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乳腺癌幸存者颈肩区域的压痛敏感性图谱

Pressure Pain Sensitivity Maps of the Neck-Shoulder Region in Breast Cancer Survivors.

作者信息

Caro-Morán Elena, Fernández-Lao Carolina, Díaz-Rodríguez Lourdes, Cantarero-Villanueva Irene, Madeleine Pascal, Arroyo-Morales Manuel

机构信息

*Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.

Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada, Granada, Spain.

出版信息

Pain Med. 2016 Oct;17(10):1942-1952. doi: 10.1093/pm/pnw064. Epub 2016 Apr 25.

Abstract

OBJECTIVE

The aim of the present study was to report pressure pain sensitivity topographical maps of the frontal and dorsal parts of the shoulder region, and locate the pressure pain sensitive areas in breast cancer survivors compared with matched healthy control subjects.

METHODS

Twenty-two breast cancer survivors (BCS) and 22 matched control subjects participated. A numeric pain rating scale of the neck-shoulder area and pressure pain thresholds (PPTs) was assessed bilaterally over 28 points in the frontal and dorsal neck-shoulder area. Topographical pain sensitivity maps of the upper trapezius, pectoral, and anterior deltoid areas were computed.

RESULTS

A three-way analysis of variance was carried out to evaluate the differences in PPTs. The BCS reported spontaneous neck pain (mean ± SD 3.6 ± 2.8), pain in the affected shoulder (4.3 ± 2.7), and pain in the non-affected shoulder (0.9 ± 1.8). Additionally, the BCS exhibited bilaterally lower PPTs in all the measurement points as compared with the control subjects (P < 0.05). The PPTs were lower at the superior part of the trapezius muscle (P < 0.001), the musculotendinous insertion, the anterior part of the deltoid muscle (P < 0.001), and the tendon of the pectoral muscle (P < 0.001) as compared with the control subjects.

CONCLUSIONS

The results suggest the sensitization processes in the BCS and give preliminary evidence to most sensitive areas in the superior part of the upper trapezius and musculotendinous insertion of the pectoral muscle.

摘要

目的

本研究旨在报告肩部区域额部和背部的压力疼痛敏感性地形图,并确定与匹配的健康对照受试者相比,乳腺癌幸存者的压力疼痛敏感区域。

方法

22名乳腺癌幸存者(BCS)和22名匹配的对照受试者参与了研究。通过数字疼痛评分量表评估颈肩区域,并双侧测量颈肩区域额部和背部28个点的压力疼痛阈值(PPT)。计算上斜方肌、胸肌和三角肌前部区域的疼痛敏感性地形图。

结果

进行了三因素方差分析以评估PPT的差异。BCS报告有自发性颈部疼痛(平均±标准差3.6±2.8)、患侧肩部疼痛(4.3±2.7)和未患侧肩部疼痛(0.9±1.8)。此外,与对照受试者相比,BCS在所有测量点的双侧PPT均较低(P<0.05)。与对照受试者相比,斜方肌上部(P<0.001)、肌腱附着处、三角肌前部(P<0.001)和胸肌腱(P<0.001)的PPT较低。

结论

结果表明BCS存在致敏过程,并初步证明了上斜方肌上部和胸肌肌腱附着处是最敏感的区域。

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