Abstract

Certain secondary effects derived from medical treatment in breast cancer can favor the development of alterations in shoulder biomechanics. To the best of our knowledge, persistent peripheral pain as a key factor for the development of neuromuscular activity impairments has not been analyzed. A cross-sectional descriptive study was carried out. A total of 90 women were included and allocated to three groups: (i) 30 women with persistent peripheral pain after breast cancer treatment, (ii) 30 women without pain after breast cancer treatment, and (iii) 30 healthy women. Surface electromyography was employed to measure the onset and amplitude of the muscle activity of three shoulder movements. Statistically significant differences were found in the neuromuscular activity for all the muscles and shoulder movements among women with persistent pain versus healthy women (i.e., amplitude muscle activity variable p < 0.001). Statistically significant differences were also observed in the neuromuscular activity for certain muscles in shoulder movements among women with persistent pain versus women without pain, as well as between women without pain versus healthy women. Therefore, following breast cancer treatment, women showed alterations in their shoulder neuromuscular activity, which were more significant if persistent pain existed. These findings may contribute to developing a selective therapeutic exercise program that optimizes the shoulder neuromuscular activity in women after breast cancer treatment.

Highlights

  • The improvement in the effectiveness of breast cancer medical treatment has increased the survival rate to between 78%–88% at five years [1]

  • We aimed to describe differences in shoulder neuromuscular activity among women with peripheral persistent pain after breast cancer treatment versus women without pain after breast cancer treatment versus healthy women; and whether differences exist among women without pain after breast cancer treatment versus healthy women

  • Significant differences were found in relation to the root mean square (RMS)% of the middle deltoid muscle between Group 1 (G1) versus Group 2 (G2) (p = 0.001), G1 versus Group 3 (G3) (p < 0.001), and G2 versus G3 (p = 0.043), finding the amplitude of muscle activity increased in both G1 and in G2 compared to G3, as well as G1 versus G2

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Summary

Introduction

The improvement in the effectiveness of breast cancer medical treatment has increased the survival rate to between 78%–88% at five years [1]. During arm elevation, the normal movement of the scapula consists of upward rotation, posterior tilt, and internal rotation, and many studies related the shoulder pain to a decrease in the upward rotation and posterior tilting of the scapula, and an increase in the scapular internal rotation [14,15,16,17,18]. Alterations in shoulder neuromuscular activity were found in women following breast cancer treatment. These alterations depend on the type of surgery, operated side and breast cancer treatment received [2,5,8,11,20]

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