Breast cancer is the most common malignant tumor in female patients in developed countries. Recent articles indicate that one-sided mastectomy or minor breast surgery to treat breast cancer can have deleterious effects on posture and the musculoskeletal system. The purpose of this study was to investigate the alterations post-breast cancer surgery of the spine alignment associated to the balance not reported by the noninvasive instrumentation. We enrolled 30 women who had undergone treatment for breast cancer (BG) and were on a waiting-list for rehabilitation treatment and a control group of 30 healthy volunteer women (CG), matched by age and body mass index. The stabilometry was performed using a force platform (Kistler Instruments, Winterthur, Switzerland) test during quiet standing with closed-eyes (EC) and open-eyes (EO), recording the position of the center of pressure (CoP) for 51.2 sec. The stabilogram or the time plot of the two coordinates, X and Y, of the CoP was obtained, which represent anteroposterior and midlateral balance. Spinal posture was measured using the Formetric-4D rasterstereographic system (DIERS, International GmbH, Schlangenbad, Germany), and thoracic kyphotic angle, lumbar lordotic angle, and surface trunk rotation were evaluated. Sixty participants were analyzed (CG:30; BG:30). For the spine rasterstereography a statistically significant difference was shown with regard to anterior–posterior flexion of the trunk major in BG; pelvic inclination and twist of half-pelvis decreased in BG; normalized lumbosacral inversion point decreased in BG; surface rotation major in BG; and lateral deviation major in BG. Compared with the values for the stabilometry test with EO and EC, a statistically significant difference was observed, respectively, for ellipse length (mm; p = 0.04) and ellipse area (mm 2 ; p = 0.04) with EO and in ellipse area (mm 2 ) with EC ( p = 0.05), increased in BG for both conditions. No difference was shown for CoP velocity and oscillations between the groups. Breast cancer survivors after prostheses or tissue expanders for mastectomy showed a spine's misalignment present both on the sagittal plane, both on the coronal and frontal plane, increased in BG regard to anterior–posterior flexion of the trunk, surface rotation, and lateral deviation. It is associated with greater energy expenditure for the postural balance control increased in BG with a major ellipse area in EO and EC conditions and major ellipse length in EC condition.

The survival rate of women after breast cancer has improved significantly worldwide. More attention should be paid to the rehabilitation intervention after surgery. Cancer rehabilitation helps breast cancer survivors maintain the highest possible physical, social, psychological, and vocational function in the limits that are imposed by the cancer and its treatments. The aim of our research was to determine the rehabilitative setting that promotes greater efficacy of the rehabilitation. A double-blind, randomized controlled trial with 45 patients enrolled was conducted. All participants were randomized into two groups: single rehabilitative training ( N = 22) and group rehabilitative training ( N = 23). Outcomes were assessed for each group before treatment (T0), after first 6 weeks of rehabilitative treatment (T1), and after 3 months (T2). All patients underwent the same rehabilitation treatment, but the setting differed between single and group rehabilitative training, which included four to five patients each and evaluated using Minnesota Multiphasic Personality Inventory (MMPI-2), Working Alliance Inventory Patient form (WAIP), Disabilities of Arm, Shoulder and Hand Questionnaire (DASH), and visual analog scale (VAS). Two patients dropped out in the single treatment group. In the within-group analysis at the three evaluation times, on the VAS, a significant reduction in pain was reported and maintained at the follow-up, as was observed for the DASH and WAIP scales. In the between-group analysis WAIP and Bond scale scores differed significantly in favor of the single treatment. In the group treatment, the Psychopathic Deviate, Masculine/Feminine, and Social Discomfort scales of the MMPI-2 correlated with WAIP Tot at T1. There was an association between the Correction, Hysteria, Paranoid, and Schizophrenia MMPI-2 scales and Δ VAS T0T1 in the total sample. Proposing the same rehabilitative intervention in both breast cancer groups, our results showed significant reduction in pain and good functional recovery of the upper limb, which did not depend on the setting (single or group). However, with single rehabilitation treatment, patients developed a better therapeutic alliance and experienced a more comfortable environment.

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Introduction: Breast-cancer is leading cause of morbidity and mortality in women. The prognosis and survival rate of women with breast-cancer have significantly improved worldwide; more attention needs to be paid to rehabilitative interventions after surgery. This paper describes use of reaching movement to assess upper limb motorcontrol and functional ability after breast-cancer surgery (BC). Material and Methods: We conducted a cross-sectional observational study consisting of biomechanical evaluation of upper limb limitations in women BC, versus a controlgroup (CG). Thirty breast-cancer survivors and thirty healthy women participated in this study. Both groups were subjected to clinical evaluation of the shoulder joint ROM on the operated side, as an assessment of the muscular-strength of the shoulder with the MRC-scale. The Functional-Assessment was evaluated by the DASH and Constant-Murley-Score. The EORTC QLQ-C30 and VAS were used to measure the quality of life assessment and pain respectively. A Biomechanical evaluation was performed, using Reaching-Task and Surface-EMG. Results: Normal Jerk for BC was higher than CG. Target approaching velocity and movement duration BC was lower than CG. Synergy Anterior Deltoid/Triceps Brachii muscles in CG was higher than BC. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems CorporationConclusion: In BC, upper limb movement is less fluid. Upper limb movement analysis during reaching task is important to monitor rehabilitation. Further studies should verify condition before surgery.