The Impact of an External Breast Prosthesis on the Gait Parameters of Women After Mastectomy.

The Impact of an External Breast Prosthesis on the Gait Parameters of Women After Mastectomy.

Cancer Nurs. 2013 Apr 29;
Hojan K, Manikowska F, Molinska-Glura M, Chen PJ, Jozwiak M

BACKGROUND:: An integral part of the recovery process after mastectomy involves the consideration of restorative options, including external prosthesis use; however, only few studies regarding the influence of breast prostheses on functional status have been done. OBJECTIVE:: This study aimed to determine whether wearing an external breast prosthesis affects gait in women after a mastectomy. METHODS:: Spatiotemporal gait parameters were collected in 40 women, postmastectomy, aged 37 to 70 years, divided into age subgroups of 37 to 54 years and 55 to 70 years, and in 38 healthy controls, women aged 38 to 69 years. Gait parameters were assessed with and without the breast prosthesis, including walking velocity, cadence, step length, step time, and left-right step time asymmetry. RESULTS:: Significant differences were found in the gait parameters of the younger age group with and without a prosthesis. No significant differences were found in the women of the older group with and without the prosthesis. CONCLUSION:: Gait parameters of the younger age group were closer to those of the healthy control group when they were wearing an external prosthesis, as compared with when they were not. This suggests a positive influence of breast prosthesis use on the functional status of women after mastectomy. IMPLICATIONS FOR PRACTICE:: Clinical practitioners should be aware of the study results suggesting a positive influence of breast prosthesis use on gait parameters after mastectomy surgery, which could improve the patient’s functional status after surgery; however, further research is still needed on factors affecting changes in gait with a larger study population. HubMed – rehab


Physical Activity Behavior Change in Persons With Neurologic Disorders: Overview and Examples From Parkinson Disease and Multiple Sclerosis.

J Neurol Phys Ther. 2013 Apr 29;
Ellis T, Motl RW

: Persons with chronic progressive neurologic diseases such as Parkinson disease (PD) and multiple sclerosis (MS) face significant declines in mobility and activities of daily living, resulting in a loss of independence and compromised health-related quality of life over the course of the disease. Such undesirable outcomes can be attenuated through participation in exercise and physical activity, yet there is profound and prevalent physical inactivity in persons with PD and MS that may initiate a cycle of deconditioning and worsening of disease consequences, independent of latent disease processes. This Special Interest article highlights the accruing evidence revealing the largely sedentary behaviors common among persons living with physically disabling conditions and summarizes the evidence on the benefits of physical activity in persons with PD and MS. We then examine the social cognitive theory as an approach to identifying the primary active ingredients for behavioral change and, hence, the targets of interventions for increasing physical activity levels. The design and efficacies of interventions based on the social cognitive theory for increasing physical activity in persons with PD and MS are discussed. Finally, a rationale for adopting a secondary prevention approach to delivering physical therapy services is presented, with an emphasis on the integration of physical activity behavior change interventions into the care of persons with chronic, progressive disabilities over the course of the disease. VIDEO ABSTRACT AVAILABLE: (see Video, Supplemental Digital Content 1, for more insights from the authors. HubMed – rehab


The influence of high and low heeled shoes on EMG timing characteristics of the lumbar and hip extensor complex during trunk forward flexion and return task.

Man Ther. 2013 Apr 27;
Mika A, Clark BC, Oleksy L

BACKGROUND: Recent studies suggest that wearing high-heel shoes increases the risk of developing certain musculoskeletal pain conditions. In this study we sought to examine whether heel height alters lumbar and hip extensor muscle timing characteristics during a standardized trunk flexion task. METHODS: Thirty-one young, healthy women (22-27 years; 168.6 ± 5.1 cm; 57.1 ± 11.8 kg) participated in this study. Lumbar erector spinae (ES), gluteus maximus (GM), and biceps femoris (BF) electromyographic (EMG) signals were recorded during a trunk flexion task where subjects were instructed to flex their trunk in the sagittal plane and then return to a neutral posture. The task was repeated under three footwear conditions: while wearing no footwear, while wearing shoes with 4-cm heels, and while wearing shoes with 10-cm heels. EMG onset and offset times, as well as EMG duration, were calculated for each muscle and compared across conditions. RESULTS: We observed a significantly earlier onset of the ES EMG activity (1.36 ± 0.61 vs. 1.56 ± 0.67 s), and significantly delayed onset of the GM EMG activity (1.72 ± 0.66 vs. 1.28 ± 0.58 s) during the flexion phase of movement in the 10-cm heeled compared to the no footwear condition. The GM muscle also exhibited an earlier offset time in the 10-cm heel condition compared to the no footwear condition during the flexion movement (2.57 ± 0.67 vs. 3.30 ± 0.61 s) as well as during the return from flexion movement phase (10.87 ± 0.58 vs. 11.69 ± 0.65 s). These alterations in timing characteristic resulted in an overall decrease in the EMG duration for the GM muscle during the flexion movement. CONCLUSION: The results of this study suggest that high-heels alter trunk and hip extensor muscle coordination patterns. These findings, when considered in combination with other recent findings on the biomechanical effects of wearing high-heels, raise concern about whether wearing high heels results in abnormal spine loading patterns and increases the risk for developing musculoskeletal injuries. HubMed – rehab