Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Unilateral Radikal Mastektomi Sonrası Lenfödemi olan Kadınlarda Torakal Kifoz, Denge ve Üst Ekstremite Fonksiyonları Arasındaki İlişki: Bir Pilot Çalışma
The Relationship BetweenThoracic Kyphosis, Balance, and Upper Extremity Functions in Women with Lymphedema After Unilateral Radical Mastectomy: A Pilot Study
Şeyda TOPRAK ÇELENAYa, Cansu ŞAHBAZ PİRİNÇÇİb, Meltem DALYANc, Sibel ÜNSAL DELİALİOĞLUc
aAnkara Yıldırım Beyazıt Üniversitesi Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, Ankara, TÜRKİYE b
bAnkara Şehir Hastanesi Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, TÜRKİYE c
cSağlık Bilimleri Üniversitesi Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, Ankara, TÜRKİYE
Turkiye Klinikleri J Health Sci. 2021;6(1):62-8
doi: 10.5336/healthsci.2020-74886
Article Language: TR
Full Text
ÖZET
 Amaç: Unilateral radikal mastektomi sonrası lenfödemi (LÖ) olan kadınlarda torakal kifoz ile denge ve üst ekstremite fonksiyonları arasındaki ilişkiyi incelemekti. Gereç ve Yöntemler: Unilateral radikal mastektomi sonrası LÖ (yaş: 55,06±8,17 yıl; beden kitle indeksi: 28,78±4,53 kg/m2 )'sü olan 30 kadın dâhil edildi. Hastalar, Haziran ve Aralık 2019 tarihleri arasında değerlendirildi. LÖ şiddeti çevre ölçümü ve Frustum metodu ile torakal kifoz açısı, Baseline dijital inklinometre, denge Mini-Denge Değerlendirme Sistemler Testi (Mini-DDSTest) ile üst ekstremite fonksiyonları ise Kol, Omuz ve El Sorunları [Disability of the Arm, Shoulder and Hand (DASH)] Anketi ile değerlendirildi. İki kol arasındaki volüm farkı 200-250 mL ise hafif, 250 mL'den büyük ve 500 mL'den küçük ise orta, 500 mL'den büyük ise şiddetli olarak sınıflandı. Pearson korelasyon analizi kullanıldı. Bulgular: Torakal kifoz ile Mini-DDSTest'in alt skorları olan sezgisel (p=0,003; r=-0,523) ve duyusal oryantasyon skorları (p=0,003, r=-0,521) arasında orta şiddetli bir ilişki; torakal kifoz ile toplam denge skoru (p=0,045, r=-0,369) arasında ise zayıf bir ilişki bulundu. Torakal kifoz ile Mini-DDSTest'in reaktif postüral kontrol, dinamik yürüyüş parametreleri ve DASH skoru arasında ilişki yoktu (p>0,05). Sonuç: LÖ'lü kadınlarda torakal kifoz ile bazı denge parametrelerinin ilişkili olduğu, ancak üst ekstremite fonksiyonlarının ilişkili olmadığı görüldü. Üst ekstremite LÖ'sü olan hastalarda torakal kifozun dengeyi etkileyebileceği göz önünde bulundurulmalıdır. Ayrıca daha büyük örneklemlerde ileriki çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Lenfödem; postür; postüral denge
ABSTRACT
 Objective: To investigate the relationship between thoracic kyphosis and balance and upper extremity functions in woman with lymphedema after unilateral radical mastectomy. Material and Methods: Thirty women with lymphedema (age: 55.06±8.17 years; body mass index: 28.78±4.53 kg/m2 ) after unilateral radical mastectomy were included. The patients were evaluated between June to December 2019. The severity of the lymphoedema with circumferential measurements and Frustum model, thoracic kyphosis angle with Baseline Digital Inclinometer, balance with Mini Balance Evaluation Systems Test (Mini-BESTest), upper limb functions with the Disability of the Arm, Shoulder and Hand (DASH) questionnaire were evaluated. Results were classified as light if the volume difference between the two arms is 200-250 mL; medium if greater than 250 mL and less than 500 mL, and severe if greater than 500 mL. Pearson correlation analysis was used. Results: A moderate correlation between the thoracic kyphosis and intuitive (p=0.003, r =-0.523) and sensory orientation (p=0.003, r =-0.521) scores which are sub-scores of Mini-BESTest; a weak correlation between the thoracic kyphosis and total balance score (p=0.045, r=-0.369) were found. There was no relation between the thoracic kyphosis and reactive postural control and dynamic gait parameters of Mini-BESTest, and DASH score (p>0.05). Conclusion: It was seen that the thoracic kyphosis was associated with some balance parameters; however, it was no associated with the upper extremity functions in women with lymphedema. It should be taken into account that the thoracic kyphosis may affect the balance in patients with upper limb lymhedema. Besides, further studies are needed for larger samples.

Keywords: Lymphedema; posture; postural balance
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