Evaluation of arm and shoulder mobility and strength after modified radical mastectomy and radiotherapy

Abstract

Seventy-five women, of whom 30 had received postoperative radiotherapy, were tested for range of motion (ROM) and shoulder strength with a goniometer and an isokinetic device (Orthotron II), respectively. On the individual level, irradiated patients exhibited significantly reduced range of motion (varying from p < 0.05 to p < 0.001) for all movements compared with the non-operated side. In contrast, in the non-irradiated patients only flexion was significantly reduced (p < 0.05). The same individual pattern was evident for shoulder strength where all movements except external rotation were significantly reduced in irradiated patients (varying from p < 0.05 to p < 0.001). Non-irradiated patients exhibited a significant reduction in shoulder strength for flexion and abduction (p < 0.05), whereas other movements were less affected. The observed differences in ROM and strength were less pronounced when analyzed on a group level, but were still significant for ROM (p < 0.001) for flexion and abduction. Group level analysis also showed reduced shoulder strength for all movements but only rotation was significantly (p < 0.01) impaired.

Efficacy of shoulder exercises on locoregional complications in women undergoing radiotherapy for breast cancer: clinical trial

“…Blomqvist et al 17 evaluated 75 women who had undergone modified radical mastectomy (30 of them received RT) and found that radiation was the greatest cause of impaired ROM. These investigators concluded that patients undergoing RT should be PG: Physical therapy Group; CG: Control Group.…”

“…The segment undergoing evaluation needed to be in the anatomical position, with the proximal segment stabilized so as to permit only the desired joint motion. The women were asked to perform active motion so as to reach the greatest range possible, and the angles were recorded in degrees 17,19 .…”

“…The relevance of physical therapy following breast cancer surgery has been well documented in the literature 3,14,15 , although adequate programs and the timing of postoperative exercises have yet to be established 5 . However, despite the known physical complications resulting from RT, women are usually not provided with physical therapy during RT 10,11,16,17 . The hypothesis of this study was that the adoption of a rehabilitation program during RT could minimize its biological effect, with consequent functional improvement.…”

The Orthopedic Burden of U.S. Cancer Care

“…Additionally, strength was found to be diminished on the operative side, worse when combined with radiation therapy [56,57]. In addition to upper extremity complications, postural effects commonly ensue, and postural failures are seen in 83% of breast cancer survivors as a result of treatment [58].…”

Three Versus Six Months of Exercise Training in Breast Cancer Survivors

“…Surgical treatment and radiation can result in significant upper body limitations [3][4][5] including impaired range of motion [6,7], reduction in muscle activity [8], and the development of lymphedema [9] which can lead to a reduction in quality of life and psychological distress [10]. Chemotherapy is commonly used as an adjuvant treatment to reduce the likelihood of metastasis [2].…”