EBM CRITICAL APPRAISAL

COURSE AND PROGNOSIS OF SHOULDER SYMPTOMS IN GENERAL PRACTICE

Disusun oleh : Desta Murdinia 1102010067

Dosen Pembimbing : dr.

FAKULTAS KEDOKTERAN UNIVERSITAS YARSI MARET 2013

EBM

Nama : Desta Murdinia NIM : 1102010067

TUGAS EVIDENCE BASED MEDICINE Skenario Seorang wanita berumur 55tahun datang ke dokter dengan diagnosis kanker payudara. Kemudian ia menanyakan kepada dokter apakah dengan latihan fisik kekuatan otot dapat mengurangi kecacatan di masa depan. Dan dokter menjelaskan tentang prognosis dilakukannya latihan tersebut dengan dampaknya bagi kanker payudara pasien.

Pertanyaan (foreground question) Apakah perbedaan pasien kanker payudara dengan frekuensi latihan otot lebih banyak dengan pasien yang lebih jarang latihan?

PICO Population Intervention Comparison Outcomes : Pasien wanita lanjut usia dengan kanker payudara : Pasien yang lebih sering latihan kekuatan otot : Pasien yang lebih jarang latihan kekuatan otot : Pasien kanker payudara dengan latihan kekuatan otot dapat

mengurangi kecacatan di masa depan

Pencarian bukti ilmiah Alamat website Kata kunci Limitasi Hasil Pencarian : http://www.ncbi.nlm.nih.gov/pubmed/ : breast cancer AND disability AND prognosis : May 2008 24 November 2012 : 33

Dipilih artikel berjudul

The effect of resistance training on muscle strength and physical function in older, postmenopausal breast cancer survivors: a randomized controlled trial.

REVIEW JURNAL Pendahuluan Older breast cancer survivors (BCS) report more falls and functional limitations than women with no cancer history. Exercise training could reduce risk factors for future falls and disability. Metoda We conducted a randomized, controlled trial in 106 early-stage, postmenopausal BCS who were 50 years old at diagnosis and post-treatment. Women were randomly assigned to a 1year resistance + impact exercise program or a stretching placebo program. Endpoints were 1-repetition maximum bench press and leg press strength, timed 5-chair stands, 4m usual walk speed, timed stance tests, handgrip strength, self-report physical function, and fatigue. We also examined the influence of age, adjuvant hormone therapy use and exercise adherence on study outcomes. Hasil Women in the resistance + impact training program significantly improved maximal leg (p=.04) and bench (p=.01) press strength compared to the stretching group. Women who attended 50% or more of prescribed resistance training sessions had significantly better changes in maximal strength measures compared to less adherent women. Kesimpulan Resistance + impact exercise is superior to stretching at improving maximal muscle strength and exercise adherence contributes to the degree of improvement. http://www.ncbi.nlm.nih.gov/pubmed http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488606/