0.002）和对侧（p = 0.03）方向的DCL显著降低。
这些发现表明，单侧上肢淋巴水肿可能对姿势平衡产生具有挑战性的影响。
