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Objectives:
In this study, we aimed to investigate the availability of the Timed Up and Go (TUG) test in daily practice instead of the Tampa Scale for Kinesiophobia (TSK) test for the evaluation of fear of movement and to assess the functionality of the upper extremity in postmastectomy lymphedema patients.
Patients and methods:
Between March 20...
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Introduction: Post radical mastectomy patients will have physical problems like reduced shoulder movements and upper limb muscles strength. The performance and overall function of upper limb and Quality of Life (QOL) will reduce followed by these muscle’s reduced activity. The aim of present study is to find the effects of manual lymphatic drainage with low resistance training of upper limb on shoulder function and QOL of post mastectomy patients. Generally, upper limb muscles like Trapezius, serratus anterior, pectoralis s group. 1 subject from experimental group withdrawal from study. The treatment duration is 12 weeks based on cancer Rehabilitation principle. Outcome measures are taken Lymph ICF (for QOL), anatomical circumferential measurements (for Lymphedema). Patients selected based on the inclusion and exclusion criteria. Experimental group patients receiving upper limb low resistance training and manual lymphatic drainage techniques and control group patients receiving only manual lymphatic drainage techniques. Both group of patients are advised to wear upper limb elastic stockings for 8 hours per day. Result: All Outcome measures taken in baseline (pre) and end of 12 weeks (post) in both groups. Data was analysed by using paired ’t’ test. Results analysed based on pre and post test values. Conclusion: The study has designed a structured low resistance upper limb exercise program for post radical mastectomy patients in improving shoulder function and QOL.
Sanır, R. (2021). Lenfödem Değerlendirmesinde Farklı Yöntemlerin Etkinliğinin
Araştırılması. İstanbul Üniversitesi-Cerrahpaşa Lisansüstü Eğitim Enstitüsü, Fizyoterapi
ve Rehabilitasyon Ana Bilim Dalı. Yüksek Lisans Tezi. İstanbul.
Çalışmamızın amacı; objektif ölçüm yöntemlerinden, dokudaki sertlik miktarını
belirlemede kullanılan myoton cihazının ve sıkça kullanılan yöntem olan mezura ile
ölçüm yöntemlerinin lenfödem miktarını belirlemedeki etkinliğini değerlendirmekti.
Lenfödem tanılı 54 hasta çalışmaya dahil edildi. Hastaların kişisel bilgileri,
palpasyon ve inspeksiyon bulguları bir sosyodemografik veri formuna kaydedildi. Ağrı
değerlendirmesinde Vizüel Analog Skala (VAS) kullanıldı. Yaşam kalitesi LYMQOLKol ve LYMQOOL-Bacak Ölçekleri ile değerlendirildi. Hastaların etkilenen ve sağlıklı
ekstremitelerine mezura ile referans noktalardan 10 cm aralıklarla çevre ölçümü ve
myoton ölçümleri yapıldı. Çevre ölçüm değerleri Frustum formülü kullanılarak hacim
ölçülerine çevrildi.
Değerlendirmeler sonucunda katılımcıların ağrı şiddeti ortalamaları VAS’a göre
1,59±2,43 olarak bulundu. Çevre ölçümü ve Frustum hacim hesaplamalarında, etkilenen
taraf ve sağlıklı taraf arasında tüm seviyelerde anlamlı fark bulunurken (p<0,05) myoton
ile değerlendirildiğinde birçok ölçüm seviyesinde anlamlı fark saptanmadı (p>0,05).
Etkilenen taraf myoton ölçümleri ile palpasyon bulgularından gode, sertlik, fibröz doku
arasında düşük ve orta düzeyde korelasyon bulundu (p<0,05). Korelasyon tespit edilen
myoton değerleri için ROC analizi uyguladığımızda: myotonun, sertlik, gode ve fibröz
doku varlığının ayırımını yaptığı saptandı (p<0,05).
Lenfödem değerlendirilmesinde myotonun etkin bir yöntem olmadığı sonucuna
ulaşılmıştır. Ancak lenfödemde gözlenen sertlik, gode, fibröz doku varlığı gibi doku
değişikliklerinin var olup olmamasını düşük sensivite ve spesifite ile belirleyebileceği
gösterilmiştir.
Anahtar Kelimeler: Lenfödem, Ölçüm, Ekstremite Hacmi, Çevre Ölçümü, Tıbbi Cihaz
ABSTRACT
Sanır, R. (2021). İnvestigation of the Efficiency of Different Methods in the
Assessment of Lymphedema İstanbul University-Cerrahpasa, Institute of Graduate
Studies, Division of Physiotherapy and Rehabilitation. Master Thesis. İstanbul.
The purpose of study; is to evaluate the effectiveness of the myoton device is used to
determine the amount of hardness tissue and the tape measurement, which is a frequently
used method, in determining the amount of lymphedema.
Personal informations, palpation and inspection findings of all 54 patients with
lymphedema were recorded in sociodemographic data form. Visual Analogue Scale
(VAS) was used for pain assessment. Quality of life was evaluated with the LYMQOLArm and LYMQOL-Leg. Circumference and myotone measurements were made with
tape measure at 10 cm intervals from the reference points on both extremities of the
patients. Circumference values were converted to volume measurements using the
Frustum formula.
As a result, the mean pain intensity of participants was found to be 1.59±2.43 on VAS.
In tape measurements and Frustum volume calculations, while significant difference was
observed at all levels between the affected and healthy side (p<0,05), in myoton
evaluations a significant difference was not found at many levels (p>0,05). A low and
moderate correlations found between the myotone measurements of the affected side and
the palpation findings such as pitting, stiffness, and fibrous tissue at various levels,
(p<0.05). When we performed ROC analysis for the correlated myotone values; it was
found that myotone differentiated the presence of hardness, pitting and fibrous tissue.
It was concluded that myotone is not an effective method in the evaluation of
lymphedema. However, it has been shown that it can determine the presence of tissue
changes such as stiffness, pitting and fibrous tissue observed in lymphedema, with low
sensitivity and specificity.
Key Words: Lymphedema, Measurement, Limb Volume, Medical Device,
Circumference
Purpose: Lymphedema is an important situation that causes physical and psychological life-threatening problems. This study researches kinesiophobia in lower extremity patients and scrutinizes the relationship between kinesiophobia, physical performance and balance. Methods: This cross-sectional controlled study included 40 individuals diagnosed with lower extremity lymphedema with a mean age of 42.58±10.30 years and 31 healthy individuals with a mean age of 40.65 ± 9.53 years. The evaluation of patients with unilateral lymphedema without cognitive and visual problems and those without orthopedic and neurological disorders that would prevent walking and those without heart disease and hypertension was carried out between November 2018 and March 2019. Static balance was evaluated with standing on One leg Balance Test, fear of movement was evaluated with Tampa Scale Kinesiophobia and functional levels were evaluated with Timed Up and Go test. Results: Static balance and physical performance of lower extremity lymphedema patients were found to be statistically different than healthy individuals (p
Purpose:
The purpose of this study was to translate and evaluate the psychometric properties of the Chinese version of the Upper Limb Lymphedema Quality of Life Questionnaire (C-ULLQoL).
Methods:
Eighty-five participants completed the C-ULLQoL and the Functional Assessment of Cancer Therapy-Breast (C-FACT-B). The Cronbach's alpha (α) was used to determine the internal consistency, and intraclass correlation coefficients (ICCs) - to evaluate the test-retest reliability. The content validity index (CVI) was assessed by a group of experts. Construct validity was examined by performing factor analysis and criterion validity by observing the correlations between C-ULLQoL with C-FACT-B.
Results:
Cronbach's α of the total scale was 0.930. ICC scores ranged from 0.874 to 0.938. The content validity of C-ULLQoL was acceptable. Two factors (65.488% of the variance) were extracted by exploratory factor analysis. A significant correlation was observed between C-ULLQoL and C-FACT-B (r = -0.611, p < 0.01).
Conclusion:
The C-ULLQoL is a reliable and valid questionnaire that can be used in clinic and scientific practice for evaluating health-related quality of life in Chinese patients with breast cancer-related lymphedema.IMPLICATIONS FOR REHABILITATIONAn effective and comprehensive scale to measure the health-related quality of life (HRQoL) is essential because breast cancer-related lymphedema (BCRL) leads to various complications for patients, caregivers, and society.The Chinese version of the Upper Limb Lymphedema Quality of Life Scale (C-ULLQoL) is a valid, reliable, and practical instrument to comprehensively assess HRQoL in Chinese patients with BCRL.The C-ULLQoL can be used in both clinical and research settings to evaluate HRQoL of BCRL patients in China.
