Abnormality of Shoulder Motions in Postmastectomy Patients

乳癌切除手術後病人之肩關節活動異常

黃麗麗(Li-Li Hwang) ； 曹昭懿(Jau-Yih Tsauo) ； 李慧媛(Hwey-Yuan Lee) ； 連倚南(I-Nan Lien)

《物理治療學會雜誌》 11卷 (1986/11) Pp. 72-79

https://doi.org/10.29617/JPT.198611.0012

摘要

The range of shoulder motions of 107 postmastectomy patients were evaluated by physical therapists during the monthly activities of the Breast Cancer Club, National Taiwan University Hospital in Mar., Apr., and May, 1986. Among them, 12 patients received radical mastectomy, and the 95 patients the modified radical mastectomy (MRM), while 17 patients received post-operative radiotherapy. The mean duration of wound healing of all patients was 22.5±19.6 days.
Seventy percent of the patients had limited range in one or more directions of motion of ispilateral shoulders (affected side) after mastectomies. The incidence of abnormal ROM of the affected shoulder was significantly higher than that of the sound shoulders. The range of motions including flexion, abduction, external and internal rotation of the affected shoulders decreased significantly (p＜0.01) than those of the sound sides of the patients. The mean ROM of them were 159.9°, 151.6°, 77.4° and 81.0° respectively.
The incidence and severity of limited motions of the affected shoulders were different. Although 72 patients got limitation in shoulder flexion, the limitations were quite mild. Shoulder external and internal rotation showed least but most severely affected.
Prolnged immobilization was considered to be the cause of limited mobility of affected shoulder of patients. Duration of wound healing and postoperative radiotherapy were also correlated with the decreased ROM of affected shoulders of patients. Other possible correlated factors such as age of patients, side of operation, postoperative activities did not show any significant relations with the limited motions of the affected shoulders of patients in this study. A comprehensive rehabilitation program for breast cancer patients should be set up to help the patients from the development of shoulder contractures.

並列摘要

The range of shoulder motions of 107 postmastectomy patients were evaluated by physical therapists during the monthly activities of the Breast Cancer Club, National Taiwan University Hospital in Mar., Apr., and May, 1986. Among them, 12 patients received radical mastectomy, and the 95 patients the modified radical mastectomy (MRM), while 17 patients received post-operative radiotherapy. The mean duration of wound healing of all patients was 22.5±19.6 days.
Seventy percent of the patients had limited range in one or more directions of motion of ispilateral shoulders (affected side) after mastectomies. The incidence of abnormal ROM of the affected shoulder was significantly higher than that of the sound shoulders. The range of motions including flexion, abduction, external and internal rotation of the affected shoulders decreased significantly (p＜0.01) than those of the sound sides of the patients. The mean ROM of them were 159.9°, 151.6°, 77.4° and 81.0° respectively.
The incidence and severity of limited motions of the affected shoulders were different. Although 72 patients got limitation in shoulder flexion, the limitations were quite mild. Shoulder external and internal rotation showed least but most severely affected.
Prolnged immobilization was considered to be the cause of limited mobility of affected shoulder of patients. Duration of wound healing and postoperative radiotherapy were also correlated with the decreased ROM of affected shoulders of patients. Other possible correlated factors such as age of patients, side of operation, postoperative activities did not show any significant relations with the limited motions of the affected shoulders of patients in this study. A comprehensive rehabilitation program for breast cancer patients should be set up to help the patients from the development of shoulder contractures.

並列關鍵字

mastectomy ； shoulder motion