Avaliação da força muscular isocinética em mulheres no pós operátorio de câncer de mama

Abstract

Breast cancer (BC) is a neoplasm that develops from the interaction between genetic mutations and epigenetic factors and has a significant impact on the physical and emotional health of patients. Surgical treatment, including mastectomy and breast-conserving surgery, can result in changes in muscle function, particularly in the upper limbs, affecting the quality of life (QoL) of female survivors. Analyzing muscle strength in post-BC surgery patients using isokinetic dynamometry to assess movements of the shoulder on the operated (ipsilateral) and non- operated (contralateral) sides is extremely important. This cross-sectional, observational study was conducted with 37 women who had undergone oncological breast surgery. Muscle strength was assessed using isokinetic dynamometry, considering shoulder flexion, extension, internal rotation, and external rotation movements at a speed of 60°/s. Statistical analysis was performed using STATA 18.0 software, with t-tests and Kruskal-Wallis tests to compare peak torque (PT) and total work (TW) indices between limbs. The results indicated that, overall, there were no significant differences between the involved and uninvolved limbs for flexion, extension, internal rotation, and external rotation movements, in terms of both total work and peak torque. Internal rotation showed a trend toward difference but did not reach statistical significance. No statistically significant differences in muscle strength were observed between the limbs involved and not involved in surgery. However, radical mastectomy was associated with higher peak torque in all movements, especially in external rotation, indicating that the type of surgery may impact muscle strength. The analysis also revealed that shoulder flexion strength was related to better QoL, although fatigue did not show a significant correlation. Post-surgical rehabilitation should take these differences in muscle function and the impacts of surgery into account, aiming to optimize recovery and improve patients' quality of life.