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Shoulder proprioception changes in postmastectomy patients: an observational study.
Meryem Çalik1, Yıldız Erdoğanoğlu2, Mahmut Çalik3
1Bakırköy Dr Sadi Konuk Training Hospital, Physical Therapy and Rehabilitation Department, Lymphedema Unit, University of Health Sciences, Zuhuratbaba Mah. Tevfik Sağlam Cad. No:11, Bakırköy, Istanbul, Turkey. akgul-86@hotmail.com.
Postmastectomy patients, with or without lymphedema, experience impaired shoulder joint position sense compared to healthy individuals. This highlights the need for personalized rehabilitation strategies to restore joint position sense.
Area of Science:
- Orthopedics
- Oncology
- Rehabilitation Medicine
Background:
- Breast cancer surgery can lead to shoulder dysfunction and lymphedema.
- Impaired shoulder mobility and anatomical changes are common postmastectomy.
- Lymphedema increases the risk of long-term arm morbidity.
Purpose of the Study:
- To evaluate active shoulder joint position sense (AJPS) in postmastectomy patients.
- To compare AJPS in patients with and without lymphedema.
- To assess the impact of lymphedema on shoulder proprioception.
Main Methods:
- 66 women participated: 22 with lymphedema, 22 without, and 22 healthy controls.
- AJPS was assessed using active position repetition testing at 55°, 90°, and 125° shoulder flexion.
- Shoulder range of motion and pain/edema severity were also evaluated.
Main Results:
- Postmastectomy patients (with and without lymphedema) showed significantly poorer AJPS than healthy controls across all tested angles (p < 0.01).
- A significant difference in AJPS error was found at 55° shoulder flexion (p < 0.05).
- No significant difference in AJPS error was observed between patients with and without lymphedema at 90° and 125° flexion (p > 0.05).
Conclusions:
- Active shoulder joint position sense is negatively affected in postmastectomy patients, regardless of lymphedema status, compared to healthy controls.
- These findings underscore the necessity of incorporating personalized approaches to improve joint position sense within rehabilitation programs.
- Targeted interventions are crucial for restoring proprioception and function in this patient population.
