| 제목 |
Predicting the functional status after breast reconstruction : A prospective, longitudinal study |
| 소속 |
Seoul National University Bundang Hospital, Department of Rehabilitation Medicine1, Seoul National University Bundang Hospital, Department of Plastic and Reconstructive Surgery2 |
| 저자 |
Jun Heon Lee1*, Jae Hoon Jeong2, Chan Yeong Heo2, Eun Joo Yang1† |
Purpose:
To evaluate the functional status of breast cancer patients after breast reconstruction with transverse rectus abdominis flap and to identify factors affecting functional outcomes.
Methods:
A prospective longitudinal study in patients with breast cancer who visited the department of rehabilitation at 1 month (T0) and 3 months (T1) after breast reconstruction with TRAM.
Manual muscle test of shoulder. abdomen by hand held dynamometer, Isometric Double Straight Leg Lowering Test (IDSLLT) and Abdominal muscle related Activities of Daily Living (ArADL) using questionnaires were used to functional status. Personal and cancer-related factors were recorded. Univariable and multivariable analyses were used to identify factors associated with changes in physical function.
Results:
A total of 53 patients (mean age; 48.1 5.8 yrs) were enrolled from March 2017 to June 2018. Functional status such as abdominal strength, shoulder strength, LDSLLT and ADL scores were improved from T0 to T1 (3.2±0.8 vs 4.0±0.6, p<0.001; 2.5±1.1 vs 3.6±0.8, p<0.001; 5.5±5.0 vs 16.1±9.9, p<0.001; 46.0±3.0 vs 49.4±2.4, p<0.001, respectively). Abdominal muscle strength at T0 (less than 3) were significantly associated with IDSLLT (β =8.307, 95% CI, 1.539 to 15.075) and ADL (β =-1.684, 95% CI, -3.353 to -0.015) at T1.
Conclusions
Breast cancer patients with poor abdominal muscle strength at 1 month after reconstruction with TRAM are likely to show lower ArALD level at 3 months after surgery. Rehabilitation program with abdominal strengthening exercise should be prioritised for breast cancer patients with poor abdominal muscle at 1 month after TRAM for better activities of daily living.
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Association between abdominal muscle strength at 1 months and ADL scores at 3 months after breast reconstruction
Association between abdominal muscle strength at 1 months and Isometric Double Straight Leg Lowering Test (IDSLLT) at 3 months after breast reconstruction
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