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神经组织动员对乳腺癌伴淋巴水肿幸存者感觉运动障碍的影响:一项实验研究。

Effect of Neural Tissue Mobilization on Sensory-Motor Impairments in Breast Cancer Survivors with Lymphedema: An Experimental Study.

机构信息

Department of Musculoskeletal Sciences, Faculty of Physiotherapy, Krishna Institute of Medical Sciences, Deemed to Be University, Karad, Maharashtra, India.

Department of Musculoskeletal Physiotherapy, Krishna college of Physiotherapy, Krishna Institute of Medical sciences "Deemed To Be University", Karad, India.

出版信息

Asian Pac J Cancer Prev. 2023 Jan 1;24(1):313-319. doi: 10.31557/APJCP.2023.24.1.313.

Abstract

BACKGROUND

Breast surgery, Axillary Lymph Node Dissection (ALND), radiation and chemotherapy may develop several complications such as axillary web syndrome, frozen shoulder, numbness, shoulder pain and range of motion restriction, lymphostasis, and lymphedema. Up to 77% report sensory disturbance in the breast or arm after breast surgery. These short- and long-term consequences have dramatic impact on physical function and quality of life in this population.

AIMS

The aim of the study was to determine the effect of neural tissue mobilization on sensory-motor impairments in breast cancer survivors with lymphedema.

SUBJECTS AND METHODS

This study was carried out by analyzing total 100 breast cancer survivor women, with lymphedema aged between 30-65 years of age who had undergone breast surgery mostly lumpectomy along with chemotherapy or radiation therapy. Participants were divided into two groups by random allocation. One group underwent neurodynamic mobilization and the other group conventional physiotherapy.The treatment protocol was given for 6 weeks. Parameters such ROM, pain, lymphedema and sensory-motor impairments were assessed at the baseline before the treatment and 6 weeks after the treatment.

RESULT

The result from this study shows that there is significant improvement (p<0.0001, t-value 4.69) in mTNS of patients undergoing neural tissue mobilization,whereas there was no significant improvement (p=0.05, t-value 1.951) seen in patients undergoing conventional physiotherapy.

CONCLUSION

This study concludes that effect of neural tissue mobilization has significant impact on sensory motor impairments as compared to conventional treatment protocol in breast cancer survivors with lymphedema.Pain and ROM showed similar difference with both the treatment protocols. It was also observed that patients with mild and moderate lymphedema showed significant improvement as compared to patients with severe lymphedema.

摘要

背景

乳房手术、腋窝淋巴结清扫术(ALND)、放疗和化疗可能会引发多种并发症,如腋网综合征、冻结肩、麻木、肩部疼痛和活动范围受限、淋巴水肿和淋巴水肿。高达 77%的患者在乳房手术后报告乳房或手臂感觉障碍。这些短期和长期后果对该人群的身体功能和生活质量有显著影响。

目的

本研究旨在确定神经组织动员对乳腺癌幸存者伴淋巴水肿的感觉运动障碍的影响。

受试者和方法

本研究通过分析总共 100 名年龄在 30-65 岁之间的乳腺癌幸存者女性,她们因接受乳房手术(大多为保乳手术)而患有淋巴水肿,同时接受化疗或放疗。参与者通过随机分配分为两组。一组接受神经动力学动员,另一组接受常规物理治疗。治疗方案持续 6 周。在治疗前和治疗 6 周后评估 ROM、疼痛、淋巴水肿和感觉运动障碍等参数。

结果

本研究结果表明,接受神经组织动员的患者 mTNS 有显著改善(p<0.0001,t 值 4.69),而接受常规物理治疗的患者则没有显著改善(p=0.05,t 值 1.951)。

结论

本研究得出结论,与常规治疗方案相比,神经组织动员对乳腺癌幸存者伴淋巴水肿的感觉运动障碍有显著影响。疼痛和 ROM 与两种治疗方案都显示出类似的差异。还观察到轻度和中度淋巴水肿患者的改善明显优于重度淋巴水肿患者。

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