Fig 2 - uploaded by Justyna Hanuszkiewicz
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Angular parameters of the sagittal spinal curvatures (source: own material). Abverations: α -alfa angle (lumbosacral angle); β -beta angle (thoracolumbar angle); γ -gamma angle (upper thoracic angle)
Source publication
Purpose:
Assessment of the impact of aquatic exercises on the relationship between sagittal spinal curvatures and isokinetic trunk muscle endurance against standard land exercises in women after breast cancer treatment.
Methods:
40 women post breast cancer divided into two groups: a study group (n = 20) participated in the aquatic exercises and...
Contexts in source publication
Context 1
... to each other and heels in a line; next, the examined participant's spatial record of the trunk image was taken in the computer memory. The parameters determining sagittal spinal curvatures were selected for analysis based on the literature on computer diagnostics of body posture [3], [4]. The following angular parameters were evaluated in detail (Fig. 2): alpha angle [°] -inclination of the lumbosacral section; beta angle [°] -inclination of the thoracolumbar section; gamma angle [°] -inclination of the upper thoracic ...
Context 2
... to each other and heels in a line; next, the examined participant's spatial record of the trunk image was taken in the computer memory. The parameters determining sagittal spinal curvatures were selected for analysis based on the literature on computer diagnostics of body posture [3], [4]. The following angular parameters were evaluated in detail (Fig. 2): alpha angle [°] -inclination of the lumbosacral section; beta angle [°] -inclination of the thoracolumbar section; gamma angle [°] -inclination of the upper thoracic ...
Citations
... Breast cancer is the most common cancer among women worldwide [1,2]. Depending on the indication, surgery, radiotherapy, and conservative treatment are usually applied [3]. ...
... Changes in breast size or total loss of breast may cause a change in the center of gravity, spinal geometry, and posture. In the literature, following breast cancer surgery, postural changes in all planes, but especially in the sagittal plane in the spine, were declared and these changes occurred shortly after surgery and progressed over time [1,2,[4][5][6]. As a result of biomechanic changes in the spine, adaptive changes may occur at the thorax that further may affect respiratory muscles at various rates, especially the diaphragm. ...
... Changes in the thorax and spine following mastectomy have been the subject of much research [1,2,5,20]. A range of conditions, including restricted joint mobility, pain, muscular weakness, peripheral nerve damage, and tissue fibrosis, contribute to postural and balance disorders. ...
Purpose
Despite the research on structural and functional changes that may occur in breast cancer survivors, no study has investigated the relationship between spinal characteristics and the respiratory system. Therefore, we aimed to investigate the relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions in breast cancer patients who have completed their treatment
Methods
This cross-sectional study included 38 female breast cancer surgery survivors. Participants underwent the following evaluations: Chest wall mobility with a tapeline; postural assessments (spinal curvature, spinal mobility, and spinal inclination) with a non-invasive, computer-assisted electromechanical device; and pulmonary function test and respiratory muscle strength with a portable digital spirometer device. The relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions was analyzed by the bivariate correlation analysis.
Results
Increased thoracic curvature angle was associated with decreased FEV1 (r=−0.360, p=0.026) and decreased subcostal mobility (r=−0.385, p=0.017), and the increase in thoracic frontal mobility was associated with decrease in PEF (r=−0.342, p=0.036). Increased lumbar mobility was associated with increased FVC (r=0.324, p=0.047), and increased total spinal inclination mobility was associated with decreased MIP (r=−0.396, p=0.017). Chest wall mobility was associated with postural assessments at varying rates (the r value ranged from −0.357 to 0.661, p<0.05).
Conclusion
The changes in spinal posture and mobility of women who have undergone unilateral breast cancer surgery were associated with respiratory parameters and thoracic cage mobility. These patients’ spinal posture and mobility should be taken into account in conjunction with respiratory functions for a comprehensive assessment.
... The results of several scientific reports indicate that mastectomies may cause body posture disorders such as 2 of 14 asymmetry in the trunk in the frontal plane [18,21,[42][43][44][45][46][47], asymmetry in the shoulder girdle [23,[42][43][44][45][46], the curvature of the spine [18,30,34,48], anterior-posterior [10,19,24,27,41] deepening of thoracic kyphosis [11,23,34,41,47], deepening of lumbar lordosis [47], and pelvic abnormalities [10]. Researchers are currently trying to answer questions surrounding whether the body postures of women after mastectomy depend on which side of the body was operated on [7,19,20,32,34,47], the type of procedure performed [20,21,24,34,39], lymphedema [26,27,31], the time elapsed since the procedure [21], breast reconstruction [22,25,28,30,33,40], and type reconstruction [25] as well as the type of physical activity practiced or rehabilitation [19,[35][36][37][38]. The literature on the subject and popular opinion have indicated the importance of external breast prostheses in restoring correct trunk statics and protecting against body posture disorders and balance disorders [32]. ...
... Moiré topography is a method that allows for the precise analysis of the locations of individual body segments (e.g., spine, shoulder girdle, and hip girdle) in relation to the body's main axis in three planes. Because of its high accuracy, MT has been widely recognized as a gold-standard research tool to study the body postures of women who have had mastectomies [19][20][21]23,24,29,33,35,36,38,39]. The results of the above studies report the occurrence of body posture disorders in women following mastectomies, particularly in the sagittal plane [10,19,24,27]. ...
Most women who have had a mastectomy and have not opted for breast reconstruction choose to use an external breast prosthesis. This study aimed to assess the impacts of external breast prostheses on the body postures of women after unilateral mastectomies. An additional aim was to identify whether postural asymmetry depended on the side of mastectomy. This study involved 52 women after unilateral mastectomy and consisted of two parts: (1) anthropometric measurement and (2) assessment of body posture using the moiré topography method. The posturometric indices showed that the body posture of the subjects in the sagittal plane is characterized by forward trunk inclination and a tendency to excessive kyphosis. There were no significant differences between parameters characterizing body posture with and without external breast prosthesis. The lack of external breast prosthesis had a significant effect only on excessive forward trunk inclination. Significant differences were found in the posturometric parameters in the transverse plane between the groups of patients after left- and right-sided mastectomy. The obtained results did not fully confirm the hypothesis that the external breast prosthesis affects the body posture of women after unilateral mastectomy.
... The participant was placed in a semi-standing position [19,[21][22][23][24] in a chair so that the arm of the dynamometer was positioned at the L5-S1 spine segment. The starting position began with a maximum extension of the trunk. ...
... Each measurement was preceded by a verbal instruction and a warm-up exercise (several test runs). The selection of total work-TW (J) and average power-AP (W) parameters for endurance measurements of the trunk muscles were based on existing studies using isokinetic tests [19,[21][22][23][24]. TW represents the ability of the muscle's capability to generate strength and maintain it throughout the range of motion. ...
... The angular parameters of the spine, alpha angle (°)-the inclination of the lumbosacral section, beta angle (°)-the inclination of the thoracolumbar section, and gamma angle (°)-the inclination of the upper thoracic section, were selected for sagittal spinal curvature assessment [19,21,23,27]. Additionally, in order to determine the trunk inclination The selection of total work-TW (J) and average power-AP (W) parameters for endurance measurements of the trunk muscles were based on existing studies using isokinetic tests [19,[21][22][23][24]. TW represents the ability of the muscle's capability to generate strength and maintain it throughout the range of motion. ...
Nordic walking (NW) is a popular form of rehabilitation. NW improves psychophysical condition in breast cancer (BC) survivors. This study aimed to analyze the effects of NW on functional and postural changes of the trunk in women of different ages after BC. We hypothesized that an age relationship would be found. BC survivors (n = 39) were stratified by age as "middle- aged" (45-59 years) or "older" (60-75 years), then randomly allocated to the training intervention. A study group (SG, n = 19) participated in NW and a control group (CG, n = 20) performed general gymnastics. The sagittal spinal curvatures and isokinetic trunk muscle endurance were recorded at two time points, pre- and post-training intervention. Significant within NW group changes (p < 0.05) were found for the total work (TW) and average power (AP) of trunk flexors and extensors and the upper thoracic angle in middle-aged women. In older Nordic walkers, significant increases in TW and AP of the trunk flexor muscles were observed, with a negative increase in the trunk inclination angle. In CG, no significant functional or postural changes were observed in response to general gymnastics. NW improved both functional and postural changes in middle-aged women. This study identified the limitations of NW training in older women.
Introduction:
The constant improvement of the diagnostic process and the crescent efficacy of treatment options for Breast Cancer have led to an increase in the survival rate of patients. Thereby, it has become fundamental for Breast Care Units to deal with short-, medium-, and long-term sequelae of the disease and its treatment. Among these, changes in posture seem to have a crucial role. This review aims to collect and summarize the current knowledge on postural disorders in Breast Cancer Survivors, focusing on evaluation methods and rehabilitation protocols.
Evidence acquisition:
A systematic research was conducted on PubMed, Scopus and World of Science databases, considering all the studies published up to 2021. Case reports, case series, cross-sectional, retrospective and prospective studies were included. Narrative and Systematic reviews were excluded.
Evidence synthesis:
After applying the eligibility criteria and bibliographic expansion, 55 articles were selected. Forty-four studies focused on the analysis and the quantification of postural abnormalities, showing a huge variability in population characteristics, valuative methods and outcome measures. Most of them are cross-sectional studies. Rehabilitation treatments have been considered in only 12 studies: all the rehabilitative treatments proved to be effective but, the heterogeneity among the evaluation methods has made a comparison impossible. Hence, we designed a complete evaluation protocol for the assessment of postural abnormalities in Breast Cancer Survivors. Our protocol has been drawn following the structure of International Classification of Functioning, Disability and Health.
Conclusions:
Our review pointed out the crescent interest of the current Literature on analysis and treatment of postural alterations in breast cancer survivors. Since the extreme variety of outcome measures made it impossible to give a clear indication for evaluation and treatment of this disorder, we designed a complete evaluation protocol for the assessment of postural abnormalities in breast cancer survivors, with the goal of guiding the design of new clinical trials on these subjects.
