Examining upper limb kinematics and dysfunction of breast cancer survivors in functional dynamic tasks |
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| Institution: | 1. Breast Surgical Unit, University Hospital of Parma, Parma, Italy;2. University Plastic and Reconstructive Unit, University Hospital of Parma, Parma, Italy;3. Neuroscience Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy;4. Pharmacological and Drug Clinical Governance Service, University Hospital of Parma, Parma, Italy;1. Section for Surgical Pathophysiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark;2. Department of Breast Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark;3. Anesthesiological Department, the Abdominal Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark;1. Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, Box 0736, San Francisco, CA 94143-0736, USA;2. Department of Physical Therapy, Samuel Merritt University, 450 30th Street, Oakland, CA 94609, USA;3. Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, USA |
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| Abstract: | BackgroundComorbidities within the breast cancer population can reduce quality of life. Current breast cancer survivor upper limb kinematic strategies unfortunately lack robust connection with performing important activities of daily living.MethodsAccordingly, fifty breast cancer survivors performed 88 dynamic tasks (divided into range of motion-reach, range of motion-rotate, activity of daily living, and work tasks). Humerothoracic and scapulothoracic angles were extracted from motion capture data. Bilateral differences existed for range of motion, and maximal and minimal scapulothoracic and humerothoracic angles.FindingsGenerally, the affected side used less range of motion across task types. Humerothoracic angles on the affected side experienced 6.7° less range of motion in plane of elevation in range of motion-reach (p < 0.01), 2.3° less elevation angle range of motion in range of motion-rotate (p = 0.01), and 7.1° more internal rotation range of motion in range of motion-rotate (p < 0.01). Scapulothoracic angles on the affected side had 2° more anterior/posterior tilt range of motion in work tasks (p = 0.03), 3.4° less maximal protraction in activity of daily living tasks (p = 0.01), and 3.5° less minimum downward rotation in range of motion-rotate (p < 0.01).InterpretationA reduced range of motion on the affected side suggests the breast cancer population had less varied movement strategies, keeping movements in narrower ranges to avoid disability, pain, or subacromial impingement. This investigation produced an unprecedentedly diverse collection of three-dimensional humerothoracic and scapulothoracic kinematics for a breast cancer population. Documentation of physical capability, dysfunction, and adaptive strategies is a crucial step towards developing targeted strategies for enhancing functional recovery in breast cancer survivors. |
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