Evaluation of Posture and Quality of Life in Females Undergone Modified Radical Mastectomy: A Research Protocol (original) (raw)
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The effect of physiotherapy in patients with modified radical mastectomy
National Journal of Physiology, Pharmacy and Pharmacology
Background: Through the years, breast cancer management evolved toward conservation surgery. It is obvious that the clinical management requires a multidisciplinary approach to restoration of activity if daily living and quality of life after modified radical mastectomy. Aims and Objectives: The objectives of the study were to measure pain after physiotherapy intervention, to measure chest expansion after physiotherapy intervention, and to measure and improve shoulder range of motion (ROM) after physiotherapy intervention. Materials and Methods: This was a cross-experimental study in which initial data were recorded from the medical records, and then, after assuming proper resting status of the patient, the patients were assessed first numeric pain rating scale (NRS) for pain, ROM of shoulder joint, and chest expansion before and after the physiotherapy treatment given till patient get discharged. Results: In the present study, a total of 7 participants were included who fulfilled inclusion criteria. All the participants underwent routine physiotherapy treatment started from the day 1 till discharged, and NRS for pain, ROM of shoulder joint, and chest expansion all parameters were statistically significant (P < 0.005). Conclusion: The present study concluded that physiotherapy is more effective in modified radical mastectomy.
Arm Function and Quality of Life Among Patients after Mastectomy
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2018
Introduction: For many women with breast cancer, mastectomy is a common form of treatment which has an indirect effect on female beauty, sexuality and feminity. Also, the patients suffer severe arm and shoulder morbidity post surgery which affects their quality of life. Aim: To determine the arm function and quality of life among patients after mastectomy and find correlation between these two aspects. Materials and Methods: A quantitative descriptive correlational design with non probability convenience sampling technique was used to collect data from 60 post mastectomy women. The setting used for the study was Gynecological Oncology OPD at Amrita Institute of Medical Sciences (AIMS), Kochi, Kerala, India. Data collection was done from November 2016 to December 2016. A standardized Quality of Life-Breast Cancer Patient Version (QOL-BCV) questionnaire and DASH (Disability of Arm Shoulder Hand) tool was used for the assessment along with a structured questionnaire to assess socio demographic and clinical data. Karl Pearson correlation test was used for data analysis. Results: The study result showed that majority of the patients 48 (80%) had good arm function with less disability. Quality of life of 21 (35%) patients was high and 39 (65%) patients had moderate quality of life. There was a significant correlation found between disability score and quality of life (r=-0.802) and with all the domains of quality of life {physical (r=-0.771), psychological (r=-0.695), social (r=-0.746) and spiritual (r=-0.500)}. Also a significant association was found between arm function and the clinical variables like edema (p=0.006) and radiation therapy (p=0.017). Conclusion: Arm disability influences quality of life of patients after mastectomy. The results of this study will help to improve actions to reduce arm disabilities such as lymphedema as early as possible, through proper assessment and post mastectomy exercises, including special care for patients undergoing radiation therapy. This will improve the quality of life of post mastectomy patients.
https://ijshr.com/IJSHR\_Vol.6\_Issue.3\_July2021/IJSHR-Abstract.020.html, 2021
Background: Many complications may occur after modified radical mastectomy (MRM) such as restricted shoulder mobility, wound infection, seroma formation, pain and lymph edema. Purpose: To find the correlation between shoulder flexion and abduction range of motion (ROM) with upper extremity disability and quality of life in female post MRM. Methodology: A cross section observation study was conducted in a tertiary care hospital. A total of 20 breast cancer survivors who underwent MRM before 6 months or more were included. Their affected side shoulder flexion and abduction ROM was measured using universal goniometer, upper extremity disability was assessed using Upper Extremity Functional Index (UEFI) and Quality of Life was assessed using WHOQoL-BREF questionnaire. Results: Karl Pearson's correlation coefficient was used to find the correlation. Strong positive correlation was found between shoulder flexion ROM and UEFI score, physical, psychological and environmental domains, whereas moderate positive correlation was found between shoulder flexion ROM and overall QoL, these were statistically significant (p<0.001). But there was weak positive correlation found between shoulder flexion ROM and social domain of WHOQoL-BREF which was statistically not significant (p>0.001). Further strong positive correlation was found between shoulder abduction ROM and UEFI score, overall Qol, physical and psychological domain and moderate positive correlation was found between shoulder abduction ROM and environmental domain whereas again weak positive correlation found with social domain which was statistically not significant (p>0.001). Conclusion: Decreased shoulder ROM can increase upper extremity disability and affect overall QoL in breast cancer survivors post MRM.
Impact of Physical Therapy in Patients Undergoing Modified Radical Mastectomy: A Case Report
Journal of Pharmaceutical Research International, 2021
Introduction: Breast Cancer is responsible for 2.09 million cases and 6,27,000 deaths worldwide, as per WHO. In India, women have one of the most common cancer, accounting for 14 per cent of all women's cancers. Numerous risk factors are present, such as ethnicity, aging, hormones, family medical history, genetic abnormalities, and unhygienic lifestyles. Side effects of cancer treatment may be alleviated by exercise interventions. Physical- therapy has been shown to be effective in post-operative situations. It improves the functioning of the patient and the quality of life. Presenting Symptoms and Diagnosis: Main symptoms from the patient were pain in the upper extremity, lack of control, power and range of motion. The main clinical results in this case have been a severe decrease in the range of shoulder joint motion. Reduced strength in the upper extremity muscles and swelling (lymphoedema) in the upper extremity. Diagnosis of the case was Infiltrative Ductal Carcinoma th...
The Efficacy of Physiotherapy Recovery After a Modified Radical Mastectomy
Journal of Medical pharmaceutical and allied sciences, 2021
Breast cancer is the most common disease in females and the major cause of mortality and morbidity. In reality, 1.67 million new cases of breast cancer are diagnosed around the world, with 458,000 deaths per year. Approximately 89 percent of breast cancer survivors live for a minimum of five years after treatment, but adverse effects can last for months or years after surgery. The most common side effects of the upper limb are pain and joint dysfunction, which is described as having a prevalence range of 12 percent to 51 percent for pain and 1.5 percent to 50 percent for joint dysfunction.(1) The mainstay in primary breast cancer care is surgery.(2) To assess the impact of an early recovery program on shoulder mobility, functional ability, postoperative complications such as seroma, hematoma, and wound infection in patients who had undergone a modified radical mastectomy (MRM)and to assess the impact of variables in clinical practice (e.g., age, education, BMI, previous shoulder pro...
TURKISH JOURNAL OF MEDICAL SCIENCES, 2021
The aim of this study was to determine whether breast surgery changes body posture in patients with early-stage breast cancer. Materials and methods: Study variables include age, side and localization of the tumor in the breast, applied breast surgery, axillary interference, pathological tumor size, axillary lymph node metastasis, body mass index, bone density, adjuvant therapies, and histological type. Thoracic kyphosis angle due to the anatomically affected primary region to detect changes in body posture and Cobb's method were used to measure this. Results: There was a statistically significant difference in the mean Cobb's angle between the follow-up times of 57 patients (P < 0.001), with a cumulative increase in the Cobb's angle from baseline to the second year. As the age of the diagnosis progressed, the Cobb's angle increased significantly at 2 years when compared to baseline (r = 0,616, P < 0,001). In terms of baseline, the higher the BMI level in the 2 nd year, the higher the Cobb's angle in the 2nd year as compared to the baseline (r = 0,529, P < 0,001). Conclusion: It was concluded that the increase in thoracic kyphosis in patients with breast cancer should be examined psychosocially. The study should be supported by a larger number of patients.
Physiotherapeutic performance in mastectomy after breast cancer: a literature review
Journal of Cancer Prevention & Current Research, 2021
Cancer is characterized by disorganized and chaotic cell growth that results from genetic changes inherited or acquired by the action of certain environmental, chemical, radioactive, viral and hormonal agents named carcinogens, which thereby initiate the process of tumorigenesis. 1 Breast cancer is the second most common form of cancer in the world and the leading cause of death by cancer among females. It mainly affects women aged between 40 and 60 years. 1,2 The main risk factors are genetics and external, such as environment, living habits, eating habits, age, menarche, exposure to estrogen, radiation, obesity, sedentarism and environmental toxins. 1,2 According to the World Health Organization (WHO), about 40% of deaths could be prevented by eliminating or minimizing exposure to carcinogens. Primary prevention consists in promoting health and avoiding external risk factors. Secondary prevention involves actions aimed at early diagnosis of the disease. The main objectives of treatments are to cure, prolong survival and improve the quality of life (QoL) of patients. 1 Primary treatment for breast neoplasm is a surgical intervention called mastectomy, whose goal is tumor removal. The most commonly used surgical procedure is modified radical mastectomy, in which the entire breast is removed, along with axillary lymph nodes. 1,3,4 After mastectomy, women face a psychological trauma. These feelings lead them to explore the possibilities of breast reconstruction, in order to reconstitute their body image, with improvements to QoL and well-being, so it should be considered as an integral part of breast cancer treatment. 5 Treatment-associated morbidities include paresthesia of the axillary region and the lateral wall of the thorax, pain, enlargement of upper limb, reduction of shoulder's range of motion, limitation of daily living activities (DLAs), and interference in QoL. 6 Patients undergoing physical therapy have their recovery time reduced and return more quickly to their daily, occupational and sports activities, as well as can reacquire movement amplitude, strength, good posture, coordination, self-esteem and, mainly, minimize possible postoperative complications and increase their QoL. 3 In the preoperative phase, the work of musculature maintenance is important, besides a previous evaluation of the patient's overall conditions. The post-surgical treatment aims at a significant improvement in skin texture, absence of fibrotic nodulation, reduction of edema, pain relief, minimization of possible tissue adhesions, rapid recovery of areas with hypoesthesia, that is, less of complications and acceleration of patient's return to daily activities. 7,8 The main physical therapy resources used to achieve that, are: manual lymphatic drainage, ultrasound, cryotherapy, laser therapy, electrotherapy, active exercises and complex decongestive therapy (CDT), which is fundamental to the recovery process. 7 Because of the high incidence of breast cancer, and the search for a treatment that ranges from tumor removal surgery to breast reconstruction
Qualidade de vida pós-mastectomia e sua relação com a força muscular de membro superior
Fisioterapia e Pesquisa, 2014
This research transversal, analytical, exploratory and quantitative approach aimed to identify the quality of life of women who have had a mastectomy surgery, relate the results with the strength of the upper limb muscle affected and draw a sociofunctional profile. A total of 10 women participated, from 30 to 60 years old, who underwent to unilateral modified radical mastectomy in a medium-sized hospital in an inner city of Rio Grande do Sul, for at least one year from the date of data collection. The strength of the upper limb muscle was evaluated by manual testing and the handgrip was tested with the dynamometer. A sociofunctional questionnaire was applied and the quality of life data were collected through the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire, followed by the module BR-23. The strength had decreased in all muscle groups homolateral to the surgery. The life quality in a global health bases resulted as regular. The main changes found in the functionality were at scales: emotional, cognitive and sexual. Statistically, it was found significance and correlation between physical health and social function (p=0.04; r=0.65), cognition and functional performance (p=0.01; r=0.75), emotional performance and cognition (p=0.005; r=0.9) and between handgrip of the affected limb with the global health (p=0.008; r=0.77). Breast cancer and mastectomy has a direct impact on the upper limb muscle strength, functionality and on life quality of women, in sexual, cognitive and emotional domains, and physiotherapy plays an important role in the rehabilitation and in social rehabilitation of these.
Indian Journal of Surgical Oncology, 2019
Breast cancer is the most common cancer among females worldwide, of whom more than 80% survive for more than 5 years. Hence, ensuring a good quality of life (QOL) is essential to achieve holistic approach in treating patients. A cross-sectional study was conducted to compare the QOL in women who underwent modified radical mastectomy (MRM) and breast conservation surgery (BCS) for breast cancer in the last 5 years. QOL was evaluated based on the long-term quality of life-breast cancer (LTQOL-BC) questionnaire. A greater percentage of women who underwent MRM complained of difficulty in completing their house work compared with the BCS group (50% compared with 31%). Twenty-five percent (6) of the women who had undergone MRM reported feeling of being incomplete as women, along with a lack of femininity. However, more than 80% of the women in both groups said that they felt stronger as survivors and derived strength from their experience. There were significant differences in the quality of life of women from both groups in terms of physical function and body image, with the BCS group appearing to have a better QOL.