The Relatıonshıp Between Kınesıophobıa, Upper Extremıty Functıon, Lymphedema, Paın, Sensatıon And Depressıon In Women Underwent Breast Cancer Surgery

Meme kanseri ve tedavilerine bağlı olarak hastalarda kinezyofobi gelişebilmektedir. Literatürde kinezyofobinin ilişkili olduğu bozuklukları kapsamlı olarak inceleyen bir çalışma bulunmamaktadır. Bu çalışmanın amacı meme cerrahisi geçiren kadınlarda kinezyofobi, üst ekstremite fonksiyonu, lenfödem, ağrı, hafif dokunma duyusu ve depresyon ilişkisini incelemekti. Çalışmaya yaş ortancası 55 (35-68) yıl olan 56 kadın dahil edildi. Lenfödem, omuz eklem hareketleri, elin hafif dokunma duyusu, ağrı, üst ekstremite fonksiyonu, anksiyete, depresyon ve kinezyofobi değerlendirildi. Değerlendirme yöntemi olarak sırasıyla çevre ölçümü, gonyometrik ölçüm, Semmes Weinstein Monofilament Testi, McGill Ağrı Anketi (MAA), Kol Omuz ve El Sorunları Anketi (KOESA), Hastane Anksiyete ve Depresyon Ölçeği (HADÖ), Tampa Kinezyofobi Ölçeği (TKÖ) kullanıldı. TKÖ ile lenfödem şiddeti (r=0,275, p=0,040), HADÖ-A (r=0,566, p=0,000) ve HADÖ-D (r=0,290, p=0,030) arasında pozitif yönde anlamlı ilişki bulundu. KOESA ile omuz fleksiyon limitasyonu (r=0,272, p=0,043), omuz abdüksiyon limitasyonu (r=0,292, p=0,029), ağrı şiddeti (r=0565, p=0,000), HADÖ-A (r=0,306, p=0,022) ve HADÖ-D arasında pozitif yönde anlamlı ilişki (r=0,405, p=0,002) olduğu tespit edildi. Etkilenen taraf ile sağlam taraf arasında hafif dokunma duyusu açısından fark bulunmadı (p>0,05). Bu bulgulara göre, meme cerrahisi geçiren kadınlarda kinezyofobinin hastaların anksiyete ve depresyon düzeyinden ve lenfödem şiddetinden etkilenebileceği sonucuna varıldı. Omuz eklem hareket limitasyonlarının ve ağrının üst ekstremite fonksiyonunu olumsuz yönde etkileyebildiği ve üst ekstremite fonksiyon bozukluğunun hastaların anksiyete ve depresyon düzeyleri ile ilişkili olduğu saptandı.Kinesiophobia can develop in patients due to breast cancer and treatments. In the literature there is no comprehensive study investigated the disorders related to kinesiophobia. The aim of this study was to examine the relationship between kinesiophobia, upper extremity function, lymphedema, pain, light touch sensation and depression in women who underwent breast surgery. 56 women with a median age of 55 years (range 35-68) were included in the study. Shoulder range of motions, light touch sensation of hand, pain, upper extremity function, anxiety, depression and kinesiophobia were evaluated. The circumference measurement, goniometric measurement, Semmes Weinstein Monofilament Test, McGill Pain Questionnaire (MPQ), Disability of Arm Shoulder and Hand (DASH) Questionnaire, Hospital Anxiety and Depression Scale (HADS), Tampa Kinesiophobia Scale (TKS) were used respectively as assessment methods. Significant positive correlations between TKS and severity of lymphedema (r=0,275, p=0,040), HADS-A (r=0,566, p=0,000) and HADS-D (r=0,290, p=0,030) were determined. It was detected that there were significant positive correlations between DASH and shoulder flexion limitation (r=0,272, p=0,043), shoulder abduction limitation (r=0,292, p=0,029), intensity of pain (r=0565, p=0,000), HADS-A (r=0,306, p=0,022) and HADS-D (r=0,405, p=0,002). There was no significant differences in light touch sensation between affected and healthy side (p>0.05). According to these findings, it was concluded that kinesiophobia can be affected by anxiety and depression level and lymphedema severity in women who underwent breast surgery. It was determined that shoulder joint limitations and pain can affect the upper extremity function negatively and upper extremity dysfunction was associated with anxiety and depression levels of the patients

Clinical characteristics of and services provided for patients with lymphedema referred to a physiotherapy program during the years 2009 through 2019

Background: Lymphedema is a chronic and progressive disease whose diagnosis involves determination of clinical and demographic characteristics. The aim of this retrospective study was to analyze the clinical characteristics of patients with lymphedema and their various diagnoses. We studied patients who were referred for physiotherapy services at any point during the years 2009 through 2019. Methods: Retrospective data were collected from the files of 430 lymphedema patients. The type, cause, localization, stage, and severity of lymphedema and physiotherapy needs were analyzed and reported. Results: Primary and secondary lymphedema were observed in 18 (4.2%) and 412 (95.8%) patients, respectively. The patients' mean body mass index score was 30.66 kg/m(2). The data indicated that the most common cause of secondary lymphedema was breast cancer and its treatments (n = 196, 47.6%). Other causes were chronic venous insufficiency (CVI) (n = 140, 34%), lipolymphedema (n = 11, 2.7%), and other types of cancers (n = 65, 15.7%). According to the affected body regions, 416 patients had unilateral/bilateral upper and lower extremity lymphedema and 14 had head and neck lymphedema. The patients were followed with a home-based physiotherapy program (n = 353, 82.1%) or they underwent treatments through an outpatient program (n = 77, 17.9%). Conclusions: Most patients admitted to the clinic had a diagnosis of breast cancer and CVI. The severity and stages of lymphedema were variable. The data indicated that most patients were followed through a home-based physiotherapy program. These results may set a frame for understanding the treatment and care needs of patients with lymphedema