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    Determınants Of Upper Extremıty Functıonalıty Before Adjuvant Radıotherapy In Patıents Wıth Breast Cancer Surgery: A Cross-Sectıonal Observatıonal Study
    (Selçuk Üniversitesi, 2024 Şubat) Feyzioğlu, Özlem; Dinçer, Selvi
    Abstract Aim: Comprehensive surgeries lead to decreased shoulder mobility and muscle strength in the upper extremity in patients with breast cancer. Post-operative pain and pain-related kinesiophobia also cause functional impairments. This study aimed was to investigate the relationship between shoulder mobility, muscle strength, pain, and kinesiophobia with upper extremity functionality after breast cancer surgery. Method: This cross-sectional study involved 89 patients undergoing axillary lymph node dissection within the first 6 months after breast cancer surgery. Shoulder range of motion (ROM) was evaluate using a digital goniometer, muscle strength with a manual dynamometer, functionality via the Disabilities of the Arm Shoulder and Hand (DASH) scale. The Tampa Kinesiophobia Scale (TKS) and Visual Analog Scale (VAS) were used to assess kinesophobia and pain intensity. Findings: In multivariable regression models, increased degree of shoulder abduction (?±SE=0.20 ± 0.09, p=0.028), and internal rotation muscle strength (?±SE=4.62± 1.51, p=0.003), were important independent predictors of shoulder functionality. Increased kinesiophobia (?±SE=0.69± 0.28, p=0.016), and pain level (?±SE=2.90±0.68, p=0.000) were significantly associated with upper extremity disability. DASH score was negatively correlated with shoulder flexion (r=0.3), abduction (r=0.4), and internal rotation (r=0.3) ROM and shoulder internal rotation muscle strength (r=0.4), but positively correlated with TKS score (r=0.4) and VAS (r=0.5). Results: Increasing shoulder abduction ROM and internal rotation muscle strength seems superior to restoring the decreased upper extremity functionality. Pain is the most restrictive symptom so coping management strategies with pain can be integrated into the rehabilitation programs, and kinesiophobia levels of patients should be considered during the rehabilitation process.