Breast cancer is ranked the top in types of cancer that affects internationally. It affects up to 1 in 13 women during their lifetime. Physiotherapy is one of the major sources of recovery in patients of Mastectomy in terms of pain, ranges, and function. OBJECTIVE: To compare the effects of pre-operative shoulder rehabilitation program versus post-operative mastectomy patients. METHODS: This was a randomized clinical trial. The study setting was Oncology Department, Mayo Hospital Lahore, Shokat Khanum and Gulab Devi Hospital Lahore. The study was completed in 6 months. Total 50 subjects were allocated in two groups using lottery method of randomization. Patient with age less than 40 years, diagnosed with breast cancer were included, while those with associated signs of musculoskeletal problems, autoimmune systemic disease and advanced medical problem was excluded. Group A received set of exercises comprised of range of motion exercises and lymph edema education pre and post operatively. Group B received post rehabilitation exercises only. Data was analyzed by SPSS 16.0. Independent t test was applied to analyze between group differences and paired sample t test to see within group improvement. Descriptive statistics was in form of mean, variance and appropriate graphs. RESULTS: Independent sample test results regarding post interventional disability of arm, shoulder, and hand (DASH) score showed significant p value 0.000 with a mean difference of 23.28000 while assuming equal variances. The mean and standard deviation of pain score was 3.76 (SD+0.778) pre/post combination group and post-operative rehabilitation program alone 4.1200 (SD+0.78102) with a statistically equal improvement in both groups (0.109). CONCLUSION: The study concluded that there was significant difference with better outcomes in terms of improvement in function, pain and range in patients having combination protocol i.e. pre-operative and post-operative rehab protocol in patient of mastectomy as compared to post-operative rehabilitation protocol alone.
Women have been wearing high heels for decades and they remain a must-have for females going out on the town or to the workplace every day. It causes prolonged pressure on the muscles, bones, and tissues of the feet and ankles, on the other hand, may cause chronic foot discomfort or abrupt injuries that need surgical intervention in the feet and ankle. Objective: To determine an association between foot pain and high-heeled shoes in working women. Methods: A cross-sectional study was conducted to measure the prevalence of foot pain among females wearing heeled footwear, focusing only working women. A sample size of 285 was taken. Foot Health Status Questionnaire was used to collect data from the respondents from different areas of Lahore. The data was collected from office workers and school teachers. Considering inclusion and exclusion criteria. females were requested to participate. The questionnaire consisted of 13 questions that were used in this survey. The questionnaire had multiple options out of which only one option was to be selected which was nearest to representing their condition of foot. All the data was analyzed on SPSS (version 25) software. A scoring of 0-100 was used to calculate the results. Results: According to this study, a majority of 162 females had mild to moderate foot pain, 84.4% of females had foot pain and 15.6% of females had no pain. Foot pain had a statistically significant association with walking, climbing stairs, and doing work or activities, (P-value 0.000). Respondents having foot pain couldn’t do all the above activities normally. Restrictions and limitations were found among the respondents with foot pain. A P-value of less than 0.05 indicates that there is a significant association between the severity of foot pain and difficulties during work or activities of daily life Conclusions: The study concluded that there is very high prevalence of foot pain (96%) among females wearing high heels. Long term use of high heels significantly affects the foot health and activities of respondents.
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