Meme kanserı̇ hastalarında fonksı̇yonel denge ve yaşam kalı̇tesı̇

Abstract

Giriş: Meme kanseri, kadınlarda kanser bağlı ölümlerde ikinci ölüm oranına sahip önemli bir sağlık sorunudur. Meme kanserini atlatan kadınlarda mastektomi ve radyoterapi sonrası omuz ve üst ekstremite hareketliliği azalabilir, gövde ve üst ekstremite kasları zayıflayabilir, biyomekanik ve fonksiyonel denge bozulabilir. Buna ek olarak, meme kanserine bağlı lenfödem (MKBL) nedeniyle artan ekstremite hacmi statik ve dinamik dengeyi bozabilir. Bugüne kadar, meme kanserini hastalarında lenfödemin denge üzerindeki etkisini araştıran çalışmalar sınırlıdır. Bu çalışmanın amacı, meme kanserini hastalarında lenfödemin denge ve yaşam kalitesi üzerindeki etkisini incelemektir. Yöntemler: Bu prospektif çalışmada yaş, eğitim, medeni durum, vücut kitle indeksi (VKİ) (kg/m2), etkilenen lenfödem ekstremitesi (sağ-sol) ve ekstremite hacim farkı değerlendirildi. Hastalara denge düzeylerini ölçmek için Fullerton İleri Denge Skalası (FAB-Scale) uygulandı. Lenfödem Yaşam Kalitesi Anketi (LYMQOL-Arm) uygulandı. Bulgular: Çalışmaya dahil edilen 40 hastanın yaş ortalaması 59.02±7.50 yıl idi. Fab-skalası ≤ 25 olan ve düşme riski taşıyan hastaların oranı %55 idi. Fab ölçeği ≤ 25 olan hastalar ile Fab ölçeği 25< olan hastalar arasında yaşam kalitesi skoru (LYMQOL-Arm) açısından istatistiksel bir fark yoktu (p=0,344). Etkilenen lenfödem tarafı ile denge düzeyi arasında istatistiksel olarak anlamlı bir fark yoktu (p=0.563). Yaş ile denge düzeyi arasında anlamlı bir negatif korelasyon vardı (p=0.0138). Ekstremite hacim farkı, VKİ, yaşam kalitesi ve denge düzeyi arasında anlamlı bir korelasyon görülmedi (p>0.05). Sonuç: Çalışmamızda özellikle yaşlı hastalarda dengenin bozulmuş olduğu ve düşme riskinin arttığı tespit edildi. MKBL'li her kadın denge ve yürüme bozukluğu hakkında bilgilendirilmeli ve mümkün olan en kısa sürede lenfödem tedavisi almaya teşvik edilmelidir. Lenfödem tedavisinde fonksiyonel stabilite, yaşam kalitesi ve düşme riskini inceleyen gelecekteki çalışmaların ve denge ile ilgili özel müdahalelerin geliştirilmesinin onkolojik rehabilitasyon protokolüne katkı sağlayacağını düşünüyoruz.

Keywords

• Meme kanseri
• Lenfödem
• Yaşam Kalitesi
• Fonksiyonel Denge
• Fullerton İleri Denge Ölçeği

Functional balance and quality of life in breast cancer survivors

Abstract

Aims: Breast cancer is an important health problem with the second mortality rate in cancer-related deaths in women. After mastectomy and radiotherapy, shoulder and upper extremity mobility may decrease, trunk and upper extremity muscles may weaken, and biomechanical and functional balance may be impaired in women who have survived breast cancer. In addition, increased limb volume due to breast cancer-related lymphedema (BCRL) may impair static and dynamic balance. To date, studies investigating the effect of lymphedema on balance in BCRL are limited. We aimed to examine the impact of lymphedema on balance and quality of life in breast cancer survivors. Methods: In this prospective study, age, education, marital status, body mass index (BMI) (kg/m2), affected lymphedema limb (right-left), and extremity volume difference were evaluated. Fullerton Advanced Balance Scale (FAB-Scale) was applied to the patients to measure their level of balance. The Lymphedema Quality of Life Questionnaire (LYMQOL-Arm) was applied. Results: The mean age of the 40 patients included in the study was 59.02±7.50 years. The proportion of patients with a Fab-scale ≤25 who were at risk of falls was 55%. There was no statistical difference between patients with Fab-scale ≤25 and patients with Fab-scale 250.05). Conclusion: In our study, balance deteriorated and the risk of falls increased especially in elderly patients. Every woman with BCRL should be informed about balance and gait impairment and encouraged to receive lymphoedema treatment as soon as possible. We think that future studies examining functional stability, quality of life, and fall risk in the treatment of lymphedema and the development of special interventions related to balance will contribute to the oncological rehabilitation protocol.

Keywords

• Breast cancer
• lymphedema
• quality of life
• functional balance
• fullerton advanced balance scale

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