Impingement pain affects kinematics of breast cancer survivors in work-related functional tasks

Lang, Angelica E.; Dickerson, Clark R.; Kim, Soo Y.; Stobart, Jamie; Milosavljevic, Stephan

doi:10.1016/j.clinbiomech.2019.10.001

Cited by 25 publications

(37 citation statements)

References 47 publications

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“…Next, five functional tasks were performed, in the same order for each participant, as follows: First, while seated, participants performed a reach to a shelf that was centered in front of their body at a height of 1.5 meters. 16,17 The task was performed separately by each arm in both unloaded and loaded (1 kg) conditions, three times each. The repetitive reach was the second task.…”

Section: Methodsmentioning

confidence: 99%

“…Both the noncancer control and mastectomy only groups were part of the first phase of this project. 16 The study protocol was approved by the University of Saskatchewan research ethics board.…”

Section: Participantsmentioning

confidence: 99%

“…Most investigations have been limited to arm elevation in a single plane, [12][13][14][15] and two of the most recent studies of shoulder kinematics in functional and workrelated activities were completed by this research team. 16,17 Regardless of assessment methods, investigations of shoulder biomechanics after breast cancer treatment have noted some type of alteration, often in a scapular angle. 12,13,15,16,18 However, previous investigations have either not included breast reconstructions or did not intentionally examine the effects of reconstructions, which may have a more substantial effect on both scapular and humeral motion.…”

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confidence: 99%

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“The effect of breast reconstruction on kinematics and performance during upper limb-focused functional tasks”

Lang

Card

Barden

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Breast reconstruction after curative breast cancer surgery is becoming increasingly common. There is evidence to suggest that these surgeries have negative effects on shoulder function, but to date there have been no investigations of shoulder biomechanics during functional tasks in this group. The purpose of this study was to define and compare upper limb motion of patients with breast cancer who underwent mastectomy only or mastectomy with reconstruction with a control group without cancer during a range of work-related functional tasks. Methods: Ninety-five women participated: 25 controls, 25 patients with breast cancer who received a mastectomy only, and 45 patients with breast cancer who received a mastectomy with reconstruction (implant, latissimus dorsi flap, or deep inferior epigastric artery perforator flap). Motion of the torso, humeri, and scapulae were tracked during arm-focused functional tasks, involving reaching, dexterity, and lifting overhead, and joint angles were calculated. Mean, maximum, and minimum angles were calculated and compared among groups using one-way analyses of variance (p < 0.05). Results: The reconstruction group had significantly different kinematics than the other two groups. Throughout task performance, patients who had reconstruction had increased scapular posterior tilt and increased humeral external rotation. These findings are consistent with reconstruction surgical procedures and may highlight muscle pattern alterations that interfere with co-contraction, stability, and functional task performance. Conclusions: The findings suggest that breast reconstruction surgery influences functional task performance. Scapular and humeral kinematics may indicate movement pattern differences that are important to address in rehabilitation. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.

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Section: Methodsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

mentioning

confidence: 99%

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“The effect of breast reconstruction on kinematics and performance during upper limb-focused functional tasks”

Lang

Card

Barden

et al. 2022

Plastic &Amp; Reconstructive Surgery

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“…In breast cancer patients, tightening of the pectoral muscles is common and can occur through a combination of mechanisms including pain induced contraction and radiation fibrosis [109]. This misalignment has been demonstrated and likely creates a predisposition to impingement as one study showed positive impingement signs in 13/25 breast cancer survivors vs. 0/25 controls [110,111].…”

Section: Shoulder Impingement Syndromementioning

confidence: 99%

A Targeted Approach to Post-Mastectomy Pain and Persistent Pain following Breast Cancer Treatment

Chang

Asher

Smith

2021

Cancers

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Persistent pain following treatment for breast cancer is common and often imprecisely labeled as post-mastectomy pain syndrome (PMPS). PMPS is a disorder with multiple potential underlying causes including intercostobrachial nerve injury, intercostal neuromas, phantom breast pain, and pectoralis minor syndrome. Adding further complexity to the issue are various musculoskeletal pain syndromes including cervical radiculopathy, shoulder impingement syndrome, frozen shoulder, and myofascial pain that may occur concurrently and at times overlap with PMPS. These overlapping pain syndromes may be difficult to separate from one another, but precise diagnosis is essential, as treatment for each pain generator may be distinct. The purpose of this review is to clearly outline different pain sources based on anatomic location that commonly occur following treatment for breast cancer, and to provide tailored and evidence-based recommendations for the evaluation and treatment of each disorder.

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“…In addition, it allows to draw conclusions regarding cerebral lesions [15], cognitive processing [16, 17], and on executive and social functioning [18, 19]. Moreover, score changes have been shown to be of prognostic value in disease progression [20, 21] and the incidence of post-operative complications [22, 23].…”

Section: Introductionmentioning

confidence: 99%

Routine Cancer Treatment Regimens and Its Impact on Fine Motor Dexterity in Breast Cancer

et al. 2021

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Introduction: Breast cancer can be a major challenge for those affected. Knowledge of changes in fine motor dexterity in affected women due to routine cancer therapies can help guide effective support. Methods: For this prospective observational study, we collected data of 79 women with a mean age 54.6 ± 9.5 years prior to, after breast cancer therapy (T1), and at 3-month follow-up. The fine motor dexterity was assessed for 4 treatment subgroups: SC = Surgery + Chemotherapy, SCR = Surgery + Chemotherapy + Radiotherapy Therapy, SR = Surgery + Radiotherapy, and S = Surgery. Results: Over time, women with breast cancer showed significant decreases in fine motor dexterity across all treatment groups (p < 0.001). The strongest negative effect was seen in the treatment groups receiving additional chemotherapy. SCR group showed pronounced limitations for dominant hand (DH) −12%; non-dominant hand (NDH) −15%; both hands (BH) −17%; assembly (ASSY) −11% at T1. Significant interaction was noticeable in DH (F = 5.59, p < 0.001), NDH (F = 6.61, p < 0.001), BH (F = 13.11 p < 0.001), and ASSY (F = 5.84 p < 0.001). Discussion/Conclusion: Our study showed that the extent of change in fine motor dexterity depends on the treatment regimen. The detection of unmet care needs could help to personalize and optimize clinical and survivorship care. Based on our findings, multidisciplinary support initiated early in breast cancer therapy is required.

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Impingement pain affects kinematics of breast cancer survivors in work-related functional tasks

Cited by 25 publications

References 47 publications

“The effect of breast reconstruction on kinematics and performance during upper limb-focused functional tasks”

“The effect of breast reconstruction on kinematics and performance during upper limb-focused functional tasks”

A Targeted Approach to Post-Mastectomy Pain and Persistent Pain following Breast Cancer Treatment

Routine Cancer Treatment Regimens and Its Impact on Fine Motor Dexterity in Breast Cancer

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