Comparison of isokinetic parameters of the operated side versus non-operated side shoulder joint in breast cancer survivors

Morbidity of the upper extremity after breast cancer (BC) is a well-known phenomenon. Axillary lymph node dissection (ALND) and radiotherapy are an integral part of treatment in patients with invasive breast cancer and axillary lymph node metastases. Radiotherapy is routinely applied to reduce the local recurrence rate after ALND (1). It is known that upper extremity muscle strength is less than healthy women due to reasons such as deterioration of soft tissue integrity with surgical intervention, fibrosis and adhesion formations that can occur with radiotherapy, making movement difficult, and patients tending to protect their arms (2,3). The aim of this study is to compare the isokinetic test parameters of the operated and nonoperated shoulder joints of patients who have undergone ALND and received radiotherapy. Is there a difference between the isokinetic parameters of the operated side and the non-operated side shoulder joint in BC Survivors? Fifty female individuals (mean age: 46.3±8.3) who were treated with ALND and radiotherapy due to unilateral BC, 6 months-2 years after the end of the treatment were included in the study. Shoulder flexors/extensors, abductor/adductors, internal/external rotator muscle groups were evaluated bilaterally by isokinetic dynamometer (Humac Norm, model770, Stoughton, USA) (4). Muscle strength was measured at 60°/s (maximum 5 voluntary repetitions), endurance 180°/s (maximum 15 voluntary repetitions), angular velocity level and concentric/concentric mode. Student's t-test was used for statistical analysis. It was found that the operated side then non-opereted side was significantly lower in all muscle groups in the measurement of peak torque at 60°/s angular velocity, and in the extensor, adductor, internal and external muscle groups in the endurance measurement performed at 180°/s angular velocity (p<0,05) (Table 1).Download : Download high-res image (237KB)Download : Download full-size image Our findings show that women with BC have significantly less muscle strength and endurance on the operated side compared to the non-operated side. These results that it may be beneficial to include training programs and rehabilitation programs for shoulder girdle strength and endurance restoration in patients who underwent ALND and radiation therapy and mastectomy during the treatment of patients with BC. In the light of the information obtained; detection of the most deficit in strength and edurance in the adductor muscle group can be explained by the incision localization of the surgery. In the rehabilitation of these patients, especially the adductor muscle group should be considered. In addition this is the first study to evaluate the upper extremity strength and endurance together after ALND and to reveal the difference between operated and non-operated upper extremity.