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    Assessment of sensorimotor and strength related function of breast cancer patients during systemic drug therapy: a prospective observational study
    (Bmc, 2023) Tugral, Alper; Aribas, Zeynep; Akyol, Murat; Bakar, Yesim
    Background Chemotherapy is a well-known risk factor for sensorial and motor disturbances. Chemotherapy induced peripheral neuropathy (CIPN) which predominantly affects sensory nerves might cause a diminished fine motor function. This prospective observational study aimed to assess the sensorimotor functions of breast cancer patients before, during, and after chemotherapy.Methods A total of 56 breast cancer patients were evaluated at three different times as follows: T1 (before chemotherapy), T2 (middle chemotherapy), and T3 (completion of chemotherapy). Motor function was assessed with handgrip strength (HGS), peripheral muscle strength (PMS), and the Minnesota Manual Dexterity Test (MMDT). Semmes Weinstein Monofilament Test (SWMT) was performed to assess the sensory function. Fatigue was evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Module Cancer Related Fatigue (EORTC-QLQ-FA12), respectively.Results HGS and MMDT were found significant (chi 2: 11.279, p = 0.004 and chi 2: 9.893, p = 0.007, respectively) whereas PMS was not found significant (F (2,110) = 1.914, p = 0.152). Pairwise comparisons with Bonferroni adjustments revealed that HGS was found significant between T1 and T3, while significant results were obtained between T1 and T2 as well as T2 and T3 in MMDT (p = 0.01 and p = 0.042). There were significant results in some reference points of SWMT, though they were not found after pairwise comparisons with Bonferroni adjustment (p > 0.05). Fatigue was found significantly increased from T1 through T3 (Median: 19.44 vs 27.77, z: -2.347, p = 0.019, Wilcoxon test).Conclusion Our study showed that decreased handgrip strength and fine motor function, as well as increased fatigue, are evident during the chemotherapy. SWMT can be an optional assessment in the context of tracking changes in cutaneous sensation during chemotherapy due to its non-invasive, cheap, and easily repeatable features among cancer patients. To preserve functional capacity as well as independence in daily living, precautions and follow up assessments during the systemic therapy process should be integrated as early as possible to prevent future deteriorations in daily life for patients who undergo chemotherapy.
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    The Characteristics of Pain Tolerance in Patients Who Underwent Unilateral Breast Cancer Surgery: The Effect of Handedness and Surgical Site to Assess the Potential Musculoskeletal Symptoms and Function
    (Cig Media Group, Lp, 2022) Tugral, Alper; Bakar, Yesim; Akyol, Murat
    Diminished strength and altered musculoskeletal pain characteristics are well-known consequences of breast cancer treatment. This study aimed to assess myofascial pain and strength in breast cancer survivors (BCS). A total of 96 BCS were included. A Strength imbalance was prominent in BCS who underwent surgery in their nondominant site, while the pain tolerance was significantly lower in the surgical site. Background: Breast cancer survivors (BCS) usually experience musculoskeletal pain and strength imbalance between surgical and nonsurgical sites. Material and methods: This study aimed to assess the effect of handedness and surgical site on pain tolerance and upper extremity strength in BCS. A total of 96 female BCS (Mean age and BMI: 51.06 +/- 9.36 years and 27.77 +/- 3.75 kg/m(2)) were included in this study. BCS were categorized as DoS or NoS whether they had surgery on their dominant or nondominant site, respectively. Socio-demographic data, upper extremity strength, pain tolerance, and pain-related function measurements were performed by simple form, manual muscle tester, pain algometer, and Disabilities of Arm, Shoulder, and Hand's (DASH) pain subscale, respectively. Results: Pain tolerances were significantly lower in upper trapezius muscle region in the surgical site (t = -4,263, P <.001 and t = -2138, P = 0.037) while in the deltoid tuberosity, pain tolerance was significantly higher in surgical site (t = 2633, P = 0.011). Mean differences in strength in shoulder flexion and abduction were significantly lower in the DoS group compared to the NoS group (z = -3.166, P =.002 and z = -2.131, P =.033, respectively), whereas the pain subscale was significantly higher in the DoS (P =.013). Conclusion: Pain tolerance decreased in the upper trapezius muscle region on the surgical site irrespective of the handedness. However, in deltoid tuberosity, the effect of handedness was remarkable. Exercise programs should focus to establish a strength balance in nondominant surgery BCS since strength imbalance might be more prominent to affect them to take part in activities in daily living.
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    EMPATHY AND ATTITUDE UPON AN AGED BODY: SHORT TERM EFFECTS OF THE AGED SIMULATION SUIT AMONG UNDERGRADUATE PHYSIOTHERAPY STUDENTS
    (Dokuz Eylul Univ Inst Health Sciences, 2023) Ozdemir, Kadirhan; Tugral, Alper; Ismailoglu, Elif Gunay; Bakar, Yesim; Taskiran, Nihal; Onder, Hatice Erdem; Sari, Dilek
    Purpose: When empathy and attitude levels of health professionals are high, patient compliance and satisfaction are increased. The purpose of this study was to assess the empathy and attitude levels of undergraduate physiotherapy students towards older people before and after wearing the aged simulation suit by performing pre-defined related scenarios.Material and Methods: The aged simulation suit was put on 63 students to complete the pre-defined scenarios, which included reading, eating, walking, and sitting to determine the experiences and emotions of students via semi-structured questions and interviews. The empathy and attitude levels were evaluated using the Jefferson Scale of Empathy-Health Professions Students (JSE-HPS) version and Kogan's Attitudes Towards Old People (KAOP) scales at baseline and immediately after performed scenarios.Results: The scores of the JSE-HPS and its sub-scales, including perspective-taking (p < 0.001) and compassionate care (p=0.008), were significantly improved, while standing in patient's shoes was significantly decreased after the intervention (p=0.005). KAOP positive items were found to be higher compared to the baseline results (p=0.040). Besides, 87.1% of the students stated that their behavior towards older people would change positively.Conclusion: Using aged simulation suits may be an effective educational technique that positively contributes to undergraduate physiotherapy students' attitudes and empathy.