{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:12:07Z","timestamp":1760145127567,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Spanish Ministry of Education","award":["FPU:21\/00451","FPU:22\/01543"],"award-info":[{"award-number":["FPU:21\/00451","FPU:22\/01543"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Lung resection represents the main curative treatment in lung cancer; however, this surgical process leads to several disorders in tissues and organs. Previous studies have reported cardiovascular, pulmonary, and muscular disturbances that affect the functional capacity of these patients in the short, mid, and long term. However, upper limb impairment has been scarcely explored in the long term, despite the relevance in the independence of the patients. The aim of this study was to characterize the upper limb impairment in survivors of lung cancer one year after pulmonary resection. In this observational trial, patients who underwent lung cancer surgery were compared to control, healthy subjects matched by age and gender. Upper limb musculoskeletal disorders (shoulder range of motion, pain pressure threshold, nerve-related symptoms) and functional capacity (upper limb exercise capacity) were evaluated one-year post-surgery. A total of 76 survivors of lung cancer and 74 healthy subjects were included in the study. Significant differences between groups were found for active shoulder mobility (p &lt; 0.05), widespread hypersensitivity to mechanical pain (p &lt; 0.001), mechanosensitivity of the neural tissue (p &lt; 0.001), and upper limb exercise capacity (p &lt; 0.001). Patients who undergo lung cancer surgery show upper limb musculoskeletal disorders and upper limb functional impairment after a one-year lung resection. This clinical condition could limit the functionality and quality of life of patients with lung cancer.<\/jats:p>","DOI":"10.3390\/cancers16122279","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T11:47:17Z","timestamp":1718797637000},"page":"2279","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Musculoskeletal Disorders Related to Upper Limb Disability after One-Year Lung Cancer Resection"],"prefix":"10.3390","volume":"16","author":[{"given":"Javier","family":"Mart\u00edn N\u00fa\u00f1ez","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Raya Ben\u00edtez","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florencio","family":"Quero Valenzuela","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Department, Hospital Virgen de las Nieves de Granda, 18014 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9s","family":"Calvache Mateo","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alba","family":"Navas Otero","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2130-7901","authenticated-orcid":false,"given":"Alejandro","family":"Heredia Ciur\u00f3","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2368-1307","authenticated-orcid":false,"given":"Marie Carmen","family":"Valenza","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/0003-4975(95)00537-U","article-title":"Randomized trial of lobectomy versus limited resection for T1 No non-small cell lung cancer. Lung Cancer Study group","volume":"60","author":"Ginsberg","year":"1995","journal-title":"Ann. Thorac. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1007\/s11912-018-0741-7","article-title":"Surgical Management of Lung Cancer: History, Evolution, and Modern Advances","volume":"20","author":"Abbas","year":"2018","journal-title":"Curr. Oncol. Rep."},{"key":"ref_3","first-page":"1489","article-title":"Uniportal VATS-a new era in lung cancer surgery","volume":"7","author":"Ng","year":"2015","journal-title":"J. Thorac. Dis."},{"key":"ref_4","first-page":"217","article-title":"Major morbidity after lung resection: A comparison between the European Society of Thoracic Surgeons Database system and the Thoracic Morbidity and Mortality system","volume":"5","author":"Salati","year":"2013","journal-title":"J. Thorac. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1183\/09031936.00199212","article-title":"Quality of life after lung resection is not associated with functional objective measures","volume":"42","author":"Pompili","year":"2013","journal-title":"Eur. Respir. J."},{"key":"ref_6","first-page":"307","article-title":"An assessment of quality of life, health, and disability in patients undergoing lung resection","volume":"25","year":"2023","journal-title":"KONTAKT J. Nurs. Soc. Sci. Relat. Health Illn."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1378\/chest.117.6.1551","article-title":"Patient preferences regarding possible outcomes of lung resection: What outcomes should preoperative evaluations target?","volume":"117","author":"Cykert","year":"2000","journal-title":"Chest"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e1927","DOI":"10.1097\/MD.0000000000001927","article-title":"Bilateral shoulder dysfunction related to the lung resection area after thoracotomy","volume":"94","author":"Miranda","year":"2015","journal-title":"Medicine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"E41","DOI":"10.1097\/01.REO.0000000000000311","article-title":"Shoulder Dysfunction After Lung Cancer Resection","volume":"40","author":"Lowe","year":"2022","journal-title":"Rehabil. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1997","DOI":"10.1093\/pm\/pny230","article-title":"Musculoskeletal Signs Associated with Shoulder Pain in Patients Undergoing Video-Assisted Thoracoscopic Surgery","volume":"20","author":"Valenza","year":"2019","journal-title":"Pain Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/j.ejcts.2006.12.012","article-title":"Muscle-sparing versus posterolateral thoracotomy: A prospective study","volume":"31","author":"Athanassiadi","year":"2007","journal-title":"Eur. J. Cardio-Thorac. Surg. Off. J. Eur. Assoc. Cardio-Thorac. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"41","DOI":"10.2106\/00004623-199801000-00008","article-title":"The relationship between motion of the shoulder and the stated ability to perform activities of daily living","volume":"80","author":"Triffitt","year":"1998","journal-title":"J. Bone Jt. Surg."},{"key":"ref_13","first-page":"18","article-title":"Postoperative discomfort and its influence on daily life in patients with lung cancer: A study concern-ing the period from hospital discharge to 6 months after surgery","volume":"29","author":"Bando","year":"2015","journal-title":"J. Jpn. Soc. Cancer Nurs."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/1749-8090-9-92","article-title":"Postoperative complications do not influence the pattern of early lung function recovery after lung resection for lung cancer in patients at risk","volume":"9","author":"Ercegovac","year":"2014","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.thorsurg.2012.07.006","article-title":"Changes in quality of life after pulmonary resection","volume":"22","author":"Brunelli","year":"2012","journal-title":"Thorac. Surg. Clin."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1016\/S0022-5223(94)70384-1","article-title":"Prevalence of chronic pain after pulmonary resection by thoracotomy or video-assisted thoracic surgery","volume":"107","author":"Landreneau","year":"1994","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"13318","DOI":"10.1038\/s41598-023-40117-5","article-title":"Estimation of disability free life expectancy in non small cell lung cancer based on real world data","volume":"13","author":"Lin","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies","volume":"12","author":"Altman","year":"2014","journal-title":"Int. J. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/S1010-7940(02)00721-2","article-title":"Validation of the Charlson comorbidity index in patients with operated primary non-small cell lung cancer","volume":"23","author":"Birim","year":"2003","journal-title":"Eur. J. Cardio-Thoracic Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"52","DOI":"10.7196\/SAMJ.6197","article-title":"Guideline for office spirometry in adults, 2012","volume":"103","author":"Koegelenberg","year":"2012","journal-title":"S. Afr. Med. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1093\/ptj\/67.5.668","article-title":"Goniometric reliability in a clinical setting. Shoulder measurements","volume":"67","author":"Riddle","year":"1987","journal-title":"Phys. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"707","DOI":"10.26603\/ijspt20180707","article-title":"Reliability and validity of the halo digital goniometer for shoulder range of motion in healthy subjects","volume":"13","author":"Correll","year":"2018","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1097\/AJP.0b013e3182261650","article-title":"Neurophysiological characterization of persistent postthoracotomy pain","volume":"28","author":"Wildgaard","year":"2012","journal-title":"Clin. J. Pain"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1097\/AJP.0b013e318154b6ae","article-title":"Interrater reliability of algometry in measuring pressure pain thresholds in healthy humans, using multiple raters","volume":"23","author":"Chesterson","year":"2007","journal-title":"Clin. J. Pain"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1016\/j.jpain.2007.04.003","article-title":"Test-retest reliability of pressure pain threshold measurements of the upper limb and torso in young healthy women","volume":"8","author":"Jones","year":"2007","journal-title":"J. Pain"},{"key":"ref_26","first-page":"B5326","article-title":"From acute to chronic postsurgical pain: The significance of the acute pain response","volume":"65","year":"2018","journal-title":"Dan. Med. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/s0304-3959(02)00344-5","article-title":"Temporal summation of pain from mechanical stimulation of muscle tissue in normal controls and subjects with fibromyalgia syndrome","volume":"102","author":"Staud","year":"2003","journal-title":"Pain"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Butler, D.S. (2000). The Sensitive Nervous System, Noirgroup Publications.","DOI":"10.1016\/B978-012529650-2\/50026-3"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1111\/pme.12567","article-title":"Nerve pressure pain hypersensitivity and upper limb mechanosensitivity in breast cancer survivors: A case\u2013control study","volume":"15","year":"2014","journal-title":"Pain Med."},{"key":"ref_30","unstructured":"Norkin, C.C., and White, D.J. (2009). Measurement of Joint Motion: A Guide to Goniometry, F.A. Davis. [4th ed.]."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/00008483-200311000-00007","article-title":"A new unsupported upper limb exercise test for patients with chronic obstructive pulmonary disease","volume":"23","author":"Takahashi","year":"2003","journal-title":"J. Cardiopulm. Rehabil."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1055\/s-2008-1026080","article-title":"Ratings of perceived exertion and heart rates during short-term cycle exercise and their use in a new cycling strength test","volume":"3","author":"Borg","year":"1982","journal-title":"Int. J. Sports Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1282937","DOI":"10.3389\/fsurg.2023.1282937","article-title":"Chronic postoperative pain after non-intubated uniportal VATS lobectomy","volume":"13","author":"Farkas","year":"2023","journal-title":"Front. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1007\/s00520-021-06537-7","article-title":"Psychological distress prior to surgery is related to symptom burden and health status in lung cancer survivors","volume":"30","author":"Valenza","year":"2022","journal-title":"Support. Care Cancer"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1053\/j.jvca.2016.04.032","article-title":"Shoulder pain after thoracic surgery: Type and time course, a prospective cohort study","volume":"31","author":"Andersen","year":"2017","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"823259","DOI":"10.3389\/fsurg.2022.823259","article-title":"Effect of Upper Arm Position Changes on the Occurrence of Ipsilateral Shoulder Pain After Single-Operator Port Thoracoscopy","volume":"2","author":"Ren","year":"2022","journal-title":"Front. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/j.1526-4637.2010.01027.x","article-title":"Widespread mechanical pain hypersensitivity as a sign of central sensitization after breast cancer surgery: Comparison between mastectomy and lumpectomy","volume":"12","year":"2011","journal-title":"Pain Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/S0894-1130(97)80066-X","article-title":"Physical evaluation of the peripheral nervous system in disorders of pain and dysfunction","volume":"10","author":"Elvey","year":"1997","journal-title":"J. Hand Ther."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/S0079-6123(00)29026-2","article-title":"Referred pain as an indicator for neural plasticity","volume":"129","author":"Laursen","year":"2000","journal-title":"Prog. Brain Res."},{"key":"ref_40","first-page":"1541","article-title":"From acute to chronic pain after thoracic surgery: The significance of different components of the acute pain response","volume":"16","author":"Andersen","year":"2018","journal-title":"J. Pain Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1016\/j.ejcts.2005.08.001","article-title":"Changes in pulmonary function test and cardio-pulmonary exercise capacity in COPD patients after lobar pulmonary resection","volume":"28","author":"Bobbio","year":"2005","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"76","DOI":"10.22631\/ijaep.v7i2.263","article-title":"Cancer Related Fatigue and Upper Limb Disabilities Cannot Improve after 6 Weeks Resistance Training with Thera-Band in Breast Cancer Survivors","volume":"7","author":"Nouri","year":"2018","journal-title":"Int. J. Appl. Exerc. Physiol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Izawa, K., Kasahara, Y., Hiraki, K., Hirano, Y., and Watanabe, S. (2017). Relation between the disability of the arm, shoulder and hand score and muscle strength in post-cardiac surgery patients. Diseases, 5.","DOI":"10.3390\/diseases5040031"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"40","DOI":"10.3138\/ptc.2011-49","article-title":"Relationship and responsiveness of three upper-limb tests in patients with chronic obstructive pulmonary disease","volume":"65","author":"Hill","year":"2013","journal-title":"Physiother. Canada"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.21037\/jtd.2017.05.49","article-title":"Effectiveness of perioperative pulmonary rehabilitation in thoracic surgery","volume":"9","author":"Vagvolgyi","year":"2017","journal-title":"J. Thorac. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/ACO.0000000000000149","article-title":"Preoperative evaluation of the patient with lung cancer being considered for lung resection","volume":"28","author":"Choi","year":"2015","journal-title":"Curr. Opin. Anaesthesiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1590\/S1413-35552012005000088","article-title":"Late morbidity in upper limb function and quality of life in women after breast cancer surgery","volume":"17","author":"Assis","year":"2013","journal-title":"Braz. J. Phys. Ther."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.pain.2006.09.030","article-title":"Does the presence of sensory hypersensitivity influence outcomes of physical rehabilitation for chronic whiplash? A preliminary RCT","volume":"129","author":"Jull","year":"2007","journal-title":"Pain"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/12\/2279\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:01:23Z","timestamp":1760108483000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/12\/2279"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,19]]},"references-count":48,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["cancers16122279"],"URL":"https:\/\/doi.org\/10.3390\/cancers16122279","relation":{},"ISSN":["2072-6694"],"issn-type":[{"type":"electronic","value":"2072-6694"}],"subject":[],"published":{"date-parts":[[2024,6,19]]}}}