Reabilitação robótica nas complicações clínicas após câncer de mama: exoesqueleto de membros superiores

Background: Breast cancer promotes several physical and functional changes. Innovative techniques of physiotherapeutic treatment, such as robotic rehabilitation may contribute to the prevention or treatment of these complications. Here we aim to evaluate the effects of robotic rehabilitation on clinical complications secondary to breast cancer. Methods: This is a longitudinal clinical study consisting of 26 subjects divided into the following groups: 13 patients (women after breast cancer - G1, Robotic Rehabilitation Group) and 13 healthy women who did not undergo surgery due to breast cancer and constituted the GC (Control Group) to obtain data from electromyography and dynamometry. Ten consecutive therapeutic sessions were performed. The following parameters were evaluated in three sessions (session 1 - S1, session 5 - S5 and session 10 - S10): scapular and manual force, myoelectric activity, pain, range of motion, lymphedemaand quality of life. Results: Pain threshold attenuation was obtained by comparing S5 with S10 (p = 0.002) and at the end of treatment (p = 0.01); lymphedema reduction after 10 sessions (p = 0.04); increase of abduction ROM when comparing S1 with S10 (p = 0.05); flexion (p = 0.002) in S1 in relation to S10 and shoulder extension (p = 0.05) in S5. Regarding the electromyographic analysis, there were increases in scapular and manual force of the GC versus G1, and changes in variables estimated from the collected signals, especially the increase in signal amplitude for the MAV, PEAK and RMS characteristics of the brachial biceps muscles, anterior and middle deltoid when comparing S1 versus S10. Before the evaluation using the dynamometer, the healthy women presented increase of scapular and manual force in relation to the volunteers after breast cancer. Conclusion: The use of robotic therapy was significantly efficient for pain attenuation, lymphedema, increase range of motion, increased recruitment of muscle fibers and improvement of muscle synergism, which contributed to the improvement of the quality of life.