Abstract
In this study, four major muscles acting on the scapula were investigated in patients who had been treated in the last six years for unilateral carcinoma of the breast. Muscle activity was assessed by electromyography during abduction and adduction of the affected and unaffected arms. The main principal aim of the study was to compare shoulder muscle activity in the affected and unaffected shoulder during elevation of the arm. A multivariate linear mixed model was introduced and applied to address the principal aims. The result of fitting this model to the data shows a huge improvement as compared to the alternatives.
Highlights
Wide local excision (WLE) with adjuvant radiotherapy is the standard treatment of breast cancer
Contrariwise, the effect of affected shoulder and unaffected shoulder cannot be modelled by considering only different intercepts for affected/unaffected shoulder. This is due to the fact that some of the risk factors are specific to the affected shoulder, such as physiotherapy and exercise
* Interaction with affected side, ** Only on affected side. This model suggests that humeral elevation of the arm, the upwards move, affected side and left shoulder will increase the electrical activity generally for all four muscles irrespective of which side is affected, whilst treatment with wide local excision and receiving chemotherapy are associated with generally decreased electrical activity
Summary
Wide local excision (WLE) with adjuvant radiotherapy is the standard treatment of breast cancer. EMG readings readings at at each each elevation point was taken as a response (dependent) variable for each patient. Bilateral EMG measurements of the four shoulder muscles were taken for each patient. EMG measurements of the four shoulder muscles were taken for each patient. EMG ismeasures were obtained (one for each ofofthe fourelevation muscles), creating potentially muscle recorded in millivolts (mV) at 10° increments humeral during upward andor downward arm movement. Summarised, correlated, repeatedly measuredofresponses forare eachand 150 ̋ , this figure represents the observations for an upward arm humeral elevation between shoulder and each movement were generated. 10° and 150°,shows this figure represents thereading observations for angiven upward movement the left arm This graph clearly that the EMG at each point very arm movement of the left arm.
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