Abstract
Background: Survivors of breast cancer show loss of function of the homolateral limb after treatment, which involves reduction of the functional range of the shoulder, as well as impairment of the involved musculature. The aim of this study was to evaluate the electromyographic activity and the strength of the muscles in the shoulder complex of women who have been subjected to mastectomies, after an intervention using Proprioceptive Neuromuscular Facilitation (PNF) exercises. Methods: This study included 18 women submitted to modified radical mastectomy, with a mean age of 52.55±8.42 years. The training exercises with Proprioceptive Neuromuscular Facilitation occurred two times per week for eight weeks, the standards used were the diagonal pattern, with flexion-abductionexternal rotation and extension-adduction-internal rotation. For the evaluation of the electromyographic activity, electrodes were positioned in the muscles of the upper trapezius and deltoid (anterior, middle and posterior muscle fibers). Results: The electromyographic analysis demonstrated a 32% elevation in the Standard Envelope (SE) of the middle fiber of the deltoid muscle (DM), 15% in the SE of the upper trapezius (UT), an increase in muscle strength of 15% in the DM and 15% in the UT, also raising the strength of these muscles by 36%. Conclusion: The results of the proposed intervention allow us to conclude that, for the sample evaluated, there was an increase in the recruitment of motor units and of muscle strength of the shoulder affected by the surgery to treat breast cancer.
Highlights
IntroductionIt is challenging to acquire knowledge on the functional changes of the upper limb and shoulder due to breast cancer treatment, such as reduction of movement, muscle weakness, pain, numbness, and lymphedema, because these changes causes numerous chronic impacts, with a clinically significant decrease in the functional capacity and quality of life of these women [1,2,3].Functional limitations associated with pain and the decrease of shoulder movement can affect daily and recreational activities of women submitted to breast cancer treatments [4], besides promoting 2.5 times more chances of losing some productive capacity at work, generating higher financial costs [5].From six to twelve months after treatment, at least half of the women reported a decrease in the range of motion of the upper limb affected
The aim of this study was to evaluate the electromyographic activity and the strength of the muscles in the shoulder complex of women who have been subjected to mastectomies, after an intervention using Proprioceptive Neuromuscular Facilitation (PNF) exercises
The results of the proposed intervention allow us to conclude that, for the sample evaluated, there was an increase in the recruitment of motor units and of muscle strength of the shoulder affected by the surgery to treat breast cancer
Summary
It is challenging to acquire knowledge on the functional changes of the upper limb and shoulder due to breast cancer treatment, such as reduction of movement, muscle weakness, pain, numbness, and lymphedema, because these changes causes numerous chronic impacts, with a clinically significant decrease in the functional capacity and quality of life of these women [1,2,3].Functional limitations associated with pain and the decrease of shoulder movement can affect daily and recreational activities of women submitted to breast cancer treatments [4], besides promoting 2.5 times more chances of losing some productive capacity at work, generating higher financial costs [5].From six to twelve months after treatment, at least half of the women reported a decrease in the range of motion of the upper limb affected. It is challenging to acquire knowledge on the functional changes of the upper limb and shoulder due to breast cancer treatment, such as reduction of movement, muscle weakness, pain, numbness, and lymphedema, because these changes causes numerous chronic impacts, with a clinically significant decrease in the functional capacity and quality of life of these women [1,2,3]. Functional limitations associated with pain and the decrease of shoulder movement can affect daily and recreational activities of women submitted to breast cancer treatments [4], besides promoting 2.5 times more chances of losing some productive capacity at work, generating higher financial costs [5]. It is a pattern of muscle contractions and diagonal movements that increase active movements, produce a correct direction of movement, and reduces fatigue, besides promoting muscular strengthening and stretching [9,10]. The use of this technique in the rehabilitation of breast cancer survivors is still very scarce in the literature
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