e20539 Background: Upper extremity dysfunction and decreased quality of life are frequently reported sequelae of the treatment for early stage breast cancer (BC). Surgical trauma and/or radiation therapy may lead to upper extremity (UE) impairments, functional limitations and disabilities including pain, stiffness, lymphedema, decreased strength and range of motion (ROM) and decreased activity tolerance. In this study we examined specific functional characteristics of shoulder impairments and associated limitations. Methods: Women (n=88, mean age = 53y [SD=11.81]) newly diagnosed with unilateral, Stage I to III BC were screened pre-operatively for this prospective trial. Patient data and physical therapy based assessments were recorded at the pre-operative visit (baseline) and at 1, 3, and 12+ months (BA, M1, M3, M12) after surgical treatment including pain (VAS on 10 point scale), bilateral shoulder ROM and strength (MMT). Volumes for upper extremities were taken using an optoelectric device (Perometer®). During post BC treatment visits, appropriate physical therapy was provided, and if there was a diagnosis of lymphedema, a light-grade compression garment was fitted. ROMs (shoulder Abd, ER, Flex, IR), a composite MMT value, and volume were analyzed with one-way repeated ANOVA including Greenhouse-Geisser correction for non-normal data where necessary. Post hoc testing was done using Within-Subjects Contrasts. Limited range of values for pain resulted in a highly skewed distribution, inappropriate for statistical testing. Results: For the variables Abd, ER, Flex, and sumMMT there was a decrease in function from BA to M1, improvement from M1 to M3, and further improvement from M3 to M12 (all p < 0.0001). For IR there was a decrease from BA to M1, no difference between M1 and M3, and an improvement from M1 and M3 to M12 (p < 0.3). Pain remained relatively low with 60–80% of the women reporting ≤2/10. Conclusions: After surgery for breast cancer, a decrement in shoulder function may be expected around 1 month after the procedure. Most subjects demonstrated significant improvement in function by 3 months after the procedure, and by 12 months, subjects achieved near complete recovery of shoulder impairment. No significant financial relationships to disclose.

INTRODUCTION:Tests of upper-extremity motor function used for people following a stroke have been described, but reliability and validity (psychometric properties) of measurements obtained with these tests have not been consistently established. This investigation was performed: (1) to review literature relative to upper-extremity motor function testing during rehabilitation following a stroke, (2) to develop selection criteria for identifying these tests in the literature, and (3) to rate the tests relative to their psychometric properties.METHOD:Literature searches were done using 2 databases. Reports of 4 psychometric properties were sought: interrater reliability, test-retest reliability, convergent validity or concurrent validity, and predictive validity.RESULTS:Nine tests met the inclusion criteria of having psychometric properties reported in the literature. No test had evidence for all 4 psychometric properties. Only the Nine-Hole Peg Test was supported by 3 out of 4 properties. Most tests had 2 properties supported. Concurrent validity or convergent validity was most frequently described; test-retest reliability was least frequently described.CONCLUSIONS:More complete psychometric support is needed for upper-extremity motor function tests applied following a stroke. The absence of psychometric support, however, does not mean that a test has no value. Clinicians are cautioned not to generalize psychometric evidence.

There is evidence that the slope of the change in oxygen uptake accompanying changes in work rate (Delta(V) over dot O-2/DeltaW) during moderate incremental exercise is influenced by fitness (peak (V) over dot O-2). We set out to determine whether Delta(V) over dot O-2/DeltaW was related to fitness in a group of healthy children and in children with juvenile dermatomyositis (JDM), a condition associated with decreased peak (V) over dot O-2 We also hypothesized that Delta(V) over dot O-2/DeltaW would be significantly decreased in children with JDM compared to healthy children. Methods: Twelve children (2 boys) with JDM, mean age 11.6 +/- 3.6 yrs, and 20 healthy children (4 boys), mean age 11.3 +/- 2.9 years, performed an incremental exercise test using a cycle ergometer A Delta(V) over dot O-2/DeltaW below the anaerobic threshold was analyzed using linear regression. Correlations between peak (V) over dot O-2 and Delta(V) over dot O-2/DeltaW were calculated, and differences between the JDM and healthy groups were analyzed using independent t-tests. Results: The Delta(V) over dot O-2/DeltaW was significantly correlated with peak (V) over dot O-2 for children with JDM (r = 0.71, p < 0.01), healthy children (r = 0.53, p < 0.01), and all children combined (r = 0. 78, p < 0.001). The Delta(V) over dot O-2/DeltaW (7.4 +/- 1.4 vs. 10.8 +/- 1.2 ml O-2.min(-1.)watt(-1)) and peak oxygen uptake ((V) over dot O(2)peak) (19.2 +/- 5.0 vs. 31.4 +/- 7.2 ml O-2. kg(-1). min(-1)) were significantly lower in children with JDM than in healthy children, respectively (all p less than or equal to 0.001). Conclusion: Fitness is significantly related to Delta(V) over dot O-2/DeltaW in healthy children and those with JDM. Children with JDM have a significantly lower Delta(V) over dot O-2/DeltaW than healthy children. Further study is needed to identify specific factors influencing Delta(V) over dot O-2/DeltaW.

1Physical Therapy Dept., Northern Arizona University, Flagstaff AZ, 2Rehabilitation Medicine Department, NIH, Bethesda, MD.

s of Poster and Platform Presentations at the 1999 Combined Sections Meeting: Platform Presentations: PDF Only

Journal Article Cancer and Ultrasound: A Warning Get access Lola Sicard-Rosenbaum, PT, OCS, Lola Sicard-Rosenbaum, PT, OCS 1National Institutes of Health, CC/RMD/6S-235, 9000 Rockville Pike, Bethesda, MD 20892 Search for other works by this author on: Oxford Academic Google Scholar Jerome Danoff, PhD, PT Jerome Danoff, PhD, PT 2Associate Professor, Department of Physical Therapy, Howard University, Washington, DC 20059 Search for other works by this author on: Oxford Academic Google Scholar Physical Therapy, Volume 73, Issue 6, 1 June 1993, Pages 404–406, https://doi.org/10.1093/ptj/73.6.404 Published: 01 June 1993

Accurate assessment of head motion can be a useful tool in clinical studies. Since the head moves on a combination of axes in the cervical spine, evaluation of neck motion is difficult. Assessment of cervical mobility is further complicated because of inadequate reference points on the head from which to measure. Hence, numerous methods for approximating cervical range have been devised. These methods include visual estimation, radiographic analysis, schematography, photography, and a variety of goniometer devices. Disadvantages of these techniques are lack of accuracy and objectivity, radiation exposure, expense, time consumption, and equipment availability. To measure cervical mobility, a standard gravity goniometer with spirit level and head adapter was used, which allowed stabilization. The gravity goniometer can be obtained in a variety of sizes at most hardware stores. The head adapter consists of a wood block into which an arc is carved and elastic straps suspended for securing on the head. The reliability of this instrument was tested and compared to the universal goniometer, and correlation coefficients were determined. When two experienced examiners used the universal goniometer to assess cervical motion, significant intraclass correlation coefficients (ICC) were found with three of the six criteria measures (p less than 0.05). When one experienced and one novice examiner used the gravity goniometer with head adapter, highly significant ICC values were found for all six criteria measures (p less than 0.01). A single experienced examiner comparing both instruments on the same subjects produced significant ICC values in four of the six criterion measures (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Interleukin-10 is a pleiotropic cytokine known to have inhibitory effects on the accessory functions of dendritic cells. In vitro, interleukin-10 converts immature dendritic cells into tolerizing antigen- presenting cells. To assess whether interleukin-10-treated dendritic cells exert tolerizing effects in vivo, CD4+ T cells from DO11.10 ovalbumin-T cell receptor transgenic mice were transferred to syngeneic BALB/c recipients. Recipient animals were treated with ovalbumin-pulsed/unpulsed, interleukin-10-treated/untreated CD11c+ dendritic cells thereafter and ovalbumin-specific proliferation of lymph node cells was assessed by restimulation with the peptide in vitro. In prophylactic experiments, recipients received naive CD4+ DO11.10 T cells and were immunized with ovalbumin323-339 peptide in incomplete Freund's adjuvant after treatment with various subtypes of dendritic cells. Strong ovalbumin-specific proliferation was observed in animals immunized with control ovalbumin-dendritic cells. Minimal proliferation was found in mice treated with ovalbumin-pulsed, interleukin-10-treated dendritic cells. In therapeutic experiments, preactivated CD4+ DO11.10 T cells were transferred, and recipients were treated with dendritic cells as described. Ovalbumin-specific proliferation was strong in recipients treated with ovalbumin-dendritic cells. CD4+ T cell proliferation from ovalbumin-interleukin-10-dendritic cell treated animals was below background. When delayed type hypersensitivity reactions in the footpads of prophylactically or therapeutically vaccinated animals were tested, mice treated with ovalbumin-interleukin-10-dendritic cells showed no footpad swelling compared with controls. Rechallenge with the antigen in vitro and in vivo did not alter the inhibitory effect of interleukin-10-treated dendritic cells. Thus, interleukin-10-treated dendritic cells inhibit ovalbumin-specific immune responses in naive and sensitized mice.