THE PHYSIOTHERAPY INTERVENTION FOR PREVENTION OF MUSCULOSKELETAL COMPLICATIONS IN SHOULDER GIRDLE AFTER MASTECTOMY

U Hrvatskoj se godišnje otkrije 2400 novih slučajeva karcinoma dojke. Od 2006.godine, karcinom dojke smatra se vodećim uzrokom smrti u Hrvatskoj te je iz tog razloga započela provedba nacionalnog programa prevencije raka dojke koja uključuje mamografski pregled za sve žene u dobi od 50 do 60 godina. Čimbenicima rizika za razvoj karcinom dojke smatraju se dob, spol, prehrana, pozitivna obiteljska anamneza, kasni prvi porođaj, stres, pušenje, hormoni te mutacije na genima BRCA1 i BRCA2. Fizioterapijski postupci oboljelim osobama od karcinoma dojke pružaju terapijske sadržaje u predoperativnoj te postoperativnoj rehabilitaciji. Jedan od glavnih ciljeva fizioterapije je poboljšanje kvalitete života prilikom obavljanja svakodnevnih aktivnosti. Isto tako važni ciljevi fizioterapije su sprječavanje mogućih komplikacija nakon operativnog zahvata poput limfedema i deformacija u posturi. Vrlo česta posljedica liječenja karcinoma dojke je u području ramena. Preveniranjem adhezije s vježbama u ramenu nakon operacije, treba započeti što prije jer ograničenje pokreta u zglobu ramena nastane nakon četvrtog dana. Primjenom PNF-a koncepta dobiva se pozitivan učinak na cirkulaciju krvi, mišićnu izdržljivost i osigurava se veća mišićna opuštenost u ramenom obruču. Zajedničkom suradnjom fizioterapeuta i pacijentice oboljele od karcinoma dojke mogu se postići jako dobri rezultati.In Croatia, 2400 new cases of this type of carcinoma are discovered each year. Since 2006, it has been considered the leading cause of death in Croatia, which led to the implementation of the national program for the prevention of breast cancer, including mammography for all women aged between 50 and 60. A person's age, gender, nutrition, positive family history, late first childbirth, stress, smoking, hormones, and mutations on the genes BRCA1 and BRCA2 are considered the main risk factors potentially leading to breast cancer. Physiotherapeutic procedures for patients with breast cancer provide therapeutic content in preoperative and postoperative rehabilitation. One of the main goals of physiotherapy is to improve the quality of life while performing diverse everyday activities. Physiotherapy also deems important preventing potential complications after surgical procedures, including lymphedema and posture deformations. A very common consequence of breast cancer treatment is in the shoulder area. Preventing adhesion with shoulder exercises after surgery should be started as soon as possible because restriction of movement in the shoulder joint occurs after the fourth day. The application of the PNF concept gives a positive effect on blood circulation, muscle endurance and ensures greater muscle relaxation in the shoulder girdle. Through a united collaboration between physiotherapists and patients diagnosed with breast cancer, it is possible to achieve great results