Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California.
Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama.
Phys Ther. 2019 Oct 28;99(10):1334-1345. doi: 10.1093/ptj/pzz096.
Adverse upper limb musculoskeletal effects occur after surgical procedures and radiotherapy for breast cancer and can interfere with activities of daily living.
The objective of this study was to examine the effects of a 16-week exercise intervention on shoulder function in women who are overweight or obese and have breast cancer.
This study was a randomized controlled trial.
The study was performed at the Division of Biokinesiology and Physical Therapy at the University of Southern California.
One hundred women with breast cancer were randomly allocated to exercise or usual-care groups. The mean (SD) age of the women was 53.5 (10.4) years, 55% were Hispanic white, and their mean (SD) body mass index was 33.5 (5.5) kg/m2.
The 16-week exercise intervention consisted of supervised, progressive, moderate to vigorous aerobic and resistance exercise 3 times per week.
Shoulder active range of motion, isometric muscular strength, and patient-reported outcome measures (including Disabilities of the Arm, Shoulder, and Hand and the Penn Shoulder Scale) were assessed at baseline, after the intervention, and at the 3-month follow-up (exercise group only). Differences in mean changes for outcomes were evaluated using mixed-model repeated-measures analysis.
Compared with the usual-care group, the exercise group experienced significant increases in shoulder active range of motion (the mean between-group differences and 95% confidence intervals (CIs) were as follows: shoulder flexion = 36.6° [95% CI = 55.2-20.7°], external rotation at 0° = 23.4° [95% CI = 31.1-12.5°], and external rotation at 90° = 34.3° [95% CI = 45.9-26.2°]), improved upper extremity isometric strength, and improved Disabilities of the Arm, Shoulder, and Hand and Penn Shoulder Scale scores.
Limitations include a lack of masking of assessors after the intervention, an attention control group, and statistical robustness (shoulder function was a secondary end point).
A 16-week exercise intervention effectively improved shoulder function following breast cancer treatment in women who were overweight or obese, who were ethnically diverse, and who had breast cancer.
乳腺癌手术后和放疗后会出现上肢肌肉骨骼不良影响，从而干扰日常生活活动。
本研究旨在探讨 16 周运动干预对超重或肥胖乳腺癌女性肩部功能的影响。
这是一项随机对照试验。
该研究在南加州大学生物运动学和物理治疗系进行。
100 名乳腺癌女性被随机分配到运动组或常规护理组。女性的平均（标准差）年龄为 53.5（10.4）岁，55%为西班牙裔白人，平均（标准差）体重指数为 33.5（5.5）kg/m2。
16 周的运动干预包括监督、渐进、适度至剧烈的有氧和阻力运动，每周 3 次。
在基线、干预后和 3 个月随访（仅运动组）时评估肩部主动活动范围、等长肌肉力量和患者报告的结局测量（包括上肢功能障碍、肩手量表和宾夕法尼亚肩量表）。使用混合模型重复测量分析评估结局的平均变化差异。
与常规护理组相比，运动组的肩部主动活动范围显著增加（组间差异的平均值和 95%置信区间（CI）如下：肩部前屈=36.6°[95%CI=55.2-20.7°]，外旋 0°=23.4°[95%CI=31.1-12.5°]，外旋 90°=34.3°[95%CI=45.9-26.2°]），上肢等长力量提高，上肢功能障碍、肩手量表和宾夕法尼亚肩量表评分改善。
局限性包括干预后评估者缺乏掩蔽、无注意对照组以及统计稳健性（肩部功能是次要终点）。
16 周运动干预可有效改善超重或肥胖、种族多样化且患有乳腺癌女性乳腺癌治疗后的肩部功能。
