Turkish Journal of Physical Medicine and Rehabilitation 2001 , Vol 47 , Num 1

Meme Cerrahisi ve Aksiller Diseksiyon Uygulanan Hastalarda Üst Ekstremite Musküloskeletal Problemleri

Barın Selçuk 1 ,Meltem Dalyan 2 ,Murat İnanır 3 ,Müfit Akyüz 4 ,Aytül Çakcı 5
1 Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, 1. Fizik Tedavi ve Rehabilitasyon Kliniği, Ankara
2 Ankara Fizik Tedavi ve Rehabilitasyon Merkezi, Ankara
3 Department of Physical Medicine and Rehabilitation, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
4 Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, Ankara, Türkiye
5 Sağlık Bakanlığı Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, Türkiye

Musculoskeletal Problems of Upper Extremities in Patients with Mastectomy and Axillary Dissection Breast cancer is the commenest cancer type of all among women. It leads decrease in range of motion, pain, dissestesia, tenderness and lympedema as most common upper extremity morbities; and causes important functional disabilities especially in fertil women and a vast quantity of economic losses. In this study, by defining upper extremity problems affected by surgery in patients with breast cancer, 96 women, age varying between 24 to 76, have been evaluated to investigate the association of those problems with patients demographic status and their illness. Patients have been evaluated for pain, tenderness, functional shoulder status, range of motion of shoulder and upper extremity and edema that were considered as upper extremity morbitidies. It has been founded that there had been at least one upper extremity problem like ROM limitation, edema, pain, tenderness and dissestesia in 84 (87.5%) patients. In 78 (%81.3%) patients, there have been limitations in flexion and abduction of the shoulder. There had been dissestesia in 76(79.2%) patients and tenderness in 78 (81.3%) patients. Of 96 patients, all showed pain at upper extremities and score of VAS was over 3.5 in 58 (60.4%) patients. The differences in arm circumferencial measurements between two upper extremities were found over 1.5 cm in 38 (39.6%) patients and this was accepted as lympedema. It was showed that there were no association between upper extremity problems and type of surgery, number of metastatic lymph node and other medical treatments (Radyotherapy, chemotherapy, hormone replacement therapy). While the patients that were given an exercise program showed an at least one upper extremity problem at a ratio of 64.7%, the patients that were not given an exercise program showed an at least one upper extremity promlems at a ratio of 100% (p<0.01).

Keywords : reast cancer, mastectomy, rehabilitation, shoulder, lympedema