title: Shoulder impairment before breast cancer surgery.
abstract: OBJECTIVE
  To compare pre- and post-operative shoulder active range of motion (AROM) values from female breast cancer survivors to population norm values for shoulder AROM; and to compare shoulder AROM differences pre- and post-surgery between female African American and White breast cancer survivors (BCA).
  
  
  METHODS
  This pilot study used a convenience sample and longitudinal design measuring participants 2 times (T0 = baseline, after biopsy but within 2 weeks before BCA surgery; T1 = 2ndpostoperative week).
  
  
  BACKGROUND
  The U.S. has the largest BCA survivor population in history and yet the mortality burden remains highest among AA BCA survivors. AAs may also have greater burden of physical and functional side effects compared to whites and the general population.
  
  
  METHODS
  The data were collected from a convenience sample (n = 33; nAA= 9, nW= 24) and included data on shoulder AROM, medical chart review for pre- and co-morbid conditions, and self-reported demographics and medical history. We used t-tests to compare sample AROM means to population norms. We then compared our sample across 2 timepoints (T0 = pre-surgery; T1 = 2 weeks post-surgery) using independent samples t-tests and repeated measures analysis of variance (p < .05) to compare AA to White sub-samples AROM means.
  
  
  RESULTS
  African Americans had significantly less shoulder abduction (at T0) and flexion (at T1) than whites. However, 100% had significantly reduced AROM for all movements at T0 (prior to surgery but after biopsy) when compared to population norms.
  
  
  CONCLUSIONS
  The significant reduction in shoulder AROM after biopsy but before surgery points to a possible unmet need for early physical therapy intervention. Further research using randomized controlled trial design is recommended.
authors.affiliation: Department of Physical Therapy, Rehabilitation and Movement Sciences, Center for Cancer Survivorship Studies, Northeastern University, Boston, MA.
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Flores
authors.affiliation: College of Nursing, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Dwyer
keywords: breast cancer; cancer survivorship; physical therapy; shoulder range of motion