Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil; Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.
J Bodyw Mov Ther. 2024 Jan;37:177-182. doi: 10.1016/j.jbmt.2023.11.055. Epub 2023 Nov 30.
Lymphedema in the upper limb as a complication of breast cancer may lead to shoulder pain and dysfunctions.
To compare the scapular positioning, the shoulder range of motion, and muscle strength among women undergoing treatment for breast cancer with and without lymphedema and a control group.
This cross-sectional study evaluated women undergoing treatment for breast cancer (N = 25) and without lymphedema (N = 25), and a control group (N = 25). Static scapular positions and shoulder range of motion were measured by using an inclinometer. The shoulder and periscapular muscle strength were measured by using a hand-held dynamometer and the Disabilities of the Arm, Shoulder, and Hand Questionnaire was applied. Linear regression of the mixed effects model was used to compare the groups.
Both groups of mastectomized women had reduced shoulder range of motion, scapular upward rotation, and muscle strength for shoulder and periscapular muscles compared to the control group. Also, women undergoing treatment for breast cancer with lymphedema had reduced shoulder range of motion, scapular upward rotation, increased anterior tilt, reduced muscle strength of the upper trapezius, and greater upper limb disability compared to women without lymphedema.
Women undergoing treatment for breast cancer with lymphedema had even greater shoulder and scapulothoracic impairments when compared to the control group and women without lymphedema.
乳腺癌引起的上肢淋巴水肿可能导致肩部疼痛和功能障碍。
比较乳腺癌伴或不伴淋巴水肿患者与对照组女性的肩胛骨位置、肩部活动范围和肌肉力量。
本横断面研究评估了接受乳腺癌治疗的女性（N=25）和无淋巴水肿的女性（N=25）以及对照组（N=25）。使用测斜仪测量静态肩胛骨位置和肩部活动范围。使用手持测力计测量肩部和肩胛间肌肉力量，并应用上肢残疾问卷。使用混合效应模型的线性回归比较组间差异。
与对照组相比，两组乳腺癌根治术后女性的肩部活动范围、肩胛骨上旋和肩部及肩胛间肌肉力量均降低。此外，与无淋巴水肿的乳腺癌患者相比，患有淋巴水肿的乳腺癌患者的肩部活动范围、肩胛骨上旋、前倾斜增加、上斜方肌力量减弱以及上肢残疾程度更大。
与对照组和无淋巴水肿的乳腺癌患者相比，患有淋巴水肿的乳腺癌患者的肩部和肩胛胸壁功能障碍更为严重。
