Study aim: the purpose of the present study was to investigate the potential of traditional games as a method of increasing the physical activity (PA) of women following mastectomy. A cross-sectional survey during the 20th ONCO Games was conducted and the sample included data from women divided into two groups: up to 50 years old (n = 26) and over 50 years old (n = 86). Material and methods: PA was assessed using a questionnaire, and the number of steps taking during 30-minute periods was measured using pedometers during each of the games. Exertion was evaluated using Borg’s Scale. Results: there was no difference in levels of coherence between the age groups. The group of younger women were statistically more active (M = 3.34 days/week) than the older group (M = 2.77 days/week). All the games were evaluated to be of light intensity, with ringo perceived as being statistically more fatiguing in the over 50 age group. The highest number of steps was performed during the game of ring-net-ball (M = 1903 steps/30 min) in both age groups, with older women performing statistically more steps. Similar situations were observed in the cases of pétanque and speedminton. In ringo, the situation was reversed. The lowest number of steps was recorded in pétanque in the younger age group (M = 296 steps/30 min). Conclusion: this study indicates that in the rehabilitation and recovery process after mastectomy, traditional games could be a bridging link between exercising and sports as they provide not just activity but also a unique and valuable social context.
Breast cancer affects a large number of women worldwide. Surgical management has evolved towards mastectomies and breast-conserving surgeries. The complications following a mastectomy can be physical and/or psychological. The physical complications include pain, scarring, lymphedema, limitation in range of motion at the shoulder, muscle weakness, change in body posture, etc. Some of the psychological complications are negative boy image, anxiety, depression and depressive disorders, negative body image. Appropriate management requires a multi-disciplinary team of which the physiotherapist is a part of. Literature has shown that there is a better improvement in physical function if physiotherapy is commenced early. Therefore, physiotherapy should be incorporated pre and post-mastectomy. Physiotherapy management should focus on lymphatic drainage, soft tissue mobilization, range of motion exercises, strengthening exercises and postural correction. Increased physical activity and recommendation of support groups can help to improve psychological outcomes. It is the role of the physical therapist to deal with the physical and psychological complications of a mastectomy to improve the quality of life of the patients.
Introduction Surgical treatment and radiotherapy can prolong the life expectancy of women with breast cancer but also might have side effects on heart rate variability. Currently breast cancer treatment has contributed to significant improvements in survival rate, but negative effects on the psycho-emotional state and functionality of the autonomic nervous system of these interventions in women is high. We aimed to investigate the heart rate variability features in breast cancer survivors who have varied attitudes towards the disease. Material and methods Heart rate variability analysis, determination of various attitudes towards the disease, and mathematical statistical methods. The survey of 110 breast cancer survivors was conducted utilizing Type of Attitude Toward The Disease questionnaire. The women were executed radical mastectomy and adjuvant radiation treatment for breast cancer. Patients aged between 56 and 60 years. Results The results of our study showed that patients with a rational type of attitude towards disease had statistically (p<0.05) better parameters of heart rate variability. Values of standard deviation of the N-N interval, root mean square of successive differences, total power, high-frequency range, and stress index were much better in patients with rational type of attitude as compared with the women who had intrapsychic and interpsychic attitudes. Conclusions These data show that identified features of various attitudes towards the disease in breast cancer survivors clarify the necessity for particular attention to their heart rate variability parameters.
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Erysipelas is a bacterial cellulitis usually associated with Streptococcal infection. It may appear as a complication following mastectomy and radiotherapy for breast cancer. The study involved 17 cases of erysipelas of the upper limbs with a median age of 62 years. Here we described the clinical, therapeutic and evolutionary aspects of erysipelas. Our results indicated that the erysipelas appeared with an average of 9 years after mastectomy and was recurrent in three patients (17.64%). It is associated with obesity in 42% and arterial hypertension in 52.9% of patients with breast cancer after radical mastectomy. Breast cancer patients in advance stages of disease at presentation (T2+ T3) are significantly more subject to erysipelas in comparison to those patients with locoregional stage of disease at presentation (T1), Mann Whitney U-test, (p<0.05). All patients had complete response to antibiotics. The recurrence occurred in 2 patients (11.76%) who underwent radiotherapy with adjuvant tamoxifen and in one patient who underwent chemotherapy and radiotherapy combined. Based on these results it is possible to suggest that patients who received radiotherapy may have an additional risk factor for developing lymphedema and erysipelas
Background: Lymphedema is a clinical manifestation of lymphatic system insufficiency. The risk of lymphedema increases especially in the case of women after mastectomy with removal of axilla lymph nodes and post-surgical radiotherapy. As a result of the above, it appears in the upper limb at the side where the surgery has been carried out. The factors that increase the risk of lymphedema include fatigue, overheating and injury to the limb at risk.Aim: To investigate the level of awareness of lymphedema prevention and the frequency of the post-mastectomy patients’ compliance with the received recommendations.Material and methods: 40 women after one-side radical mastectomy and post-surgical radiotherapy took part in the research. None of them had symptoms of recurrence. All patients had a clinical manifestation of upper limb lymphedema at the side of the surgical intervention. The patients were asked to fill in a questionnaire that consisted of 6 questions.Results: The research has shown that patients with risk of lymphedema display a low level of education in the matter and that they indicate problems with access to professional information on the topic of lymphedema prevention. The properly trained medical staff rarely proved to be a source of information on the topic. The women who participated in the survey mostly knew that they had to avoid injections and taking blood pressure in the affected upper limb as well as excessive upper limb exercise. Most frequently mentioned preventive recommendations included elevation of the limb and appropriate exercise. Among the factors generating lymphedema, most women indicated excessive physical effort as a subjective cause of the manifestation of the condition.Conclusion: Despite the knowledge of lymphedema prevention measures, the patients often fail to comply with the recommendations they have been given.Background: Lymphedema is a clinical manifestation of lymphatic system insufficiency. The risk of lymphedema increases especially in the case of women after mastectomy with removal of axilla lymph nodes and post-surgical radiotherapy. As a result of the above, it appears in the upper limb at the side where the surgery has been carried out. The factors that increase the risk of lymphedema include fatigue, overheating and injury to the limb at risk.Aim: To investigate the level of awareness of lymphedema prevention and the frequency of the post-mastectomy patients’ compliance with the received recommendations.Material and methods: 40 women after one-side radical mastectomy and post-surgical radiotherapy took part in the research. None of them had symptoms of recurrence. All patients had a clinical manifestation of upper limb lymphedema at the side of the surgical intervention. The patients were asked to fill in a questionnaire that consisted of 6 questions.Results: The research has shown that patients with risk of lymphedema display a low level of education in the matter and that they indicate problems with access to professional information on the topic of lymphedema prevention. The properly trained medical staff rarely proved to be a source of information on the topic. The women who participated in the survey mostly knew that they had to avoid injections and taking blood pressure in the affected upper limb as well as excessive upper limb exercise. Most frequently mentioned preventive recommendations included elevation of the limb and appropriate exercise. Among the factors generating lymphedema, most women indicated excessive physical effort as a subjective cause of the manifestation of the condition.Conclusion: Despite the knowledge of lymphedema prevention measures, the patients often fail to comply with the recommendations they have been given.
Wstęp: Nowotwór piersi jest najczęstszym nowotworem występującym u kobiet w Polsce, stanowiąc około 20% ogółu zachorowań na nowotwory złośliwe. Jednym z powikłań po leczeniu operacyjnym (mastektomii) jest zastoinowa niewydolność układu chłonnego. Jej kliniczną manifestacją jest obrzęk limfatyczny. Celem pracy była ocena skuteczności kompleksowego leczenia fizjoterapeutycznego obrzęku limfatycznego kończyny górnej po zabiegu mastektomii u kobiet. Materiał i metody: Badania zostały przeprowadzone w Zakładzie Rehabilitacji Centrum Ziemi Lubelskiej w Lublinie. Grupa badawcza liczyła 40 kobiet w wieku od 39 do 76 lat (średnia wieku 59,3 lat) leczonych z powodu raka piersi, u których wystąpił obrzęk limfatyczny. Każda z pacjentek poddana została leczeniu fizjoterapeutycznemu przez 10 dni w okresie dwóch tygodni. Terapia składała się z: kąpieli wirowej miejscowej kończyny górnej, rytmicznego masażu pneumatycznego, masażu za pomocą aparatu Aquavibron, manualnego drenażu limfatycznego według Voddera, miejscowej krioterapii oraz ćwiczeń zbiorowych kończyn górnych. Oceniono zmianę wielkości i konsystencji obrzęku limfatycznego, zmianę stopnia nasilenia bólu, wpływ zastosowanej terapii na zmianę objawów towarzyszących obrzękowi i na zakres ruchomości stawów kończyny górnej objętej obrzękiem limfatycznym. Wyniki: Przed rozpoczęciem terapii średnie nasilenie dolegliwości bólowych w skali VAS wynosiło 3,9±1,9, natomiast po jej zakończeniu 2,7±1,7. Średnia wartość pomiarów obwodów w dziewięciu miejscach na kończynie objętej obrzękiem zmniejszyła się o 0,9 cm (3,5%). Pod wpływem zastosowanych metod fizjoterapeutycznych uzyskano średnią poprawę zakresu ruchów w stawie łopatkowo– ramiennym o 5,1º (9%), w stawie łokciowym o 5,2º (3,9%) i nadgarstkowym o 3,6º (12%). Wnioski: Zastosowanie metod fizjoterapeutycznych w znacznym stopniu wpłynęło na zmniejszenie obrzęku limfatycznego kończyny górnej u kobiet po mastektomii. Użyta kompleksowa terapia wpływa pozytywnie na zmianę konsystencji obrzęku limfatycznego kończyny górnej. W badanej grupie zmniejszenie obrzęku limfatycznego przyczyniło się do poprawy zakresu ruchomości we wszystkich stawach kończyny górnej i zmniejszenia odczuwanych dolegliwości bólowych.
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Introduction: Lymphoedema (congestive insufficiency of the lymphatic system) is one of the complications occurring after mastectomy. The aim of this study was to assess the effectiveness of comprehensive physical therapy. Materials and methods: The study was conducted at the Department of Rehabilitation and Psychotherapy at Medical University of Lublin with a group of 40 women aged 39 to 76 years (mean age 59.3 years) who developed lymphoedema after treatment for breast cancer. The two-week physical therapy involved a whirlpool bath, rhythmic pneumatic massage, massage using an Aquavibron massager, Vodder’s manual lymphatic drainage, local cryotherapy, and collective physical exercises of the upper limbs. The aim of the study was to assess changes in lymphoedema size and consistency, pain intensity, movement range in upper limb joints, and other symptoms accompanying lymphoedema. Results: Mean pain intensity on the VAS scale was 3.9±1.9 prior to the therapy and 2.7±1.7 after it. Mean girth value measured at nine different locations on the lymphoedemic limb decreased by 0.9 cm (3.5%). Mean improvement in movement range amounted to 5.1º (9%) in the shoulder joint, 5.2º (3.9%) in the elbow joint, and 3.6º (12%) in the wrist joint. Conclusions: The therapy had a beneficial effect on the size and consistency of upper limb lymphoedema. Furthermore, an improvement in movement range and a reduction of pain intensity in the upper limb joint were observed.
Wstęp: Radykalna amputacja piersi prowadzi często do ograniczenia ruchomości w stawie ramiennym i osłabienia siły mięśniowej kończyny górnej po stronie operowanej, co opóźnia powrót do codziennej aktywności i pracy zawodowej. Cel: Porównanie odległych wyników wczesnej rehabilitacji stacjonarnej i ambulatoryjnej z indywidualnym usprawnianiem domowym po instruktażu u kobiet poddanych radykalnej amputacji piersi z powodu raka. Materiał i metody: Badaniami objęto grupę 146 „Amazonek” w wieku 32-83 lat, u których w latach 2002-2009 wykonano jednostronną radykalną amputację piersi sposobem Maddena. 71 kobiet operowano w Centrum Onkologii w Krakowie (grupa małopolska - M) i 75 w Świętokrzyskim Centrum Onkologii w Kielcach (grupa świętokrzyska - Ż). W grupie M wczesną rehabilitację pooperacyjną prowadziły przeszkolone pielęgniarki i wolontariuszki Klubu „Amazonka”, a chore kontynuowały samodzielnie ćwiczenia w domu. W grupie Ż kompleksową rehabilitację w warunkach stacjonarnych wykonywali zawodowi fizjoterapeuci. Od wszystkich kobiet uzyskano dane dotyczące wieku, przebytego leczenia i rehabilitacji, źródła utrzymania, rodzaju wykonywanych prac domowych oraz pracy zawodowej. Dokonano obustronnych pomiarów zakresu ruchów w stawie ramiennym i siły ścisku globalnego ręki. Obie grupy porównano pod względem cech antropometrycznych, przebytego leczenia oraz zdolności do wykonywania prac domowych i pracy zawodowej. Wyniki: Kobiety obu grup (M i Ż) cechowały się podobnymi zakresami ruchomości w stawach ramiennych i siłą ścisku globalnego ręki. Podobny odsetek kobiet z obu grup powrócił do wykonywania codziennych zajęć domowych i kontynuacji pracy zawodowej. Wnioski: 1. Mimo różnic w podejściu do wczesnej rehabilitacji w obu ośrodkach referencyjnych pacjentki z obu województw (M i Ż) nie różniły się istotnie zakresem ruchomości stawu ramiennego i siłą ścisku globalnego ręki. 2. Niezależnie od rodzaju wczesnej rehabilitacji podobny odsetek kobiet powrócił do codziennych czynności domowych i pracy zawodowej. 3. Uzyskane wyniki sugerują, że sposób prowadzenia rehabilitacji nie jest czynnikiem decydującym o wynikach usprawniania kobiet poddanych radykalnej amputacji piersi z powodu raka.
EN
Introduction: Radical breast amputation often results in decreased shoulder mobility on the operated side and a reduction in the muscular strength of the upper limb, which delays a return to daily activities and professional work.The objective of the research: A comparison of the distant effects of early, stationary rehabilitation with domestic rehabilitation after instructing women subjected to radical breast amputation as a result of cancer. Materials and methods: 146 women of the ‘Amazon’ Club aged 32-83 were tested following a one-sided breast amputation using Madden’s method (carried out between 2002-2009). 71 were operated on at the Oncological Centre in Krakow (the Małopolska group) and 75 at the Świętokrzyskie Oncological Centre in Kielce (the Świętokrzyska group). In the Małopolska group early postoperative rehabilitation was conducted by trained nurses and volunteers of the ‘Amazon’ Club, and the patients continued their exercises on their own at home. In the Świętokrzyska group a complex form of rehabilitation in stationary conditions was conducted by professional physiotherapists. Data from all the women was obtained including the patient’s age, past treatment and rehabilitation as well as their livelihood, the type of housework they do and their professional employment. Measurements of movements in the shoulder joint and palm muscle flexor strength were carried out. Both groups were compared in terms of anthropometric features, past treatment and the ability to perform housework and professional work.Results: The women in both groups obtained similar results of mobility in their upper extremity and hand flexor strength. The percentage of women who returned to housework and professional employment was similar. Conclusions: 1. In spite of the difference in the methods of early postoperative rehabilitation in both oncological centres, the patients in both provinces (M and Ś) did not differ significantly as far as mobility in their shoulder joints and hand flexor strength was concerned. 2. Regardless of the sort of early rehabilitation a similar percentage of women returned to their everyday tasks and professional forms of employment . 3. The results obtained suggest that the way in which rehabilitation is conductedis not a decisive factor determining the rehabilitation outcome for women treated surgically for breast cancer.
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