Concordancia entre el Perómetro y la Medición de Perímetros en la Estimación del Volumen del Miembro Superior / Concordance between perometer and perimeter measurement for estimate upper limb volume

Introducción: El linfedema es una alteración del sistema linfático cuyo tratamiento convencional es la terapia descongestiva. Para evaluar la respuesta al tratamiento, es necesario medir el volumen el miembro superior. Objetivo: Determinar el nivel de concordancia entre el perómetro y las mediciones perimetrales en la estimación de volumen del miembro superior. Métodos: Estudio transversal. El volumen de ambos miembros superiores se estimó con tres métodos: [a] perómetro, [b] perímetro cada 4cm (método 4cm), y [c] con puntos anatómicos (método 5cm). Resultados: En comparación al perómetro, el método 4cm subestimó, en promedio, 315 mL (límites de concordancia: - 875 mL a 243 mL). El método 5cm subestimó, en promedio, 394 mL (límites de concordancia: - 975 mL a 186 mL), y la subestimación aumentó a medida que aumentaba el volumen del miembro superior. Conclusiones: El perómetro y las mediciones perimetrales tienen un bajo nivel de concordancia en la estimación del volumen del miembro superior.

Introduction: Lymphedema is an alteration of the lymphatic system and the conventional treatment is decongestive therapy. The upper limb measurement is needed to evaluate the treatment results. Objective: To determine the concordance between perometer and perimeter measurements in the upper limb volume. Methods: Cross-sectional study. The volume of both upper limbs was estimated with three methods: [a] perometer, [b] perimeter every 4cm (4cm method), and [c] with anatomical points (method 5cm). Results: Compared to the perometer, the 4cm method underestimated, on average, 315 mL (concordance limits ± 875 mL to 243 mL). The 5cm method underestimated, on average, 394 mL (concordance limits: ± 975 mL to 186 mL), and underestimation increased as the upper limb volume increased. Conclusions: The perometer and perimeter measurements have a low level of concordance in the estimation of upper limb volume.

Sistema de selección de sistemas elastocompresivos en personas con cáncer de mama de un hospital con recursos limitados / Selection system for elastocompressive systems in people with breast cancer from a hospital with limited resources

El cáncer de mama es un problema de salud pública en Chile. El linfedema es un trastorno linfovascular secundario a la extirpación de los ganglios linfáticos por cirugía en el cáncer de mama, que produce un aumento del volumen y la fibrosis en el miembro superior. Diferentes prendas de compresión son usadas para la prevención y el tratamiento del linfedema. Por eso, el programa de Garantías Ex-plícitas en Salud garantiza la entrega de sistemas elastocompresivos a las personas con diagnóstico de cáncer de mama para prevenir y tratar el linfedema. Sin embargo, en hospitales públicos los sistemas elastocompresivos pueden ser recursos limitados, por eso, muchas veces se deben priorizar. Este artículo tiene por objetivo describir un sistema de selección de sistemas elastocompresivos en personas con diagnóstico de cáncer de mama en el modelo de atención kinesiológico temprano y prospectivo.

Breast cancer is a public health problem in Chile. Lymphedema is a lymphovascular disorder secondary to the removal of lymph nodes by surgery in breast cancer, resulting in increased volume and fibrosis in the upper limb. Different compression garments are used for the prevention and treatment of lymphedema. Therefore, the "Garantías Explícitas en Salud" program guarantees the delivery of compression garments to people diagnosed with breast cancer to prevent and treat lymphedema. However, in public hospitals, the compression garments can be limited resources, so they often need to be prioritized. This article aims to describe the selection system for compression garments in people diagnosed with breast cancer in the early and prospective physical therapy care model.

Telerehabilitation for people with breast cancer through the COVID-19 pandemic in Chile.

Adapting face-to-face physical therapy consultations in cancer care to a model of telerehabilitation has been necessary, given the imminent spread of the COVID-19 pandemic. In this respect, the current model of telerehabilitation for people with breast cancer can be described as a method of continuing physical therapy treatment, in a public hospital with limited resources.

Axillary web syndrome among Chilean women with breast cancer: incidence and possible predisposing factors.

PURPOSE: Breast cancer (BC) is the most common cancer in women worldwide. The main treatment for BC is surgery, which involves an axillary procedure that associates with the development of axillary web syndrome (AWS). The incidence of AWS among Chilean women with BC and its possible predisposing factors are currently unknown. Thus, we aimed to (1) determine the incidence of AWS among Chilean women with BC after surgery and (2) identify possible predisposing factors. METHODS: Within 90 days post-surgery, patients were assessed for AWS, i.e., palpable or visible axillary cords in the axillary region extending down from the mid-axilla to the ipsilateral arm. We then computed the odds ratio with 95% confidence interval (OR [95% CI]) for having AWS considering the following predisposing factors: age, body mass index (BMI), number of lymph nodes removed, axillary procedure, days from surgery to the physical therapy assessment, hospital for the surgery, type of breast surgery, and neoadyuvant chemotherapy. RESULTS: AWS was present in 49 out of 107 patients (45.8%). Younger age and lower BMI appeared as the sole predisposing factors for AWS (age, 0.95 [0.91-0.99]; BMI, normal weight 1.00, overweight 0.35 [0.11-1.12], obesity 0.28 [0.08-0.97]). CONCLUSION: The incidence of AWS among Chilean women with BC was 45.8%. Our study also confirms data from previous reports showing that younger age and low BMI are associated with the development of AWS.

Implementación de un modelo de atención kinesiológico, temprano y prospectivo, en personas con cáncer de mama / Implementation of an early and prospective physical therapy model care in people with breast cancer

Resumen El cáncer de mama es un problema de salud pública en Chile y el mundo por su alta incidencia. La cirugía es un pilar fundamental en el tratamiento del cáncer de mama. Hasta un 60% de las personas tratadas por cáncer de mama presentan alteraciones funcionales en el miembro superior. Existen modelos sanitarios para la rehabilitación de las alteraciones funcionales, sin embargo, en Chile no es un estándar en la atención de salud. Este artículo describe: 1) las alteraciones del miembro superior secundarias a la cirugía por cáncer de mama y 2) un modelo de atención kinesiológico, temprano y prospectivo, para personas tratadas por cáncer de mama.

Breast cancer is a public health problem in Chile and the world due to high incidence. Surgery is the mainstay in the breast cancer treatment. Up to 60% of people receiving this management have functional morbidity in the upper limb. There are rehabilitation health models care for the functional morbidity, however, in Chile is not a standard in the health care. This article describes: 1) upper limb morbidity secondary to breast cancer surgery, and 2) early and prospective physical Therapy model care for people with breast cancer.