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. 2013 Dec;11(4):426-34.
doi: 10.1590/s1679-45082013000400004.

Assessment of posture and joint movements of the upper limbs of patients after mastectomy and lymphadenectomy

[Article in English, Portuguese]
Cinira Assad Simão Haddad, Marcelo Saad, Maria Del Carmen Janeiro Perez, Fausto Miranda Júnior

Assessment of posture and joint movements of the upper limbs of patients after mastectomy and lymphadenectomy

[Article in English, Portuguese]
Cinira Assad Simão Haddad et al. Einstein (Sao Paulo). 2013 Dec.

Abstract
in English, Portuguese

Objective: To evaluate alterations in posture and range of motion of the upper limbs in women after mastectomy and lymphadenectomy, submitted to radiotherapy as adjuvant treatment.

Methods: Two groups were evaluated: 16 post-mastectomy women with lymphedema of the upper limb and 14 post-mastectomy women without lymphedema. Patients were submitted to analysis made by software, one for posture and the other to measure ranges of movement of the shoulder, elbow, and wrists. The results obtained were compared between the right and left sides, and operated and non-operated sides, and then were submitted to statistical tests.

Results: Both groups presented with anteriorization of the trunk. The women with lymphedema had head rotation to the right, protrusion of the left shoulder, and trunk inclination angle smaller on the operated side, besides bilateral elevation of the scapula when compared to the group with no lymphedema. Changes in range of motion were also smaller on the operated side in terms of flexion, abduction, and external rotation of the shoulder for all women, and for those with lymphedema, elbow extension and wrist flexion had a smaller range of motion.

Conclusion: Women submitted to mastectomy presented with asymmetries and modifications in posture, and lymphedema seemed to worsen this condition. Additionally, they had deficits in range of motion in the shoulders on the operated side. Women with lymphedema also showed deficits in the elbows and wrist.

Objetivo:: Avaliar as alterações posturais e de amplitudes de movimento de membro superior nas mulheres pós-mastectomia e linfadenectomia que se submeteram à radioterapia como tratamento adjuvante.

Métodos:: Foram avaliados dois grupos: 16 mulheres pós-mastectomia com linfedema de membro superior e 14 mulheres pós-mastectomia sem linfedema. As pacientes foram submetidas à avaliação feita por programas computadorizados, um para postura e outro para medir as amplitudes de movimento de ombro, cotovelo e punho. Os resultados obtidos foram comparados entre lado direito e esquerdo, e operado e não operado, sendo submetidos a testes estatísticos.

Resultados:: Ambos os grupos apresentaram anteriorização de tronco. As mulheres com linfedema mostraram rotação de cabeça à direita, protusão de ombro do lado esquerdo e medidas do ângulo de talhe menores do lado operado, além de elevação da escápula bilateralmente, quando comparadas ao grupo sem linfedema. As alterações de amplitude de movimento também foram menores do lado operado na flexão, abdução e rotação externa de ombro para todas as mulheres e, para aquelas que tinham linfedema, a extensão de cotovelo e a flexão de punho tiveram menor amplitude de movimento.

Conclusão:: Mulheres que foram submetidas à mastectomia apresentaram assimetrias e alterações de postura, e o linfedema parece agravar essa condição. Além disso, apresentaram déficits de amplitude de movimento em ombros, do lado operado. Mulheres com linfedema exibiram também déficits em cotovelo e punho.

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Conflict of interest statement

Conflicts of interest: none.

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