Üst ekstremite kas gücü lenfödemden etkilenir mi? Omuz, dirsek ve el bileği fleksör ve ekstansör kas gruplarının değerlendirilmesi
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Date
2023
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Trakya Üniversitesi Sağlık Bilimleri Enstitüsü
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info:eu-repo/semantics/openAccess
Abstract
Meme kanseri tedavisi sonrası gelişen lenfödem, etkilenen ekstremitenin kas gücünün azalmasına yol açabilmektedir. Çalışmamızın amacı meme kanseri tedavisi sonrası gelişen lenfödemin, etkilenen üst ekstremite kas güçlerine etkisini araştırmaktı. Hastalarımıza; lenfödem evrelemesi, Edinburgh el tercih anketi, Vizüel analog skala, Fiziksel Aktivite Anketi (Kısa Formu), dijital gonyometre ile eklem hareket açıklığı ölçümü, Hand-held dinamometresi ile kas gücü değerlendirilmesi yapıldı. Tümü sağ üst ekstremitesi dominant, yaş ortalaması 60.80±9.46 olan meme kanserine bağlı tek taraflı lenfödeme sahip 31 kadın hastanın dahil edildiği çalışmamızda omuz fleksiyon ve ekstansiyonu ile dirsek fleksiyonu etkilenen ekstremitede daha güçsüz saptandı. Hastalar lenfödemin sağ veya sol taraflı olmasına göre gruplandırıldığında, sol taraflı lenfödem (%71) hastalarında omuz fleksiyon ve ekstansiyonu ile dirsek fleksiyonu etkilenen tarafta daha güçsüzken, sağ taraflı lenfödem (%29) hastalarındaysa iki ekstremite arasında kas güçleri açısından anlamlı fark saptanmadı. Diğer taraftan sağ ve sol taraflı lenfödem hastaları kas gücü farkının yüzdesel değerleri açısından benzer değerlere sahip olmakla birlikte omuz fleksiyonu kas gücü farkı yüzdesi hem sağ hem de sol taraflı lenfödem hastalarında klinik olarak anlamlı kabul edilen %10 değerinin üzerindeydi. Ek olarak hastalarımızda etkilenmiş ekstremiteye omuz fleksiyon ve ekstansiyonu etkilenmemiş ekstremiteye kıyasla daha kısıtlıydı. Çalışmamız üst ekstremite lenfödeminin, omuz fleksiyon ve ekstansiyon eklem hareket açıklığı ve kas gücü ile dirsek fleksiyon kas gücünde azalmaya neden olduğu, hem sağ hem de sol taraflı lenfödem hastalarında iki ekstremite arasında omuz fleksiyon kas gücündeki azalmanın klinik olarak anlamlı olduğu ve kas gücü farkı yüzdesinde ekstremite dominansının önemi olmadığını göstermiştir. Çalışmamızın lenfödem hastalarının değerlendirilme ve rehabilitasyon protokollerinin planlanmasında yol gösterici olacağı kanaatindeyiz.
Lymphedema that develops after breast cancer treatment can lead to decreased muscle strength of the affected extremity. The aim of our study was to investigate the effect of lymphedema developing after breast cancer treatment on the affected upper extremity muscle strength. Lymphedema staging, Edinburgh hand preference questionnaire, Visual analog scale, Physical Activity Questionnaire (Short Form), joint range of motion measurement with digital goniometer, muscle strength evaluation with hand-held dynamometer were performed to all participants. In our study, which included 31 female patients with unilateral lymphedema due to breast cancer, all with right dominant extremity and a mean age of 60.80±9.46 years, strenghts of shoulder flexion and extension and elbow flexion were found to be lower in the affected extremity. When the patients were grouped according to right-sided or left-sided lymphedema, left-sided lymphedema patients (71%) had lower shoulder flexion and extension and elbow flexion strenghts on the affected side, whereas right-sided lymphedema (29%) patients was no significant difference in muscle strength between the two extremities. On the other hand, although right and left-sided lymphedema patients had similar values in terms of percentile muscle strength difference, the percentage of shoulder flexion muscle strength difference was above 10%, which was considered clinically significant in both right and left-sided lymphedema patients. In addition, in participants shoulder flexion and extension in the affected extremity were more limited compared to the unaffected extremity. In our study, it was observed that upper extremity lymphedema caused a decrease in shoulder flexion and extension joint range of motion, muscle strength and elbow flexion muscle strength. It has been shown that the decrease in shoulder flexion muscle strength between the two extremities is clinically significant in both right and left sided lymphedema patients and that extremity dominance is not important in the percentage of muscle strength difference. We believe that our study will shed light on the evaluation and planning of rehabilitation protocols for lymphedema patients.
Lymphedema that develops after breast cancer treatment can lead to decreased muscle strength of the affected extremity. The aim of our study was to investigate the effect of lymphedema developing after breast cancer treatment on the affected upper extremity muscle strength. Lymphedema staging, Edinburgh hand preference questionnaire, Visual analog scale, Physical Activity Questionnaire (Short Form), joint range of motion measurement with digital goniometer, muscle strength evaluation with hand-held dynamometer were performed to all participants. In our study, which included 31 female patients with unilateral lymphedema due to breast cancer, all with right dominant extremity and a mean age of 60.80±9.46 years, strenghts of shoulder flexion and extension and elbow flexion were found to be lower in the affected extremity. When the patients were grouped according to right-sided or left-sided lymphedema, left-sided lymphedema patients (71%) had lower shoulder flexion and extension and elbow flexion strenghts on the affected side, whereas right-sided lymphedema (29%) patients was no significant difference in muscle strength between the two extremities. On the other hand, although right and left-sided lymphedema patients had similar values in terms of percentile muscle strength difference, the percentage of shoulder flexion muscle strength difference was above 10%, which was considered clinically significant in both right and left-sided lymphedema patients. In addition, in participants shoulder flexion and extension in the affected extremity were more limited compared to the unaffected extremity. In our study, it was observed that upper extremity lymphedema caused a decrease in shoulder flexion and extension joint range of motion, muscle strength and elbow flexion muscle strength. It has been shown that the decrease in shoulder flexion muscle strength between the two extremities is clinically significant in both right and left sided lymphedema patients and that extremity dominance is not important in the percentage of muscle strength difference. We believe that our study will shed light on the evaluation and planning of rehabilitation protocols for lymphedema patients.
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Keywords
Lenfödem, Kas gücü, Üst ekstremite, Ekstremite dominansı, Lymphedema, Muscle strength, Upper extremity, Extremity dominance
