Brookham Rebecca L, Cudlip Alan C, Dickerson Clark R
Department of Kinesiology, University of Waterloo, 200 University Avenue W, Waterloo, ON N2L 3G1, Canada.
Department of Kinesiology, University of Waterloo, 200 University Avenue W, Waterloo, ON N2L 3G1, Canada.
Clin Biomech (Bristol). 2018 Feb;52:7-13. doi: 10.1016/j.clinbiomech.2017.12.011. Epub 2017 Dec 29.
Upper limb morbidities within the breast cancer population can interfere with completing daily life activities. Current knowledge of upper limb capabilities is limited; previous increases in muscle activation on the affected cancer side suggest this population works at a higher fraction of their capability. The purposes of this study were to describe upper limb capabilities and dysfunction of breast cancer survivors through muscle activation monitoring via surface electromyography and muscle-specific strength tests during functional tasks.
Fifty survivors performed 88 dynamic tasks (divided into range of motion-reach or rotate, activities of daily life and work tasks). Muscle activation was examined for functional and strength testing tasks.
Total muscle effort (summation of integrated electromyography across measured muscles) was up to 5.1% greater on the affected side during work tasks (p=0.0258). Increased activations existed in posterior deltoid, supraspinatus, upper trapezius and serratus anterior (p<0.05) for several tasks, including daily living tasks. Reduced activation occurred in affected pectoralis major sternal during all tasks (p<0.0001-0.0032), and affected infraspinatus in all but daily living tasks (p=0.0002-0.0328). The affected side infraspinatus, supraspinatus and upper trapezius muscles demonstrated significant reductions in targeted strength testing (p=0.0001-0.0057).
Both primary and secondary muscles (outside surgery and radiation fields) were affected. In general, this population works at higher levels of muscle effort for the affected side yet demonstrates weakness in strength testing, which may reflect tissue damage. Strengthening exercises for the posterior rotator cuff and upper trapezius may be the most beneficial.
乳腺癌患者的上肢疾病会干扰日常生活活动的完成。目前对上肢能力的了解有限；先前受影响癌症侧肌肉激活的增加表明该人群在其能力的更高比例下工作。本研究的目的是通过在功能任务期间通过表面肌电图和特定肌肉力量测试监测肌肉激活来描述乳腺癌幸存者的上肢能力和功能障碍。
50名幸存者执行了88项动态任务（分为运动范围 - 伸展或旋转、日常生活活动和工作任务）。对功能和力量测试任务进行肌肉激活检查。
在工作任务期间，患侧的总肌肉努力（测量肌肉的肌电图积分总和）比健侧高5.1%（p = 0.0258）。包括日常生活任务在内的多项任务中，三角肌后部、冈上肌、斜方肌上部和前锯肌的激活增加（p < 0.05）。在所有任务中，患侧胸大肌胸骨部的激活减少（p < 0.0001 - 0.0032），除日常生活任务外，患侧冈下肌在所有任务中的激活减少（p = 0.0002 - 0.0328）。患侧冈下肌、冈上肌和斜方肌上部在目标力量测试中表现出显著降低（p = 0.0001 - 0.0057）。
主要和次要肌肉（手术和放疗区域以外）均受到影响。总体而言，该人群患侧的肌肉努力水平较高，但在力量测试中表现出虚弱，这可能反映了组织损伤。对肩袖后束和斜方肌上部进行强化锻炼可能最有益。
