Browse > Article
http://dx.doi.org/10.21598/JKPNFA.2021.19.1.19

The Effect of a Four-week Scapular Stabilization Exercise Program using PNF technique on Scapular Symmetry and Range of Flexion Motion, Pain, Function, and Quality of life in Post-Mastectomy Women with Breast Cancer  

Song, Min-Jeong (Department of Physical Therapy, Wonkwang Health Science University)
Kang, Tae-Woo (Department of Physical Therapy, College of Healthand Welfare, Woosuk University)
Publication Information
PNF and Movement / v.19, no.1, 2021 , pp. 19-29 More about this Journal
Abstract
Purpose: This study aimed to compare the effects of a four-week scapular stabilization exercise program using the PNF technique on scapular symmetry and range of flexion motion (ROM), pain, function, and quality of life (QOL) in post-mastectomy women with breast cancer. Methods: This study included 20 women divided into an experimental group (n = 10) and a control group (n = 10). All patients performed complex decongestive physiotherapy for 40 min daily, five times per week for four weeks. The experimental group performed the extra scapular stabilizing exercise program using the PNF technique for 50 min daily, five times per week for four weeks. Scapular symmetry, shoulder flexion ROM, pain and function, and QOL were subsequently assessed. For ROM measurement, the range of shoulder flexion was measured using a clinometer smart phone application; the pain of the shoulder was measured using the visual analogue scale (VAS); the scapular position was measured using a lateral scapular slide test (LSST); the level of pain and functional activity was measured using the Shoulder Pain and Disability Index (SPADI); and the QOL was measured using Functional Assessment of Cancer Therapy-Breast. Results: There were significant differences in shoulder flexion ROM, VAS, SPADI, and LSST 0˚ and 45˚ when the experimental group was compared with the control group (p < 0.05). After the intervention, there was an improved within-group change in the ROM, SPADI, LSST, and QOL in both the experimental and control groups. Conclusion: These findings suggest that a scapular stabilization exercise program using the PNF technique may be used as a possible treatment option for post-mastectomy women with breast cancer that aims to improve scapular position, shoulder ROM and function, and QOL.
Keywords
Breast cancer; Function; Scapular symmetry; Scapular stabilization exercise;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 Kang TW. The effect of proprioceptive neuromuscular facilitation rehabilitation exercise on range of motion, pain, and function of breast cancer patients after surgery. PNF and Movement. 2018;16(1):133-141.
2 Baumann FT, Schule K. Bewegungstherapie und sport bei krebs. Koln: Deutscher Arzte-Verlag. 2008.
3 Helen R, Clare L, Cynthia S, et al. Development of an exercise intervention for the prevention of musculoskeletal shoulder problems after breast cancer treatment: the prevention of shoulder problems trial (UK). BMC health services research. 2018;18(1):463.   DOI
4 Werner BC, Holzgrefe RE, Griffin JW, Et al. Validation of an innovative method of shoulder range-of-motion measurement using a smartphone clinometer application. Journal of shoulder and elbow surgery. 2014;23(11):275-282.
5 Cho Y, Do J, Jung S, et al. Effects of a physical therapy program combined with manual lymphatic drainage on shoulder function, quality of life, lymphedema incidence, and pain in breast cancer patients with axillary web syndrome following axillary dissection. Support care in cancer. 2016;24(5):2047-2057.   DOI
6 Adler SS, Beckers D, Buck M. PNF in practice: an illustrated guide, 3rd ed. Heidelberg. Springer. 2008.
7 Ahn SY, Kim JJ, Ha HJ. Effects of scapular stabilizing exercise on resting scapular position of breast cancer-related lymphedema patients. Journal of the Korean society of physical medicine. 2016;11(2):131-139   DOI
8 Baskurt Z, Baskurt F, Gelecek N, et al. The effectiveness of scapular stabilization exercise in the patients with subacromial impingement syndrome. Journal of back and musculoskeletal rehabilitation. 2011;24(3):173-179.   DOI
9 Bruno E, Roveda E, Vitale J, et al. Effect of aerobic exercise intervention on markers of insulin resistance in breast cancer women. European journal of cancer care. 2018;27(2):e12617.   DOI
10 Cancer Council Western Australia. Guidelines for implementing exercise programs for cancer patients. 2016.
11 Choi Y, Park JW, Noh S, et al. Reliability, validity, and responsiveness of the Korean version of the shoulder disability questionnaire and shoulder rating questionnaire. Annals of rehabilitation medicine. 2015;39(5):705-717.   DOI
12 Cole B. Finch E, Gowland C, et al. physical rehabilitation outcome measures. Toronto, Canadian physiotherapy association. 1994.
13 Kisner C, Colby L. Therapeutic exercise. Foundations and techniques. Philadelphia. FA Davis Company. 2002.
14 Wiskemann J, Schmidt ME, Klassen O, et al. Effects of 12-week resistance training during radiotherapy in breast cancer patients. Scandinavian journal of medicine & science in sports. 2017;27(11):1500-1510.   DOI
15 Kibler WB. Role of the scapula in the overhead throwing motion. Contemporary Orthopaedics. 1991;22:525-532.
16 Kibler WB. The role of the scapula in athletic shoulder function. The American journal of sports medicine. 1998;26(2):325-337.   DOI
17 Yoo HJ, Ahn SH, Eremenco S, et al. Korean translation and validation of the functional assessment of cancer therapy-breast (fact-b) scale version 4. Quality of life research: an international journal of quality of lige aspects of treatment, care and rehabilitation. 2005;14(6):1627-1632.   DOI
18 Laino C. New guidelines for cancer patients from american college of sports medicine: Exercising during & after treatment brings health benefits. Oncology Times. 2010;32(17):16-18.   DOI
19 Lim KH. Effectiveness of individualized upper extremity exercise program for patients after mastectomy. Journal of Korea academia-industrial cooperation society. 2018;19(10):313-23.   DOI
20 Kim CH, Kim BR, Kang MG. Effect of rhythmic stabilization technique, before proprioceptive neuromuscular facilitation wrist taping, on grip strength and pain in wrist pain patients. PNF and Movement. 2016;14(2):105-112.
21 Lee BK, Lee JS, Kim TS. 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. 2013;8(2):153-161.   DOI
22 Yun TW, Lee BH. Effects of hand grip strength on shoulder muscle activity in breast cancer patients. Physical therapy rehabilitation science. 2016;5(2):95-100.   DOI
23 Tambour M, Holt M, Speyer A, et al. Manual lymphatic drainage adds no further volume reduction to complete decongestive therapy on breast cancer-related lymphoedema: a multicentre, randomised, single-blind trial. British journal of Cancer. 2018;119(10):1215-1222.   DOI
24 Nam SJ, Kang TW. 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 orthopedic manual physical therapy. 2017;23(2):69-74.
25 National cancer information center. 2018.
26 Park S, Baek Y, Seo J, et al. Effect of forward head posture on scapula stability exercise and McKenzie stretch exercise. Journal of the Korean society of integrative medicine. 2015;3(4):61-67.   DOI
27 Wilson DJ. Exercise for the patient after breast cancer surgery Seminars in Oncology Nursing. 2017;33(1): 98-105.
28 Ewertz M, Jensen AB. Late effects of breast cancer treatment and potentials for rehabilitation. Acta oncologica. 2011;50(2):187-193.   DOI
29 Curtis T, Roush JR. The lateral scapular slide test: a reliability study of males with and without shoulder pathology. International journal of sports physical therapy. 2006;1(3):140-146.
30 Deutsch M, Flickinger JC. Shoulder and arm problems after radiotherapy for primary breast cancer. American journal of clinical oncology. 2001;24(2):172176.
31 Gallagher EJ, Bijur PE, Latimer C, et al. Reliability and validity of a visual analog scale for acute abdominal pain in the ED. The American journal of emergency medicine. 2002;20(4):287-290.   DOI
32 Jeong WM, Kim BR. The effects of proprioceptive neuromuscular facilitation exercise on the pain and functional disability index of patients with chronic lower back pain. PNF and Movement. 2017;15(2):195-200.
33 Kevin G. Differences in scapular upward rotation between baseball pitchers and position players. The American journal of sports medicine. 2007;35(12):2091-2095.   DOI
34 Bong SY, Kim YJ, Kang MG, et al. Effects of proprioceptive neuromuscular facilitation exercise on forced expiratory volume at one second, pain, and functional disability index of chronic low back pain patients. PNF and Movement. 2016;14(3):185-193.   DOI