earticle

영어

Objective : The purpose of this study is to determine in patients following breast cancer surgery, the shoulder range of motion restrictions during occupational therapy as well as their upper extremity functioning and the daily life activities and their quality of life in order to assess the effects of their postoperative therapy. Methods : From September 2009 to April 2010, occupational therapy was conducted to increase the limited range of motion after breast surgery performed on 73 patients. For this treatment, occupational therapy, functional training, and daily life activities were performed more than twice weekly in order to provide home treatment programs which were then continually reviewed and appropriately modified. The duration of treatment of the limited shoulder joint range of motion continued until a normal angle of less than 20% was achieved. Information regarding the passive range of motion of the shoulder joint before and after treatment, upper extremity disability (Disability of the Arm, Shoulder and Hand; DASH), the quality of life (Functional Assessment of Cancer Therapy-General; FACT-G), and fatigue (Fatigue Severity Scale; FSS), was collected and the data then analyzed. Results : Following the occupational therapy, shoulder flexion, abduction, internal rotation, and external rotation range of motion showed significant change. (p<.001) The upper limb disability score (DASH) significantly improved (p<.001) but not show a statistically significant correlation between DASH and general characters like patient age, the period of treatment, treatment frequency. Quality of life (FACT- G) showed significant difference at physical and Well-Being(p<.001), but the social and functional Well- Being did not change significantly. Patient fatigue(FFS) significantly improved after treatment (p<.001) with the increase in the number of treatments showing a decrease in patient fatigue. Conclusion : Breast cancer resection joint occupational therapy for patients with limited shoulder range of motion, when applied to the upper extremities as well as used to promote the improvement of patients’ everyday life with a decrease in disability and improvement in their quality of life, appeared to be effective and successful. Therefore, considering this information as part of breast cancer clinical treatment together with a variety of tasks that can be used as part of the therapy should demonstrate the success and usefulness of this treatment and postoperative therapy.

한국어

목적 : 본 연구의 목적은 유방암 수술 후 어깨 관절가동범위에 제한이 있는 환자에게 작업치료의 중재를 통해 일상생활 수행 및 상지 기능, 삶의 질에 미치는 효과를 알아보기 위함이다. 연구방법 : 유방암 절제술 후 어깨 관절가동범위에 제한이 있는 73명의 환자를 대상으로 작업치료를 실시하였다. 치료는 기능적 작업치료와 일상생활 동작훈련을 주 2회 이상 시행하였고 홈프로그램을 제공하였으며 치료의 연속성과 효과를 보기 위하여 최소 8주이상 참여하도록 하였다. 치료 전후 어깨 관절가동범위의 수동 관절 범위, 상지장애정도(Disability of the Arm, Shoulder and Hand; DASH), 삶의 질(Functional Assessment of Cancer Therapy-General; FACT-G)과 피로도(Fatigue Severity Scale; FSS)에 대한 자료를 수집하여 분석하였다. 결과 : 작업치료 중재 후 어깨 관절의 굴곡, 외전, 내회전, 외회전의 관절가동범위는 모두 유의한 변화를 보였다(p<.001). 또한 상지 장애정도(DASH)도 유의하게 향상되었으며(p<.001) 삶의 질(FACT-G)은 신체적 삶의 질과 정서적 삶의 질에서 유의한 변화를 보였으나(p<.001) 사회적 삶의 질과 기능적 삶의 질은 유의한 변화를 보이지 않았다. 피로도(FFS)는 치료 후 유의하게 향상되었으며(p<.001) 치료 횟수가 증가하면 피로도가 감소하는 것으로 나타났다. 결론 : 유방암 절제술 후 관절가동범위의 제한이 있는 환자에게 작업치료를 중재하였을 때 어깨 관절가동범위를 증진시킬 뿐만 아니라 상지 장애 및 일상생활의 향상과 함께 삶의 질을 높이는 데에 효과적일 수 있는 것으로 나타났다. 따라서 이러한 내용을 고려하여 유방암 환자에게 다양한 작업치료를 임상적으로 적용할 수 있는 근거로 활용 할 수 있을 것이다.