Factors associated with upper limb dysfunction in breast cancer survivors.

OBJECTIVE: To analyze factors associated with upper limb dysfunction in women after breast cancer treatment. METHODOLOGY: A cross-sectional study with 233 women over 18 years of age diagnosed with breast cancer and undergoing at least one cancer treatment (surgery and/or adjuvant treatment). Sociodemographic, anthropometric, and cancer treatment data were collected, as well as current physical and functional complications. Changes in breast tenderness and intercostobrachial nerve pathway, winged scapula, pain, cicatricial adherence, and lymphedema were evaluated by physical examination (inspection and palpation). Upper limb dysfunction was assessed using the DASH questionnaire. Chi-square test and logistic regression were used to verify possible associations between upper limb dysfunction and other variables. RESULTS: The results showed that 55.4% of women had some level of upper limb dysfunction. Evaluating treatment conditions, lymphadenectomy, lymphedema, presence of pain, and intercostobrachial nerve injury were associated with some level of upper limb dysfunction in the crude analysis. The adjusted analysis showed that only upper limb dysfunction remained associated with intercostobrachial nerve injury, regardless of age and body mass index. CONCLUSION: Upper limb dysfunction is frequent after breast cancer treatment and may be associated with neuropathies due to changes in the intercostobrachial nerve pathway.

Kinesio taping does not improve ankle functional or performance in people with or without ankle injuries: Systematic review and meta-analysis.

OBJECTIVE: To investigate whether Kinesio taping technique, applied to ankles of healthy people as a preventive intervention and people with ankle injuries, is superior to sham or alternative interventions on ankle function. DATA SOURCES: Medline, Embase, Amed, CINAHL, SPORTDiscus, Cochrane Library and Web of Science, from inception to August 2020. REVIEW METHODS: The terms "ankle" and "kinesio taping" were used in the search strategy. Included studies were randomized controlled trials (including crossover design) investigating Kinesio taping effects on ankle functional performance compared to any alternative or control/sham technique. RESULTS: From 5,572 studies, 84 met the eligibility criteria which evaluated 2,684 people. Fifty-eight meta-analyses from 44 studies were performed (participants in meta-analyses ranging from 27 to 179). Fifty-one meta-analyses reported ineffectiveness of Kinesio taping: moderate evidence for star excursion balance test (anterior direction), jump distance, dorsiflexion range of motion, and plantar flexion torque for healthy people (effect size = 0.08-0.13); low to very-low evidence for balance, jump performance, range of motion, proprioception, muscle capacity and EMG for healthy people; balance for older people; and balance and jump performance for people with chronic instability. Seven meta-analyses reported results favoring Kinesio taping (effect size[95% CI]): low to very-low evidence for balance (stabilometry, ranging from 0.42[0.07-0.77] to 0.65[0.29-1.02]) and ankle inversion (0.84[0.28-1.40]) for healthy people; balance for older people (COP velocity, 0.90[0.01-1.78]); and balance for people with chronic instability (errors, 0.55[0.06-1.04]). CONCLUSIONS: Current evidence does not support or encourage the use of Kinesio taping applied to the ankle for improvements in functional performance, regardless the population.

Urinary Incontinence in Physically Active Young Women: Prevalence and Related Factors.

This cross-sectional survey aims to (1) verify the prevalence of urinary incontinence and its impact on the quality of life among nulliparous fit women, and to (2) analyze whether urinary incontinence is influenced by the intensity of the sport (high- vs. low-impact) or by the volume of physical activity (minutes per week) performed. Two hundred forty-five nulliparous women (18-40 years) completed the International Consultation on Incontinence Questionnaire-Short Form, the Kings Health Questionnaire and a questionnaire regarding demographic and training variables. Overall 22.9% of the participants self-reported urinary incontinence, and among them, 60.7% had stress urinary incontinence. Incontinent women demonstrated worse quality of life than continent females (p=0.000). Women practicing high-impact sports presented higher frequency in loss of urine than those practicing low-impact sports (p=0.004). Regardless the intensity of the sport, the volume of exercise showed positive association with the frequency of loss of urine (p=0.005, r=0.475). In conclusion, almost one fourth of the women enrolled in this study reported symptoms of urinary incontinence and worse quality of life than those who were continent. Women who practice high-impact sports or who have higher volume of training should be aware of the symptoms associated with pelvic floor dysfunction, since they seem to predispose to urine leakage.

Working conditions at hospital food service and the development of venous disease of lower limbs.

The present study assesses some factors that may influence the development of lower limb venous disease in workers of a hospital food service unit. An Ergonomic analysis of work was carried out at a hospital located in the south of Brazil. As for data collection, the following were used: interviews and body mass index assessment; specific clinical examination to diagnose venous disease, water displacement volumetry of the lower limbs. The activities performed at the workplace were followed by direct observation with image registration, use of pedometers, stopwatches, decibel meter, and digital thermo-hygrometer. It was observed different degrees of venous disease in 78% of the cases investigated. The volumetric variation of the lower limbs was 5.13%, showing the presence of edema. Working in hospital food service is associated with circulatory disorders of lower limbs, such as edema and venous disease. The following risk factors were identified: standing activities at work during a long period of time, high temperature, and humidity and carrying heavy weights.

Kinesio Taping does not decrease swelling in acute, lateral ankle sprain of athletes: a randomised trial.

QUESTION: Does Kinesio Taping reduce swelling in athletes who have suffered an acute, lateral ankle sprain? DESIGN: Randomised controlled trial with concealed allocation, intention-to-treat analysis and blinded assessment. PARTICIPANTS: Thirty-six athletes who participated regularly in one of seven different sports modalities and suffered an acute ankle sprain. INTERVENTION: The experimental group received Kinesio Taping application for 3 days, which was designed to treat swelling. The control group received an inert Kinesio Taping application. OUTCOME MEASURES: For the comparison between groups, the swelling was measured via volumetry, perimetry, relative volumetry and two analyses of the difference in volume and perimetry between ankles of each participant. Data were collected immediately after the 3 days of intervention and at follow-up, which was 15 days post intervention. RESULTS: At 3 days after intervention, there were no differences between groups for swelling in volumetry (MD -2 ml, 95% CI -28 to 32); perimetry (MD 0.2 cm, 95% CI -0.6 to 1.0); relative volumetry (MD 0.0 cm, 95% CI -0.1 to 0.1); and the other analyses. At day 15 follow-up, there were no significant between-group differences in outcomes. CONCLUSION: The application of Kinesio Taping, with the aim of stimulating the lymphatic system, is ineffective in decreasing acute swelling after an ankle sprain in athletes. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials, RBR-32sctf.

Management of Axillary Web Syndrome after Breast Cancer: Evidence-Based Practice / Tratamento da síndrome de rede axilar pós-câncer de mama: prática baseada em evidências

Abstract Axillary web syndrome is characterized as a physical-functional complication that impacts the quality of life of women who have undergone treatment for breast cancer. The present study aims to verify the physiotherapy treatment available for axillary web syndrome after surgery for breast cancer in the context of evidence-based practice. The selection criteria included papers discussing treatment protocols used for axillary web syndrome after treatment for breast cancer. The search was performed in the MEDLINE, Scopus, PEDro and LILACS databases using the terms axillary web syndrome, lymphadenectomy and breast cancer, focusing on women with a previous diagnosis of breast cancer who underwent surgery with lymphadenectomy as part of their treatment. From the 262 studies found, 4 articles that used physiotherapy treatment were selected. The physiotherapy treatment was based on lymphatic drainage, tissue mobilization, stretching and strengthening. The four selected articles had the same outcome: improvement in arm pain and shoulder function and/or dissipation of the axillary cord. Although axillary web syndrome seems to be as frequent and detrimental as other morbidities after cancer treatment, there are few studies on this subject. The publications are even scarcer when considering studies with an interventional approach. Randomized controlled trials are necessary to support the rehabilitation resources for axillary web syndrome.

Resumo A síndrome da rede axilar (ou cordão axilar) é uma complicação físico-funcional que interfere na qualidade de vida de mulheres que foram submetidas a tratamento para o câncer de mama. O objetivo do presente estudo foi verificar os tratamentos fisioterapêuticos disponíveis para a síndrome da rede axilar após o tratamento cirúrgico do câncer de mama no contexto da prática clínica baseada em evidências. Utilizou-se como critério de inclusão artigos que discutissem protocolos de tratamento para a síndrome da rede axilar após o tratamento para o câncer de mama. A pesquisa foi realizada nas bases de dados MEDLINE, Scopus, PEDro e LILACS, utilizando como palavras-chave síndrome da rede axilar linfadenectomia e câncer de mama, com foco em mulheres com diagnóstico de câncer de mama que realizaram cirurgia com linfadenectomia como parte do tratamento. Dos 262 estudos encontrados, foram selecionados 4 artigos que utilizaram fisioterapia, os quais incluíram drenagem linfática, mobilização tecidual, alongamento e fortalecimento. Os quatro artigos selecionados tiveram desfechos similares: melhora da dor no membro superior e na função do ombro e/ou desaparecimento do cordão axilar. Embora a síndrome da rede axilar seja tão frequente e prejudicial quanto as outras morbidades após tratamento para o câncer, existem poucos estudos sobre esse tema. As publicações são ainda mais escassas quando se considera uma abordagem intervencionista. Estudos randomizados controlados são necessários para embasar as técnicas de reabilitação na síndrome da rede axilar após tratamento para o câncer de mama.