Effects of a scapula-oriented shoulder exercise programme on upper limb dysfunction in breast cancer survivors: a randomized controlled pilot trial
Effects of a scapula-oriented shoulder exercise programme on upper limb dysfunction in breast cancer survivors: a randomized controlled pilot trial
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DOI：
10.1177/0269215510362324
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发表时间：
2010-07-01
影响因子：
3
通讯作者：
Lim, Jae-Young
中科院分区：
文献类型：
--
作者：
Lee, Seung Ah;Kang, Ji-Young;Lim, Jae-Young
目的：探讨以肩胛骨为导向的运动对乳腺癌幸存者上肢功能障碍的影响。研究设计：前瞻性随机对照试验。地点：某大学医院康复科。研究对象：32例乳腺癌患者随机分为肩胛骨运动组（n = 16）和普通运动组（n = 16）。从乳腺癌幸存者中招募了一个没有运动的历史对照组（n = 18）。干预措施：以肩胛骨为导向的锻炼主要集中在肩胸运动上。一般运动组进行身体调节运动。运动疗法每周进行一次，持续八周。主要结局指标：与上肢功能障碍相关的疼痛和肢体残疾、生活质量和抑郁作为主观结局。客观结果测量包括肩关节活动度和力量。在基线和运动后评估结果。结果：在基线时，三组间无显著差异。与基线相比，以肩胛骨为导向的运动组在疼痛、身体功能、社交功能和整体生活质量方面均有所改善，而一般运动组在疲劳和活动范围方面均有所改善。整体生活质量的变化（P = 0.067，效应量为0.33）和外旋强度的变化（P = 0.001，效应量为0.55）在肩胛骨导向运动组显著大于一般运动组和对照组。结论：以肩胛骨为导向的运动对疼痛、生活质量和力量方面都有有益的影响。在更大的确定研究中，每组需要32名受试者的样本量。
Objective: To examine the effects of a scapula-oriented exercise on upper limb dysfunction in breast cancer survivors.Study design: A prospective randomized, controlled pilot trial with historical control.Setting: Rehabilitation department at a university hospital.Subjects: Thirty-two women with breast cancer were randomly assigned to scapula-oriented exercise group (n = 16) and general exercise group (n = 16). An historical control group (n = 18) without exercise was enrolled from breast cancer survivors.Interventions: The scapula-oriented exercises were designed focusing on scapulothoracic movement. The general exercise group performed body conditioning exercise. Exercise therapies were performed for one session per week for eight weeks.Main outcome measures: Pain and physical disabilities related to upper limb dysfunction, quality of life and depression were used as subjective outcomes. Objective outcome measures included shoulder range of motion and strength. Outcomes were assessed at baseline and post exercise.Results: At baseline, no significant difference was observed among the three groups. The scapula-oriented exercise group showed improvements in pain, physical function, social function, and global quality of life compared with baseline, whereas the general exercise group showed improved fatigue and range of motion. The change in global quality of life (P = 0.067; effect size, 0.33) and strength of external rotation (P = 0.001; effect size, 0.55) were significantly greater in the scapula-oriented exercise group than in the general exercise and control group.Conclusion: Scapula-oriented exercise had beneficial effects on pain, quality of life and aspects of strength. The sample size required in a larger definitive study is 32 subjects per group.