Effect of Eight Weeks of Yoga on Range of Motion of Shoulder Joint in Breast Cancer Women with Mastectomy

Introduction: Lifestyle and the constant use of communication technologies have led to the upper crossed syndrome. The purpose of this study was to investigate of the effect of comprehensive corrective exercises carried out in water on pain, neck flexors muscles endurance and neck and upper extremity Range of Motion (ROM) in the patients with upper crossed syndrome (UCS). Methods: In this semi-experimental study, after initial screening, 30 students with upper crossed syndrome were selected and assigned randomly into experimental (n=14) and control (n=16) groups. Before and after the intervention, measurements performed to measure the level of pain by VAS scale, neck and shoulder ROM by inclinometer and neck flexors endurance by deep neck flexors endurance test. To analyze the data, SPSS Inc., Chicago, IL; version 18 software was used. The significance level was 0.05. Paired sample t-test was used to compare the mean of the pretest to posttest and independent t-test was used to compare the differences between groups. Results: The experimental group had significant improvement for endurance of neck flexors (P< 0.0001), neck ROM (P< 0.0001), shoulder ROM (P< 0.0001) and neck pain (P< 0.0001). Moreover, the results showed that there were significant differences for endurance of neck flexors (P< 0.0001), neck ROM (P< 0.0001), shoulder ROM (P< 0.0001), and neck pain (P< 0.0001) between groups. Conclusion: According to the results, we can say using water-based corrective exercises could have additional effect on increasing muscles endurance, upper extremity ROM and pain reduction in the patients with upper crossed syndrome, and could be as an effective method for the specialist

Breast cancer chemoprevention: little progress in practice?

Mammography for Older Women?

This study evaluated the hypothesis that upper extremity function and range of motion can be quantified reliably in children with cerebral palsy (CP) in a busy clinical setting. The specific aim was to determine the inter- and intrarater reliability of a modified House Functional Classification (MHC) system to evaluate upper extremity function and a standardized instrument to document upper extremity range of motion (Upper Extremity Rating Scale [UERS]). Sixty-five children with CP (43 males, 22 females, mean age 9y 2mo, SD 4y 1mo) with spasticity involving the upper extremity (quadriplegia n=22; hemiplegia n=36; diplegia n=7; Gross Motor Functional Classification System Levels I n=41, II n=6, III n=3, IV n=5, V n=10) were evaluated independently by occupational therapists and orthopedic surgeons using both instruments at several visits. Inter- and intrarater reliability were determined for both instruments by calculating measures of agreement (weighted kappa values and intraclass correlation coefficients [ICCs]). Interrater agreement (ICC=0.94) and intrarater agreement (ICC=0.96) on the MHC were good to excellent. Similarly, inter-rater agreement (kappa 0.66-0.81) and intrarater agreement (kappa 0.64-0.88) on the UERS was either good or excellent. The MHC and the UERS provide standardized, reliable, reproducible, and efficient instruments that can be used by occupational therapists and orthopedic surgeons to evaluate the upper extremities of children with CP.

Background: Early-stage breast cancer (BC) patients choose between breast conservation therapy (BCT) and mastectomy based on comparable recurrence rates and overall survival. In the absence of mortality benefit, consideration of anticipated functional impairments could guide decision making. Although BCT offers less extensive surgery, the administration of radiation therapy (RT) may adversely impact upper extremity (UE) function. The purpose of this analysis is to investigate the effect of BCT vs modified radical mastectomy (MRM) without RT on functional impairments among BC survivors. Materials and Methods: 196 women diagnosed with BC between 200105 were enrolled and treated in a prospective surveillance physical therapy program. 115 received either BCT, including lumpectomy and whole breast RT, or MRM without RT and were analyzed for this report. Participants’ UE range of motion (ROM), strength, and limb volume were assessed pre-operatively and at 1, 3, 6, 9, and 12+ months post-operatively by a physical therapist. Limb volume was assessed using infrared optoelectronic perometry. At 12+ months, overall health status, UE symptoms and function, and physical activity levels were reported using standardized questionnaires. Analysis of variance estimated differences in impairments and self-reported symptoms and function. One-way ANOVA analysis was used to determine significance between groups (p ≤ 0.05). Results: 65 women (57.5%) received BCT and 50 women (42.5%) received MRM. No significant differences in age, BMI, stage, ER/PR status, and number of dissected lymph nodes were found between groups. At 1 month post-operatively, shoulder internal rotation (p=0.03), abduction (p=0.01), and flexion (p=0.004) were worse in post-MRM patients, with a trend towards worse external rotation (p=0.06). A higher rate of axillary cording was seen in patients post-MRM (p=0.02). By 12+ months post-operatively, there were no differences in any of the shoulder ROM variables. BCT patients reported, however, greater weakness (p=0.03) and diminished ability to perform heavy household tasks (p=0.03). There was no significant difference between BCT vs. MRM in rates of early lymphedema (40% vs 38%) or seroma (14% vs 22%). Conclusion: Functional impairments represent an important category of morbidity for BC survivors and should be considered in pre-treatment decision making. Post-operative RT as part of BCT may not contribute significantly to impairment over the first year of treatment. The presence of self-reported weakness and difficulty performing heavy household tasks at 12+ months suggest possible future functional deficits, especially considering the potentially progressive nature of RT-associated tissue changes. Additional research is needed to assess longer-term changes and the impact of RT in the context of aggregate effects of other BC treatment modalities. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr PD02-03.

The role of radiation therapy in the management of primary breast cancer

Breast cancer in young women: challenges, progress, and barriers.

Breast cancer and hormone-replacement therapy: the Million Women Study

The purpose of this study was to compare upper extremity range of motion when using a straight-handled long-handled sponge versus a bent-handled long-handled sponge. Thirty-eight participants ranging in age from 20 to 55 years were randomly assigned to one of two order groups: straight-bent or bent-straight. The task involved touching a buzzer placed over thoracic vertebrae 6 and 7 with the long-handled sponge. The dependent variable was right upper extremity range of motion. Significant range of motion differences were found in wrist flexion-extension, elbow flexion-extension, and shoulder abduction-adduction between the straight-handled and the bent-handled long-handled sponge (p < .05). No significant differences were found with ulnar and radial deviation of the wrist, wrist supination-pronation, or shoulder flexion (p > .05). These results suggest that within a normal population, the bent handle may be more beneficial to individuals who have decreased range of motion in shoulder abduction-adduction and wrist flexion-extension, whereas the straight handle may be more accommodating to those with decreased range of motion in the elbow. Implications for therapeutic evaluation include ensuring proper evaluation of range of motion of all upper extremity joints in order to provide assistive devices that serve individual needs. Future research should include special populations with upper extremity orthopedic conditions as well as different degrees of handle bending with the long-handled sponge.

Breast cancer, menopause, and long-term survivorship: critical issues for the 21st century

Reduced breast cancer incidence in women treated with subcutaneous testosterone, or testosterone with anastrozole: A prospective, observational study

Abstract #1124 Introduction: About half the women who undergo breast cancer surgery report consequent shoulder problems. However, their perception of symptoms such as loss of movement and strength may not be reflected in physical measurements. The aim of this study was to compare the women's perception of symptoms with objective measurements of muscle strength and range of motion (ROM). Methods: One hundred thirty two women (mean age 53 years, SD 12) with early stage breast cancer participated in this study within 6 weeks of their surgery. Participants rated their perception of shoulder ROM and strength on a 5-point likert scale, with the anchors “no impairment” (0) to extreme (4). Shoulder abduction and forward flexion muscle strength were tested using a hand-held dynamometer and ROM with a digital inclinometer. Muscle weakness was defined as a deficit &amp;gt; 20% compared to the unaffected side in either movement. Limited ROM was categorized as &amp;gt; 20° deficit compared to the unaffected side. Results: Thirty two percent of women reported minor weakness, 17% reported moderated weakness, 4% reported major weakness, and no women reported extreme weakness. In addition, 36% reported a minor limited ROM, 32% reported moderate limited ROM, 11% reported major limited ROM, and no women reported extreme limited ROM. Fifty eight percent of women had &amp;gt; 20% muscle weakness and 15% of women had &amp;gt; 20° limited ROM in either shoulder flexion or abduction. There was a moderate relationship between participants' perception and objective measurements in range of motion (Spearman's rho = 0.55 and 0.57 for abduction and flexion, respectively) and a weak relationship for muscle strength (0.28 and 0.18). Interestingly, 28 women reported having no weakness on their affected side, although, strength measurements showed &amp;gt; 20% weakness compared to the unaffected side. Also, 20 women showed less than 20% strength difference between arms but reported having minor to major loss of muscle strength. Conclusion: The women's perception was weakly related to the objective measurements. Physical and psychological factors may contribute to the perception of symptoms. Acknowledgement: Supported by NSW Cancer Council. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1124.

Introduction: Tamoxifen is a selective estrogen receptor modulator (SERM) which is used in the treatment and prevention of breast cancer. It is a standard therapy for breast cancer in women. The CYP2D6 is one of the main enzymes responsible for converting tamoxifen into its major active metabolite, endofixen. Variants in the CYP2D6 allele may lead to reduced or absent enzyme activity. Individuals who carry these variant alleles may have reduced plasma concentrations of endoxifen and be intermediate or poor metabolizers. That is why it is recommended to study the CYP2D6 genotypic heterogeneity before administering tamoxifen in order to provide an individualized hormonal therapy of breast cancer. Aromatase inhibitors are a class of drugs, which block the enzyme aromatase and are used in the treatment of breast cancer in postmenopausal women. Aromatase catalyzes the last steps of estrogen biosynthesis and it is a cytochrome P450 enzyme complex that is encoded by CYP19 . Variants in CYP19A1 may be important, regarding both the efficacy and toxicity of aromatase inhibitors. Materials and Methods: We tested 4 women for CYP2D6 genotypic heterogeneity and 2 for CYP19A1 genetic variations. All of them had beeen diagnosed histologically with estrogen - and progesterone - receptor - positive breast cancer. We used PCR amplification method and Sanger sequencing. Results: One of the patients was an intermediate tamoxifen metabolizer, one of the patients was a heterozygous carrier for CYP19A1 genetic variations. Conclusions: It is of great significance for the treatment of breast cancer to test patients for their drug metabolism activity in order to provide a personalised approach in treating breast cancer.

Background:Shoulder, neck, and back discomforts and abdominal obesity caused by sedentariness are increasingly prominent in young and middle-aged population groups. Health Qigong improves physical functions and strengthens the disease resistance of exercisers. This study aims to explore health Qigong intervention’s effects on the cervical vertebra, lumbar vertebra, and mental status.Methods:A total of 108 sedentary young and middle-aged faculties from Yantai University in China were recruited from July to December 2020 and randomly classified into the experimental and control groups. The former received health Qigong exercises for 12 weeks, and the latter was not intervened. The total general skeletal muscle mass, range of neck joint motion, mental health, and range of waist joint motion of all respondents before and after the intervention were tested and calculated.Results:The body fat rate of the experimental group after intervention was significantly lower than that before intervention (P<0.05). The skeletal muscle mass (SMM) value was significantly higher than that before intervention. The experimental group had lower body fat rate but higher SMM value than the control group after the intervention. In addition, the range of motion (ROM) of the cervical vertebra was significantly higher in the experimental group than in the control group after intervention. Somatization, obsessive/compulsive disorder, interpersonal sensitivity, depression, anxiety, hostility, paranoia, and SCL-90 total score of the experimental group after intervention decreased significantly compared with that before intervention (P<0.05).Conclusion:Health Qigong improves the ROM of cervical and lumbar vertebrae and the mental health status of sedentary young and middle-aged groups.

BACKGROUND AND OBJECTIVES:Despite its relatively low incidence in Saudi Arabia, breast cancer has been the most common cancer among Saudi females for the past 12 consecutive years. The objective of this study was to report the results of the first national public breast cancer screening program in Saudi Arabia.METHODS:Women 40 years of age or older underwent breast cancer screening. Mammograms were scored using the Breast Imaging-Reporting and Data System (BI-RADS). Correlations between imaging findings, risk factors and pathological findings were analyzed.RESULTS:Between September 2007 and April 2008, 1215 women were enrolled. The median age was 45 years, and median body mass index was 31.6 kg/m2. Sixteen cases of cancer were diagnosed. No cancer was diagnosed in 942 women with R1/R2 scores, and only 1 case of cancer was diagnosed in 228 women with R0/R3 scores. However, among 26 women with R4/R5 scores, 50% had malignant disease and 35% had benign lesions. No correlation was found between known risk factors and imaging score or cancer diagnosis.CONCLUSIONS:Public acceptance of the breast cancer screening program was encouraging. Longitudinal follow-up will help in better determining the risk factors relevant to our patient population.