New approach to evaluate late arm impairment and effects of dragon boat activity in breast cancer survivors.

To verify the applicability of a new approach based on the strength curves (SCs) methodology in late arm impairment in breast cancer (BC) survivors and to evaluate the effects of dragon boat (DB) activity on the late regaining of the muscle strength, upper limb impairment, and quality of life in patients undergoing surgery for BC.Retrospective observational study on 64 subjects (54.5 ±â€Š9.7 years), 47 of them had undergone unilateral mastectomy surgery and were evaluated for late arm impairment. A clinical evaluation of the shoulder and compilation of functional assessment (DASH, Rowe, Constant-Murley) and quality of life (SF-36) scales were carried out. Assessment of muscle strength with SC obtained with isometric assessments and serratus anterior muscle test were performed.Differences between the SC are evident between healthy and operated subjects. Among the 3 groups of operated subjects the difference in strength is maximum at 0°. Statistically significant difference was found between operated and nonoperated only in SF-36 scale. No significant difference was found between groups for shoulder instability and winged scapula.The SC can be used in the study of upper limb impairment after surgery for BC: measurements carried out at 1st degrees of the range of motion are more useful for clinicians. DB activity is useful to reduce the late arm impairment.

Physical exercise modulates the level of serum MMP-2 and MMP-9 in patients with breast cancer.

Matrix metalloproteinases (MMPs) exhibit an important function in extracellular matrix degradation. MMPs modulate the activation of growth factors, cytokines and metastasis. At present, the effect of exercise on serum levels of MMP-2 and -9 remains unclear. The aim of the present study was to investigate the effect of various physical activities on the circulating levels of MMP-2 and -9 in breast cancer (BC) survivors and healthy subjects. A total of 66 female subjects were enrolled in the present study. The cohort included 46 BC survivors and 20 healthy subjects divided into 5 groups: Group A (17 BC survivors, participating in recreational dragon boat paddling), group B (14 BC survivors, participating in recreational physical activity), group C (15 sedentary BC survivors), group D (10 healthy subjects, participating in recreational physical activity) and group E (10 sedentary healthy subjects). ELISA assays revealed a significant increase in the level of circulating MMP-2 in group B compared with all other groups. Recreational physical activity increased the levels of MMP-9 in healthy subjects (group D vs. E), however, the differences were not statistically significant, while in the BC survivor groups the results were opposite, with exercise reducing MMP-9 levels (group B vs. C). Furthermore, a significant increase in MMP-2 was observed in group B lymph node metastasis-positive (N+) subjects compared with group A and C N+ subjects. Thus, the results of the present study indicate that various physical activities modulate the levels of circulating MMP-2 and -9 in BC survivors, and the same exercise program induces a different effect when undertaken by healthy subjects and BC survivors. These results may have important implications with regard to the selection of appropriate physical activities for BC survivors, leading to improvements to their survival and prevention of recurrence, as well as amelioration of physical function, quality of life and fatigue.

Late Isometric Assessment of Hip Abductor Muscle and Its Relationship with Functional Tests in Elderly Women Undergoing Replacement of Unilateral Hip Joint.

OBJECTIVE: The aim of this study was to evaluate the recovery of muscle strength and measure autonomy 3 yrs after hip replacement surgery in a sample of patients. DESIGN: Seventy-eight female patients (70.7 ± 6.3 yrs old) operated on for hip replacement were evaluated. They underwent evaluation tests for hip abductor muscle strength on the healthy and operated limb using strength curves obtained with isometric assessments. Autonomy was evaluated with a rating scale Western Ontario and McMaster Universities Arthritis Index (WOMAC), Harris and MOS 36-Item Short-Form Health Survey (SF-36) and functional assessment (Timed 'Up and Go' test). RESULTS: Three years after surgery, a muscle strength deficit was still noticeable on the operated limb compared with the healthy limb ranging from 9% at 5 degrees of adduction to 12% at 0 degree of abduction. The strength curves obtained on the operated side maintained the same descending trend as the healthy side. The authors found no significant correlations between the patient-reported functional measures and the hip abductor strength deficit. The Timed Up and Go test was moderately correlated with the muscle strength deficit. The association between the deficit and the Timed Up and Go test was statistically significant. CONCLUSIONS: The evaluation of muscle strength and functional tests are more useful than the rating scales in patients 3 yrs after surgery. The strength curves are useful to have different levels of information and describe joint function.

Use of vibration exercise in spinal cord injury patients who regularly practise sport.

The aim of this study was to evaluate the applicability and effects of mechanical vibration on body composition and mechanical properties of the arm in patients with spinal cord injury (SCI). For this purpose, ten volunteers with thoracic SCI were recruited. Measurements were performed before and after a period of treatment with mechanical vibration applied during forearm flexion in isometric condition. The subjects were tested performing forearm flexion (both right and left side) with increasing loads, corresponding to 5, 8, 10 and 15% of their own body weight. Average velocity (AV), average force (AF) and average power (AP) were calculated. The Functional Independence Measure was used to evaluate daily autonomy at baseline. Total body and segmental (arms) body composition, fat mass, fat-free mass, and bone mineral density, were studied by dual energy X-ray absorptiometry. Functional measurements (AV, AF, AP) and body composition were measured at three time points: after a medical examination and interview (T0); after an interval of 12 weeks without physical therapy or training (T1); and finally after a further 12-week period during which the patients performed segmental vibration exercise (T2). The results showed statistically significant increases in AV and AP on the right (dominant) side (p<0.05); AF also increased, but without the difference reaching statistical significance. Total body composition, did not change whereas the bone mineral density of the arms was higher after treatment, but again without the difference reaching statistical significance.