Effects of scapulothoracic stabilization exercises on scapular function, posture, and balance in lymphedema after mastectomy: a randomized controlled trial

ABSTRACT This study aimed to investigate the effects of scapulothoracic stabilization exercises (SSE) on scapular function, posture, and balance in women with lymphedema after mastectomy. The patients were randomly divided into two groups as complex decongestive physiotherapy (CDP) (n: 12; age: 55.25 ± 8.17 years) and CDP+SSE (n: 13; age: 54.38 ± 9.08 years). While only CDP was applied in the CDP group, CDP and SSE were applied in the CDP+SSE group. Scapulothoracic muscle strength with dynamometer, scapular endurance with Scapular Isometric Compression Test, scapular dyskinesia with Lateral Scapular Slide Test, thoracic posture with inclinometer, general posture with New York Posture Scale, and balance with Mini-BESTest were evaluated before the 3-week treatment phase (TP), after the TP, and after the fifth week of the maintenance phase (MP). Improvements in the lower trapezius muscle strength were found in both groups after the TP (p < .05). In addition, the middle trapezius muscle strength and general posture improved more in the CDP+SSE group than in the CDP group after the TP (p < .05). In the MP, scapulothoracic muscle strength, scapular endurance, and general posture improved more in CDP+SSE group compared to the CDP group (p < .05). In upper extremity lymphedema patients, incorporating additional SSE in CDP may contribute to the improvement of posture and scapular functions.

[1]  S. Masiero,et al.  Water-based exercise for upper and lower limb lymphoedema treatment. , 2022, Journal of vascular surgery. Venous and lymphatic disorders.

[2]  A. Arıkan,et al.  Combined Complete Decongestive Therapy Reduces Volume and Improves Quality of Life and Functional Status in Patients With Breast Cancer-Related Lymphedema. , 2021, Clinical breast cancer.

[3]  S. Özgül,et al.  The association of breast cancer-related lymphedema after unilateral mastectomy with shoulder girdle kinematics and upper extremity function. , 2021, Journal of biomechanics.

[4]  Consensus Document The diagnosis and treatment of peripheral lymphedema: 2020 Consensus Document of the International Society of Lymphology. , 2020, Lymphology.

[5]  M. Hadadi,et al.  Evaluating the responsiveness of the fullerton advanced balance scale in patients with lymphedema secondary to breast cancer surgery. , 2019, Lymphology.

[6]  S. T. Celenay,et al.  Comparison of Spinal Alignment and Mobility in Women With and Without Post Modified Radical Mastectomy Unilateral Lymphoedema. , 2019, Clinical breast cancer.

[7]  M. Dalyan,et al.  Complex Decongestive Therapy Enhances Upper Limb Functions in Patients with Breast Cancer-Related Lymphedema. , 2018, Lymphatic research and biology.

[8]  A. Grada,et al.  Lymphedema: Pathophysiology and clinical manifestations. , 2017, Journal of the American Academy of Dermatology.

[9]  Jo Kim,et al.  Effect of Scapular Stabilization Exercise during Standing on Upper Limb Function and Gait Ability of Stroke Patients , 2017, Journal of Neurosciences in Rural Practice.

[10]  R. Kniep,et al.  The sense of balance in humans: Structural features of otoconia and their response to linear acceleration , 2017, PloS one.

[11]  S. Toprak Celenay,et al.  An 8-week thoracic spine stabilization exercise program improves postural back pain, spine alignment, postural sway, and core endurance in university students:a randomized controlled study. , 2017, Turkish journal of medical sciences.

[12]  K. Schmitz,et al.  A Randomized Trial on the Effect of Exercise Mode on Breast Cancer-Related Lymphedema. , 2016, Medicine and science in sports and exercise.

[13]  Andrew D. Williams,et al.  The effects of yoga on shoulder and spinal actions for women with breast cancer-related lymphoedema of the arm: A randomised controlled pilot study , 2016, BMC Complementary and Alternative Medicine.

[14]  D. Kaya,et al.  Mastektomi Sonrası Lenfödemli Olguda Kompleks Boşaltıcı Fizyoterapinin Fonksiyon, Postür ve Denge Üzerine Etkileri , 2016 .

[15]  J. Jeon,et al.  EFFECTS OF RESISTANCE EXERCISES AND COMPLEX DECONGESTIVE THERAPY ON ARM FUNCTION AND MUSCULAR STRENGTH IN BREAST CANCER RELATED LYMPHEDEMA. , 2015, Lymphology.

[16]  A. Nitz,et al.  Arm dominance does not influence measures of scapular muscle strength and endurance in healthy individuals , 2015 .

[17]  S. T. Celenay,et al.  Spinal postural training: Comparison of the postural and mobility effects of electrotherapy, exercise, biofeedback trainer in addition to postural education in university students. , 2015, Journal of back and musculoskeletal rehabilitation.

[18]  H. Behtash,et al.  The Validity and Reliability of Noninvasive Methods for Measuring Kyphosis , 2014, Journal of spinal disorders & techniques.

[19]  F. Miranda,et al.  Assessment of posture and joint movements of the upper limbs of patients after mastectomy and lymphadenectomy , 2013, Einstein.

[20]  M. Hayran,et al.  Effects of different segmental spinal stabilization exercise protocols on postural stability in asymptomatic subjects: randomized controlled trial. , 2012, Journal of back and musculoskeletal rehabilitation.

[21]  Antonio Nardone,et al.  Using psychometric techniques to improve the Balance Evaluation Systems Test: the mini-BESTest. , 2010, Journal of rehabilitation medicine.

[22]  H. Sarafraz,et al.  The reliability measurements of lateral scapular slide test at three different degrees of shoulder joint abduction , 2008, British Journal of Sports Medicine.

[23]  G. Moseley,et al.  Impaired trunk muscle function in sub-acute neck pain: etiologic in the subsequent development of low back pain? , 2004, Manual therapy.

[24]  U. Alpkaya Yaşlıların fiziksel kapasitelerinin ve yaşam kalitelerinin değerlendirilmesi , 2003 .

[25]  S R Harris,et al.  Measurement of upper extremity volume in women after axillary dissection for breast cancer. , 2001, Archives of physical medicine and rehabilitation.

[26]  Ben W. Kibler Evaluation and Diagnosis of Scapulothoracic Problems in the Athlete , 2000 .

[27]  K. Glenk,et al.  Validity and Reliability , 2008, Environmental Valuation with Discrete Choice Experiments.

[28]  Jo Kim,et al.  Effect of Scapular Stabilization Exercise during Standing on Upper Limb Function and Gait Ability of Stroke Patients , 2022 .