Meme kanseri ile ilişkili lenfödemin el kas gücü, el fonksiyonları ve elde duyu kaybına etkisi

Amaç: Bu çalışmada meme kanseri ile ilişkili lenfödem’i (MKİL) olan hastaların klinik özelliklerini tanımlamak, MKİL’in el kas gücü ve fonksiyonlarına etkisini araştırmak amaçlanmıştır.Gereç ve Yöntem: Çalışmaya onkolojik rehabilitasyon polikliniğine başvuran MKİL’i olan sağ eli dominant kadınlar dahil edildi. Çalışma prospektif olarak yürütüldü. Tüm hastaların klinik ve demografik bilgileri not edildi, fizik muayeneleri yapıldı. Omuz ağrısı varlığı sorgulandı. Elin kavrama gücünü belirlemek amacıyla Jamar el dinamometresi, parmak ucu kavramalarını değerlendirmek icin pinçmetre kullanıldı. Semmes-Weinstein monofilaman testi ile duyusal kayıplar, el volümetresi ile el volümleri değerlendirildi. Bulgular: Çalışmaya yaş ortalaması 54.5±11.4 (ortalama±SS) olan 32 kadın hasta dahil edildi. Hastaların tamamına aksiller diseksiyon yapılmıştı. Hastaların %62,5’i post- operatif dönemde radyoterapi, %96,9’u kemoterapi almıştı. Hastaların %78,1’i etkilenen tarafta omuz ağrısı olduğunu bildirdi. Sağ tarafı etkilenmiş grupta ve sol tarafı etkilenmiş grupta, sağ el ve sol elin kaba kavrama güçleri, el becerileri, duyu kaybı ve volümleri arasında anlamlı fark saptanmadı. Sol tarafı etkilenmiş grupta sağ elin parmak ucu kavrama gücü ise soldan daha fazlaydı.Sonuç: MKİL’i olan hastalarda aksiler diseksiyon yapılmış olması, post-operatif dönemde kemoterapi ve radyoterapi almış olmak, obezite ve omuz ağrısı sıktır. MKİL’li hastaların değerlendirilmesi ayrıntılı ve çok yönlü olarak yapılmalı ve omuz ağrısının sorgulanması ve el değerlendirmesini de içermelidir.

Anahtar Kelimeler:

Meme kanseri, lenfödem, el kası gücü

Effects of breast cancer related lymphedema on hand muscle strength, hand functions and sensory loss of hand

Purpose: In this study, we aimed to investigate clinical features of patients with breast cancer related lymphedema (BCRL) and effects of BCRL on hand muscle strength and function.Materials and Methods: Patients applying to oncologic rehabilitation polyclinic with right hand dominancy were included in the study. Clinical and demographic data of all patients were noted, physical examinations were performed. The presence of shoulder pain was questioned. To determine the hand grip strength Jamar hand dynamometer and to evaluate the tip pinch strength pinchmeter were used. Sensory loss was assessed with Semmes-Weinstein monofilament test, hand volume measurement was made with hand volumeter.Results: Thirty two female patients with mean age 54.5 ± 11.4 (mean ± SD) were included in the study. Axillary dissection was performed in all patients. 62.5% of patients received radiotherapy in post-operative period, 96.9% received chemotherapy. 78.1% of patients reported that they had shoulder pain on the affected side. In the right side affected group and the left side affected group, there were no significant differences in grip strengths, hand functions, sensory loss and volumes between right and left hands. The tip pinch strength of the right hand was higher than the left side in the left side affected group.Conclusion: In patients with BCRL, having axillary dissection, receiving chemotherapy and radiotherapy in post-operative period, obesity and shoulder pain are common. Evaluation of patients with BCRL should be made in details, should be versatile and should include questioning shoulder pain and hand evaluation.

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