Longitudinal assessment of the impact of adapted physical activity on upper limb disability and quality of life in breast cancer survivors from an Italian cohort

Abstract

The survivorship phase of breast cancer requires a multidisciplinary collaboration involving either the cancer-care medical team or APA professionals to manage psychophysical outcomes. A specific APA protocol may represent an effective countermeasure to reduce post-treatment upper limb disability and improve the quality of life in breast cancer survivors. Participation in structured APA protocols should be maintained over time to preserve the achieved benefits.

Effectiveness of an Adapted Physical Activity Protocol for Upper Extremity Recovery and Quality of Life Improvement in a Case of Seroma after Breast Cancer Treatment

“…To date, in order to maintain the benefits achieved by following a structured PA pathway, the subject continues the AF activity. At baseline, during and after ending the structured PA intervention, the woman underwent a functional test battery to assess the upper limb mobility through active ROM test and muscle length test [3,5,13]. Active ROM test was executed with the subject standing by goniometry taking into account the extension (range 0-45 • ), flexion (range 0-180 • ), external rotation (range 0-90 • ), and abduction (range 0-180 • ) [3,13].…”

“…Muscle length test was performed with the subject in a supine position by elevating the arm and measuring the distance (cm) from the lateral epicondyle to the surface, with a smaller distance from the surface corresponding to a greater upper limb mobility [13]. Moreover, for assessing lumbar and hamstring ROM, a sit and reach test was used [3,5,13]. To perform this test, the subject sits with legs extended as straight as possible and then flexes the hip joints and vertebral column trying to touch the toes in dorsiflexion with the fingertips of both hands simultaneously.…”

“…In particular, a forward shoulder/scapular posture is frequently related to a tight PMm [14]. In addition, the subject filled in the Short Form-12 (SF-12) questionnaire and the numerical rating scale (NRS) to evaluate health-related QoL and to assess back and shoulder pain intensity, respectively [3,5,13]. The SF-12 questionnaire consists of a physical component score and a mental component score.…”

“…Surgical intervention is currently the main effective treatment for BC and can be complemented with radiotherapy, chemotherapy, hormone therapy and/or biological therapy. Despite substantial advances in technology, the frequent association of surgical procedures with other treatments, and the use of more personalized/less extensive surgical approaches, BC surgery-related complications are still observed [3,5]. The different surgical interventions include simple mastectomy or combined with reconstruction that may influence the patient's motor function soon after the treatment or years later [6].…”

“…Traumatic aspiration may increase the incidence of surgical site infection, clinic visit, and mental stress of patients [8]. While recent research supports that physical activity (PA) interventions can improve physical functioning, treatment-related symptoms, and QoL in cancer survivors [3,5,10,11], the possible effectiveness of PA in cases developing seroma has yet to be demonstrated [12]. Therefore, we herein evaluated for the first time the possible effects of a structured PA pathway for upper extremity recovery and QoL improvement in a case of peri-prosthetic seroma after BC treatment.…”