PubMed · 1529893
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L S Lamont, R S Finkelhor, S J Rupert, P S Swierad, J Alexander. 1992. Combined arm-leg ergometry exercise testing.. https://doi.org/10.1016/0002-8703(92)91007-n
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In this retrospective survey we investigated the recall of breast cancer patients (n=105) 6 months after the operation concerning postoperative instructions on exercises for shoulder mobility, and instructions for oedema prevention and treatment, upper limb strength training and the use of the upper limb in daily activities. Patients also described the content in their own words and ranked the instructors who had mostly given this education. Operation type and length of hospital stay did not have any effect on the education recalled, but the age of the respondent had some effect (r=-0.23, p<0.05). The Wilcoxon signed ranks test showed that the most commonly reported item was instructions on shoulder movements (P<0.001). Patients reported that they had more instructions for using the upper limb in daily activities than instructions for strength training (P=0.002) and oedema prevention and treatment (P=0.001). Patients own comments were sometimes conflicting: "Use the upper limb as before and you can even lift weights" and "You cannot drive a car or lift a weight over 3 kg for 6 weeks". Over half of the respondents named the physiotherapist or physiotherapy assistant as the person who had given them most of the instructions. A medical doctor was ranked in first place by 19% of the patients. Only half of the patients reported that they had some education after hospitalization. This study suggests that postoperative education of breast cancer patients is inconsistent and insufficient to provide knowledge for independent rehabilitation for future.
The aim of this study was to design a three-dimensional model of the human shoulder girdle. Fourteen muscles were modelled geometrically using robotics software (Solid Dynamics System). A static study in reverse dynamics allowed the forces developed in seven muscles to be studied, particularly in the deltoid and supraspinatus during abduction of the arm with the forearm bent at 90 degrees, the scapula being fixed. After optimization by Excel, this model allowed simultaneous curves of forces developed in every modelled muscular bundle to be obtained during various degrees of abduction of the arm from 0 degrees to 100 degrees, in the scapular plane. The analysis of supraspinatus and deltoid curves revealed an interesting chronology of action. The first muscle developed efforts estimated at 140 N, quickly relieved by the deltoid. It is also interesting to note that a constant action of supraspinatus was found throughout abduction of the arm. Clinical applications seem to be in simulation of muscular pathology of the shoulder girdle. This study is continuing by releasing the fixed scapula and by simulating muscle transfers proposed for massive ruptures of the rotator cuff.