Fischer Maarten J, Krol-Warmerdam Elly M M, Ranke Gemma M C, Vermeulen Henricus M, Van der Heijden Joke, Nortier Johan W R, Kaptein Adrian A
a Department of Clinical Oncology, Leiden University Medical Center , Leiden , The Netherlands.
J Psychosoc Oncol. 2015;33(3):278-96. doi: 10.1080/07347332.2015.1020465.
Axillary lymph node dissection and axillary radiation as part of breast cancer treatment often result in arm and shoulder morbidity and limitations in daily functioning. Over and above the general benefits for cardiorespiratory fitness, Nordic Walking particularly targets at the muscles of the upper extremities and shoulder. This may increase shoulder range of motion and lead to a reduction in functional limitations. The aim of this study was to offer a Nordic Walking intervention to women after treatment for breast cancer and to investigate changes in subjective well-being and shoulder function. Three supervised Nordic Walking courses were organized (2009-2011). The intervention consisted of ten weekly 1-hour sessions focusing on upper body strength and condition. In total, 28 women participated in one of the cohorts. Results showed that after 10 weeks, patients' vitality had improved, whereas perceived shoulder symptom severity and limitations in daily activities had decreased. Goniometric data indicated that range of motion (forward flexion, abduction, and external rotation) of the affected shoulder improved significantly within 10 weeks of training. Group interviews at 6 months follow-up confirmed that patients had appreciated the physical and psychosocial benefits of the intervention. These benefits outweighed the practical disadvantages. Patient selection, assessment and training should take place under (para-)medical supervision and group instructors should have the knowledge and skills to work with a group of recent cancer survivors. Results from this explorative study suggest that Nordic Walking is a feasible and potentially valuable tool in the rehabilitation of patients with breast cancer.
作为乳腺癌治疗的一部分，腋窝淋巴结清扫术和腋窝放疗常常导致手臂和肩部出现病变，并限制日常活动功能。除了对心肺健康具有普遍益处外，越野行走特别针对上肢和肩部肌肉。这可能会增加肩部活动范围，并减少功能限制。本研究的目的是为乳腺癌治疗后的女性提供越野行走干预，并调查她们主观幸福感和肩部功能的变化。组织了三期有指导的越野行走课程（2009 - 2011年）。干预包括为期十周、每周一次、每次1小时的课程，重点在于上身力量和身体状况。共有28名女性参与了其中一组。结果显示，10周后，患者的活力有所改善，而感觉到的肩部症状严重程度和日常活动受限情况有所减轻。角度测量数据表明，在训练的10周内，患侧肩部的活动范围（前屈、外展和外旋）显著改善。在6个月随访时进行的小组访谈证实，患者认识到了该干预在身体和心理社会方面带来的益处。这些益处超过了实际存在的不利之处。患者的选择、评估和训练应在（准）医疗监督下进行，并且小组指导员应具备与一群近期癌症幸存者合作的知识和技能。这项探索性研究的结果表明，越野行走是乳腺癌患者康复过程中一种可行且可能有价值的工具。
