Marco Tomasella

Multidisciplinary rehabilitation program after breast cancer: benefits on physical function, anthropometry and quality of life.

BACKGROUNDnDifferent clinical trials show beneficial effects of physical training offered during and/or after breast cancer treatment. However, given the variety of side effects that may be encountered, physical training could be combined with psychological, relational and social guidance. This kind of multidisciplinary program has been little studied so far.nnnAIMnThe aim of this study was to determine the benefits of a three-month multidisciplinary rehabilitation program among women after breast cancer treatment.nnnDESIGNnControlled no-randomized trial.nnnSETTINGnUniversity for outcomes, University Hospital Center for interventions.nnnPOPULATIONnTwo hundred and nine outpatients who have been treated for a primary breast carcinoma.nnnMETHODSnPatients were divided into a control group (N.=106) and an experimental group (N.=103) which has benefited from a rehabilitation program of three months including physical training and psycho-educational sessions. The assessments, performed before and after the program, included functional assessments (Sit and Reach Test, maximal incremental exercise test and Six-Minute Walk Test), body composition measurements (Body Mass Index [BMI] and body fat percentage) and a questionnaire (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30).nnnRESULTSnAfter three months, flexibility, walking distance and all parameters measured during the maximal incremental exercise, except maximal heart rate, were significantly improved in the experimental group. The body fat percentage was significantly decreased and a significant improvement was observed for perceived health status (quality of life), functional role, emotional state, physical, cognitive and social functions and for most symptoms. In the control group, most of these improvements didnt appear and a significant increase in BMI and body fat percentage was observed.nnnCONCLUSIONSnThis trial identifies the benefits of a well detailed multidisciplinary rehabilitation program, including physical re-conditioning and psycho-educational sessions, with important improvements in functional capacity, body composition and the majority of functions and symptoms among women after breast cancer treatment.nnnCLINICAL REHABILITATION IMPACTnThrough its results, this study could contribute to the development of hospital quality standards for oncologic rehabilitation. Physiotherapists can efficiently propose this kind of multidisciplinary rehabilitation program.

Lumbopelvic motor control and low back pain in elite soccer players: a cross-sectional study

ABSTRACT This study aimed to investigate the relationship between the history of low back pain and quality of lumbopelvic motor control in soccer players. Forty-three male elite soccer players (mean age, 18.2 ± 1.4 years) filled in questionnaires related to low back pain and attended a session to assess lumbopelvic motor control by means of five tests (the bent knee fall out test, the knee lift abdominal test, the sitting knee extension test, the waiter’s bow and the transversus abdominis test). A physiotherapist, blinded to the medical history of the participants, scored (0 = failed, 1 = correct) the performance of the players for each of the tests resulting in a lumbopelvic motor control score ranging from 0 to 5. Forty-seven per cent of the soccer players reported a disabling low back pain episode lasting at least two consecutive days in the previous year. These players scored worse lumbopelvic motor control than players without a history of low back pain (lumbopelvic motor control score of 1.8 vs. 3.3, P < 0.01). The between-groups difference was particularly marked for the bent knee fall out test, the knee lift abdominal test and the transversus abdominis test (P < 0.01). In conclusion, most soccer players with a history of low back pain had an altered lumbopelvic motor control. Further research should examine whether lumbopelvic motor control is etiologically involved in low back pain episodes in soccer players.