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Doctoral Thesis
DOI
https://doi.org/10.11606/T.17.2020.tde-14042020-083521
Document
Author
Full name
Monique Silva Rezende
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2019
Supervisor
Committee
Guirro, Elaine Caldeira de Oliveira (President)
Mendonça, Adriana Clemente
Carrara, Helio Humberto Angotti
Panobianco, Marislei Sanches
Title in Portuguese
Influência do linfedema de membro superior sobre a cintura escapular de mulheres submetidas ao tratamento do câncer de mama
Keywords in Portuguese
Fisioterapia
Linfedema
Neoplasia mamária
Abstract in Portuguese
A cirurgia por câncer de mama pode desencadear morbidades funcionais no membro superior, destacando-se entre estas o linfedema. Sabe-se que mulheres submetidas ao tratamento da doença podem apresentear alterações da cintura escapular, no entanto, ainda não está fundamentada a implicação desta disfunção nesta região. O objetivo do estudo foi avaliar a influência do linfedema de membro superior sobre a cintura escapular de mulheres submetidas ao tratamento de câncer de mama. Foram avaliadas 75 mulheres, sendo dividas e três grupos iguais: grupo de mulheres mastectomizadas com linfedema (GML), grupo de mulheres mastectomizadas sem linfedema (GM); e grupo controle (GC). Foram avaliadas variáveis como posicionamento escapular (inclinômetro digital), força muscular (dinamômetro manual, força de preensão palmar com dinamômetro digital), e a funcionalidade do membro (Disabilities of the arm, shoulder, and hand questionnaire, DASH). Foi aplicado o teste ANOVA one-way post hoc Bonferroni ou Kruskal-Wallis post hoc Dunn para as comparações entre os grupos, considerando um nível de significância de 5%. A rotação escapular do GML apresentou redução quando comparado aos demais grupos, além de redução da força principalmente de trapézio descendente, ascendente e transverso.A preensão palmar e a função do membro superior apresentaram diferenças significativas em relação ao GC. Diante dos achados observados pode-se concluir que existe influência do linfedema de membro superior secundário ao câncer de mama na redução do padrão de rotação superior da escápula e nos movimentos do membro superior, assim como força da musculatura escapular na população avaliada.
Title in English
Influence of upper limb lymphedema on the shoulder girdle of women undergoing breast cancer treatment
Keywords in English
Breast neoplasm
Lymphedema
Physical therapy
Abstract in English
Breast cancer surgery can trigger functional morbidities in the upper limb, especially lymphedema. It is known that women undergoing treatment of the disease may present with changes in the shoulder girdle; however, the implication of this dysfunction in this region is not yet substantiated. The aim of this study was to evaluate the influence of upper limb lymphedema on the shoulder girdle of women undergoing breast cancer treatment. Seventy-five women were evaluated, divided into three equal groups: mastectomized women with lymphedema (GML) group, mastectomized women without lymphedema (GM) group; and control group (CG). Variables such as scapular positioning (digital inclinometer), muscle strength (manual dynamometer, hand grip strength with digital dynamometer), and limb functionality (Disabilities of the arm, shoulder, and hand questionnaire, DASH) were evaluated. The one-way post hoc Bonferroni or Kruskal-Wallis post hoc Dunn ANOVA test was applied for comparisons between groups, considering a significance level of 5%. The GML scapular rotation presented a reduction when compared to the other groups, besides a reduction in the force, mainly of the descending, ascending and transverse trapezius. Palmar grip and upper limb function showed significant differences in relation to the CG. Given the findings, it can be concluded that there is an influence of upper limb lymphedema secondary to breast cancer in reducing the pattern of superior rotation of the scapula and upper limb movements, as well as scapular muscle strength in the population evaluated.
 
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Publishing Date
2020-05-04
 
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