Thesis Type: Doctorate
Institution Of The Thesis: Gazi University, Sağlık Bilimleri Enstitüsü, FİZYOTERAPİ VE REHABİLİTASYON ANABİLİM DALI, Turkey
Approval Date: 2020
Thesis Language: Turkish
Student: İLKNUR ONURLU
Supervisor: İlke Keser
Abstract:
Exercise therapies are effective methods in the treatment of complications after breast cancer surgery.
The study aims to compare exercise practices with virtual reality-based exercise training during
radiotherapy period after breast cancer surgery. Patients were randomly divided into 3 groups as
virtual reality group (n:22), exercise group (n:22) and control group (n:22), considering the order of
arrival at the clinic and the type of surgery (mastectomy and breast-conserving surgery). Patients in
virtual reality group (n:22) received virtual reality-based exercise training using Xbox 360 Kinect.
Patients in exercise group (n:22) received an exercise program including range of motion, posture,
stretching and breathing exercises. Both exercise groups participated in the exercise program for 30-
40 minutes, 3 days a week, as long as radiotherapy continued (5-6 weeks). Patients in control group
(n:22) received any exercise as in the current practice. Patients were evaluated for shoulder
movements by universal goniometer, for hand grip strength by Jamar hand dynamometer, for
shoulder proprioception by Cybex (Lumex,NY,USA) izokinetic dynamometer, for functionality by
‘Disabilities of the arm, shoulder and hand questionnaire (DASH)’, for kinesiophobia by ‘Tampa
kinesiophobia scale’, for anxiety and depression by ‘Hospital anxiety and depression scale’,for
fatique by ‘Piper fatique scale’ and for quality of life by ‘European Organization for Research and
Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)’. All evaluations were done
at the begining and at the end of the radiotherapy. As a result, shoulder range of motions in the
exercise group showed significant increase in all directions (flexion, extension, abduction, internal
and external rotation) (p<0,05). In the virtual reality group, there was significant increase only
shoulder internal and external rotation movements)(p<0,05). In both groups, improvement in
shoulder functions, decrease in fatigue level, increases in quality of life associated with symptoms
and functional status were significant(p<0,05). Hand grip strength, proprioception, kinesiophobia,
lymphedema, anxiety and depression level did not change in either group(p>0,05). In conclusion,
while exercises accompanied by a physiotherapist have proven once again to have an important role
in the rehabilitation of breast cancer patients, virtual reality-based exercises have also been shown to
be a method that can be used with standard therapies in this patient group.
Key Words : Breast cancer, Visual reality, Exercise, Radiotherapy