DOI QR코드

DOI QR Code

유방암 절제술 환자의 어깨 관절가동범위 증진을 위한 재활 연구에 관한 체계적 고찰

A Systematic Review on Rehabilitation Research for Improving the Range of Motion of Shoulder Joint Motion in Patients with Breast Cancer Resection

  • 박보라 (우석대학교 작업치료학과)
  • Park, Bo-Ra (Department of Occupational Therapy, Woosuk University)
  • 투고 : 2020.10.01
  • 심사 : 2020.11.20
  • 발행 : 2020.11.28

초록

본 논문의 목적은 유방암 절제술 환자의 어깨 관절가동범위 증진을 위한 재활 연구에 관한 연구를 체계적 고찰하여 재활의 종류와 효과를 확인하는 것이다. 체계적 고찰을 위해 RISS를 포함한 3개의 데이터베이스 검색을 통해서 최종적으로 총 8편의 연구를 선정하였다. 본 연구결과 질적근거 수준은 III단계 4편(50.0%)이었고, 재활 기간은 4주에서 12주로 다양하였다. 재활의 종류는 작업치료 재활 연구가 3편(37.5%), 물리치료 재활 연구가 3편(37.5%)이었다. 어깨 관절가동범위는 굴곡, 신전, 외회전 움직임의 평가를 한 연구가 7편(87.5%)이었다. 종속변수의 측정도구로 관절가동 범위를 평가하기 위해서 각도계를 8편(100.0%)에서 사용하였다. 본 연구는 유방암 절제술로 인해 관절가동범위 제한이 있는 환자의 중재 프로토콜 개발 및 적용 시 관련 융합분야에서 기초자료를 제공할 것으로 기대한다.

The purpose of this study is to investigate the types and effects of rehabilitation by systematically examining the rehabilitation research for improving the shoulder ROM in breast cancer resection patients. For a systematic review, a total of 8 studies were finally selected through three databases including RISS. As a result of this study, the level of qualitative was 4 studies(50.0%) in level III, and the rehabilitation period varied from 4 weeks to 12 weeks. As for the type of rehabilitation, 3 studies(37.5%) were occupational therapy and physical therapy. The ROM of the shoulder joint was 7 studies(87.5%) of flexion, extension, and external rotation. A goniometer was used in 8 studies(100.0%) to evaluate the ROM of the joint as a measuring tool. This study is expected to provide basic data in the field of convergence when developing and applying interventional protocols for patients with limited ROM due to breast cancer resection.

키워드

참고문헌

  1. U. J. Park et al. (2013). A Study on Ten Years Trend of Cancer Incidence and Evaluation of Quality of Cancer Registration in Daejeon Metropolitan City and Chungcheongnam-Do, Korea: 2000-2009. Journal of the Korea Academia-Industrial cooperation Society, 14(3), 1234-1244. DOI : 10.5762/KAIS.2013.14.3.1234
  2. A. Jemal, F. Bray, M. Center, J. Ferlay, E. Ward & D. Forman. (2011). Global cancer statistics. CA Cancer J Clin, 61(2), 69-90. https://doi.org/10.3322/caac.20107
  3. Korea National Cancer Information Center. (2019). Cancer statistics, 2017(Online). http://www.cancer.go.kr/lay1/S1T639C641/contents.do
  4. H. S. Park, G. Y. Cho & K. Y. Park. (2006). The effects of a rehabilitation program on physical health, physiological indicator and quality of life in breast cancer mastectomy patients. Journal of Korean Academy of Nursing, 36(2), 310-320. https://doi.org/10.4040/jkan.2006.36.2.310
  5. H. J. Won & J. I. Kim. (2009). The effect of cancerovercome BeHaS exercise program on pain, flexibility, grip strength and stress in breast cancer patients following surgery. Journal of Korean Academy Fundamentals of Nursing, 16(2), 181-189.
  6. T. Badger, C. Segrin, S. M. Dorros, P. Meek & A. M. Lopez. (2007). Depression and anxiety in women with breast cancer and their partners. Nursing Research, 56, 44-53. https://doi.org/10.1097/00006199-200701000-00006
  7. V. Mathiowetz, K. Weber, G. Volland & N. Kashman. (1984). Reliabilty and validity of and pinch strength evaluations. The Journal of hand surgery, 9(2), 222-226. DOI : 10.1016/S0363-5023(84)80146-X
  8. R. D. Smith & M. W. Benqu. (1985). Pinch and grasp strength. Standardization of terminology and protocol. American Journal of Occupational Therapy, 39(8), 531-535. DOI : 10.5014/ajot.39.8.531
  9. B. P. Kattel, T. K. Fredericks, J. E. Fernandez & D. C. Lee. (1986). The effect of upperextremity posture on maximum grip strength. International Journal of Industrial Ergonomics, 18(5), 423-429. DOI : 10.1016/0169-8141(95)00105-0
  10. R. Helms, E. O'Hea & M. Corso. (2008). Body image issues in women with breast cancer. Psychology, Health & Medicine, 13, 313-325. DOI : 10.1080/13548500701405509
  11. R. J. Klika, K. E. Callahan & K. S. Golik. (2008). Exercise capacity of a breast cancer survivor: A case study. Medicine and Science in Sports Exercise, 40(10), 1711-1716. DOI : 10.1249/mss.0b013e31817e30b6
  12. J. A. Woods, J. M. Davis, J. A. Smith & D. C. Nieman. (1999). Exercise and cellular innate immune function. Medicine and Science in Sports and Exercise, 31(1), 57-66. 31. https://doi.org/10.1097/00005768-199901000-00011
  13. Y. J. Jo & S. Y. Lee. (2020). The Effects of Proprioceptive Neuromuscular Facilitation(PNF) Using Elastic Bands on Edema, Range of Motion, and Pain in Post-Mastectomy Patients with Upper Limb Lymphedema: Differences between Open-Hand and Closed-Hand Grips. PNF and Movement, 18(1), 1-10.
  14. Y. W. Kim & M. S. Kim. (2009). The Effects of 12 Week's Yoga, Elastic Band Exercise and Swiss Ball Exercise Program on Physical Function Improvement for Breast Cancer Survivor. Journal of Sport and Leisure Studies, 35(2), 1051-1060. https://doi.org/10.51979/KSSLS.2009.02.35.1051
  15. H. J. Yoo. (2020). Effect of 6-Week Scapula Stabilization Exercise on Scapula Position and Range of Motion After Breast Cancer Surgery. Master dissertation, Hanseo University, Seosan.
  16. H. J. So. (2009). The Effect of Elastic Band Exercise on Postoperative Improvement Shoulder Joint Dysfunction of Breast Cancer Patients. Master dissertation, Daegu University, Daegu.
  17. K. H. Ryu & M. S. Kim. (2010). The Effects of 15 Week's Rehabilitation Program on Health-related Physical Fitness and Metabolic Syndrome Factors for Stomach Cancer and Breast Cancer Patients. Journal of Sport and Leisure Studies, 40(2), 611-620. https://doi.org/10.51979/KSSLS.2010.05.40.611
  18. S. Y. Park & J. I. Kim. (2013). Effects of BeHaS Exercise Program on Flexibility, Grip Strength, Stress and Self-esteem in Breast Cancer Survivors. J Muscle Jt Health, 20(3), 171-179. DOI : 10.5953/JMJH.2013.20.3.171
  19. Y. R. Chae & M. A. Choe. (2001). Effects of exercise on cardiopulmonary functions and shoulder joint functioning in breast cancer patients undergoing radiation therapy after breast surgery. Journal of Korean Academy of Nursing, 31(3), 454-466. https://doi.org/10.4040/jkan.2001.31.3.454
  20. M. Arbesman, J. Scheer & D. Lieberman. (2008). Using AOTA's Critically Appraised Topic(CAT) and Critically Appraised Paper(CAP) series to link evidence to practice. OT Practice, 13(5), 18-22.
  21. C. W. Kim, Y. S. Kwak, Y. S. Kim, K. C. Kim & H. E. Kim (2010). The Effect of Tai-Chi Exercise on the Function of Shoulder Joint, Heart Rate in Breast Cancer Patients. Journal of Life Science, 20(3), 345-349. DOI:10.5352/JLS.2010.20.3.345
  22. Y. J. Song, W. G. Jung, M. S. Song & E. J. Park. (2011). Intervention of Occupational Therapy for Breast Cancer Patients Who Engage in Substantial Upper Extremity Functioning in Their Daily Life and the Quality of Life Effects of Their Increase in Functioning. The Journal of Korean Society of Occupational Therapy, 19(3), 63-74.
  23. J. J. kim, S. J. Lee, J. Y. Choi & J. M. Lim. (2012). The Effects of Home-based Exercise Education on Shoulder Range of Motion, Lymphedema, and Pain for Breast Cancer Resection Patients. Korean Journal of Sports Science 21(4), 895-903.
  24. B. G. Lee, J. S. Lee & T. S. Kim. (2013). The Influence of 4 wks Complex Therapeutic Exercises on Visual Analog Scale of Pain and Range of Motion for Middle-Aged Women with Breast Cancer-Related Lymphedema. Journal of The Korean Society of Physical Medicine, 8(2), 153-161. https://doi.org/10.13066/kspm.2013.8.2.153
  25. H. M. Kim & M. H. Oh. (2017). The Efficacy of Occupational Therapy for Middle-Aged Breast Cancer Patients. Journal of the Korea Entertainment Industry Association, 11, 122-126.
  26. S. J. Nam & T. W. Kang. (2017). Effects of Scapular Stabilization Exercise on the Range of Motion, Pain, and Function in the Shoulders of Women with Breast Cancer Surgery. The Journal of Korean Academy of Orthopecic Manual Therapy, 23(2), 67-74.
  27. H. M. Kim & M. H. Oh. (2018). Effect of Occupational Therapy Intervention on Shoulder Range of Motion, Pain and Quality of Life in Breast Cancer Patients. Journal of the Korea Entertainment Industry Association, 12(1), 185-194. https://doi.org/10.21184/jkeia.2018.1.12.1.185
  28. K. H. Lim. (2018). Effectiveness of Individualized Upper Extremity Exercise Program for Patients after Mastectomy. Journal of the Korea Academia-Industrial cooperation Society, 19(10), 313-323. DOI : 10.5762/KAIS.2018.19.10.313
  29. A. Pusic et al. (1999). (1999). Surgical options for the early-stage breast cancer: factors associated with patient choice and postoperative quality of life. Plastic and reconstructive surgery, 104(5), 1325-1333. DOI : 10.1097/00006534-199910000-00013
  30. M. Hladiuk, S. Huchcroft, W. Temple & B. I. Schnurr. (1992). Arm function after axillary dissection for breast cancer: A pilot study to provide parameter estimates. Journal of Surgical Oncology, 50(1), 47-52. DOI : 10.1002/jso.2930500114
  31. Y. M. Park. (2008). Effects of an early upper-limb exercise program on the shoulder joint function after breast cancer surgery. Master dissertation, Sahmyook University, Seoul.
  32. T. Lee, S. Kilbreath, K. Refshauge, S. Pendlebury, J. Beith & I. M. Lee. (2007). Pectoral stretching program for women undergoing radiotherapy for breast cancer. Breast Cancer Research and Treatment, 102(3), 313-321. DOI : 10.1007/s10549-006-9339-0
  33. S. E. Doble & J. C. Santha. (2008). Occupational well-being: Rethinking occupational therapy outcomes. Canadian Journal of Occupational Therapy, 75(3), 184-190. DOI : 10.1177/000841740807500310
  34. H. M. Kim, G. A. Park, J. J. Park & M. H. Oh. (2019). Relationships Among Self-Efficacy, Social Support, and Community Participation in Breast Cancer Survivors. The Journal of Korean Society of Occupational Therapy, 27(4), 69-82. https://doi.org/10.14519/kjot.2019.27.4.06
  35. H. Gutman, T. Kersz. T. Barzilai, R. Raphael. (1990). Achievements of physical therapy in patients after modified radical mastectomy compared with quadrantectomy, axillary dissection, and radiation for carcinoma of the breast. Arch Surg, 125(3), 389-391. DOI : 10.1001/archsurg.1990.01410150111020
  36. M. S. Chun et al. (2005). Arm Morbidity after Breast Cancer Treatments and Analysis of Related Factors, J Korean Soc Ther Radiol Oncol, 23(10), 32-42.
  37. S. K. Park. (2019). Epidemiological characteristics of breast cancer in Koreans. J Korean Med Assoc, 62(8), 424-436. https://doi.org/10.5124/jkma.2019.62.8.424
  38. S. Y. Loh & H. Jonsson. (2016). Cancer Survivorship Care: A perspective from an OccupationalParticipation Approach. Journal of Cancer Science & Therapy, 8(7), 179-184. DOI: 10.4172/1948-5956.1000411