In this paper we use multivariate statistical techniques to gain insights into how adaptive gait involving obstacle crossing is regulated in lower-limb amputees compared to able-bodied controls, with the aim of identifying underlying characteristics that differ between the two groups and consequently highlighting gait deficits in the amputees. Eight unilateral trans-tibial amputees and twelve able-bodied controls completed adaptive gait trials involving negotiating various height obstacles; with amputees leading with their prosthetic limb. Spatiotemporal variables that are regularly used to quantify how gait is adapted when crossing obstacles were determined and subsequently analysed using multivariate statistical techniques. There were fundamental differences in the adaptive gait between the two groups. Compared to controls, amputees had a reduced approach velocity, reduced foot placement distance before and after the obstacle and reduced foot clearance over it, and reduced lead-limb knee flexion during the step following crossing. Logistic regression analysis highlighted the variables that best distinguished between the gait of the two groups and multiple regression analysis (with approach velocity as a controlling factor) helped identify what gait adaptations were driving the differences seen in these variables. Getting closer to the obstacle before crossing it appeared to be a strategy to ensure the heel of the lead-limb foot passed over the obstacle prior to the foot being lowered to the ground. Despite adopting such a heel clearance strategy, the lead-foot was positioned closer to the obstacle following crossing, which was likely a result of a desire to attain a limb/foot angle and orientation at instant of landing that minimised loads on the residuum (as evidenced by the reduced lead-limb knee flexion during the step following crossing). These changes in foot placement meant the foot was in a different part of swing at point of crossing and this explains why foot clearance was considerably reduced in amputees. The results highlight that trans-tibial amputees use quite different gait adaptations to cross obstacles compared with controls (at least when leading with their prosthetic limb), indicating they are governed by different constraints; seemingly related to how they land on/load their prosthesis after crossing the obstacle. / Yes

Yes / Passive prosthetic devices are set up to provide optimal function at customary walking speed and thus may function less effectively at other speeds. This partly explains why joint kinetic adaptations become more apparent in lower-limb amputees when walking at speeds other than customary. The present study determined whether a trans-tibial prosthesis incorporating a dynamic-response foot that was attached to the shank via an articulating hydraulic device (hyA-F) lessened speed-related adaptations in joint kinetics compared to when the foot was attached via a rigid, non-articulating attachment (rigF). Eight active unilateral trans-tibial amputees completed walking trials at their customary walking speed, and at speeds they deemed to be slow-comfortable and fast-comfortable whilst using each type of foot attachment. Moments and powers at the distal end of the prosthetic shank and at the intact joints of both limbs were compared between attachment conditions. There was no change in the amount of intact-limb ankle work across speed or attachment conditions. As speed level increased there was an increase on both limbs in the amount of hip and knee joint work done, and increases on the prosthetic side were greater when using the hyA-F. However, because all walking speed levels were higher when using the hyA-F, the intact-limb ankle and combined joints work per meter travelled were significantly lower; particularly so at the customary speed level. This was the case despite the hyA-F dissipating more energy during stance. In addition, the amount of eccentric work done per meter travelled became increased at the residual knee when using the hyA-F, with increases again greatest at customary speed. Findings indicate that a trans-tibial prosthesis incorporating a dynamic-response foot reduced speed-related changes in compensatory intact-limb joint kinetics when the foot was attached via an articulating hydraulic device compared to rigid attachment. As differences between attachment conditions were greatest at customary speed, findings indicate a hydraulic ankle-foot device is most effectual at the speed it is set-up for.

Over one million amputees are living in the United States with major lower limb loss (Ziegler-Graham et al. 2008). Lower limb amputation leads to the functional loss of the ankle plantar flexor muscles, which are important contributors to body support, forward propulsion, and leg swing initiation during walking (Neptune et al. 2001; Liu et al. 2006). Effective prosthetic component design is essential for successful rehabilitation of amputees to return to an active lifestyle by partially replacing the functional role of the ankle muscles. The series of experimental and computer simulation studies presented in this research showed that design characteristics of energy storage and return prosthetic ankles, specifically the elastic stiffness, significantly influence residual and intact leg ground reaction forces, knee joint moments, and muscle activity, thus affecting muscle output. These findings highlight the importance of proper prosthetic foot stiffness prescription for amputees to assure effective rehabilitation outcomes. The research also showed that the ankle muscles serve to stabilize the body during turning the center of mass. When amputees turn while supported by their prosthetic components, they rely more on gravity to redirect the center of mass than active muscle generation. This mechanism increases the risks of falling and identifies a need for prosthetic components and rehabilitation focused on increasing amputee stability during turning. A proper understanding of the effects of prosthetic components on amputee walking mechanics is critical to decreasing complications and risks that are prevalent among lower-limb amputees. The presented research is an important step towards reaching this goal. / text

INTRODUÇÃO: Há poucos estudos bem estruturados sobre a eficácia do bloqueio anestésico do gânglio estrelado (BGE) e do bloqueio simpático torácico (BST) para o tratamento da síndrome complexa de dor regional (SCDR) do membro superior. Há evidências anatômicas e clínicas de que o BGE frequentemente não interrompe a atividade neurovegetativa simpática do membro superior. OBJETIVOS: Avaliar-se a eficácia do BST para tratar a SCDR do membro superior. CASUÍSTICA E MÉTODOS: De acordo com estudo controlado com amostra aleatória e duplamente encoberto, doentes com SCDR, com duração maior que seis meses, foram aleatoriamente submetidos ao método padronizado de tratamento (polifarmacoterapia e terapia física) associadamente aos procedimentos BST ou ao bloqueio controle. Foram comparados os aspectos demográficos, a apresentação clínica, a intensidade da dor, as alterações do humor, a qualidade de vida, a função do membro acometido e os eventos adversos dos procedimentos até um ano após sua realização. Foram utilizadas entrevistas estruturadas, o Inventário Breve de Dor (IBD), o Questionário de Dor McGill (QDM), o Questionário para Diagnóstico de Dor Neuropática (DN4), o Inventário de Sintomas de Dor Neuropática (NPSI), o questionário \"Hospital Anxiety and Depression Scale\" (HAD), o questionário de qualidade de vida WHOQOL-bref, o questionário de avaliação funcional \"Disabilities of Arm, Shoulder and Hand\" e a análise de amplitude dos movimentos (ADM) como métodos de avaliação. RESULTADOS: Foram elegíveis 63 doentes, dos quais 42 foram incluídos, destes, 36 completaram o estudo. Em 17 realizou-se o BST e em 19 o bloqueio controle. Não houve diferenças estatísticas quanto às características demográficas e clínicas entre doentes tratados com BST ou do grupo controle. Houve melhora significativa da dor em relação ao IBD \"dor agora\" e \"atividade geral\"; soma dos pontos do QDM ; questões sete, nove e 11 do NPSI nos doentes tratados com BST em relação aos doentes do grupo controle em curto prazo (um e dois meses após o bloqueio). Em longo prazo, também observou-se que ocorreu melhora significativa nos doentes tratados com BST em relação aos do grupo controle de acordo com o IBD \"dor média\", soma dos pontos QDM e questões quatro, oito e dez do NPSI um ano após o procedimento. Um ano após o procedimento evidenciou-se melhora significativa da qualidade de vida, de acordo com questões quatro, 11, 19 e 21 do WHOQOL-bref nos doentes tratados com BST em relação aos do grupo controle. Nos doentes do grupo controle evidenciouse maior pontuação de depressão de acordo com a Escala HAD em relação aso doentes tratados com BST. Nos doentes tratados com BST a ocorrência de visão turva após o procedimento foi maior que nos doentes do grupo controle. Não houve diferença estatisticamente significativa quanto a evolução funcional em curto prazo entre os dois grupos. CONCLUSÕES: Ocorreu redução significativa da percepção da dor em curto prazo (um e dois meses) e em longo prazo (um ano) e melhora da qualidade de vida e menor ocorrência de transtorno do humor, um ano após o tratamento nos doentes tratados com BST. O BST é procedimento seguro e eficaz / INTRODUCTION: There are few well-structured studies evaluating the efficacy stellate ganglion block (SGB) or the thoracic sympathetic block (TSB) for treatment of the complex regional pain syndrome (CRPS) of the upper limb. It is possible that a large proportion of SGBs does not interrupt the sympathetic activity of the upper limb. OBJECTIVES: Evaluation of the efficacy of the TSB in treatment of the CRPS of the upper limb. PATIENTS AND METHODS: Patients with CRPS I were randomly treated with polypharmacotherapy plus physical therapy and TBS or a control block. The epidemiological aspects, clinical presentation of the CRPS, severity of pain, mood abnormalities, quality of life, functionality of the affected limb, and adverse events of the interventions were evaluated. Structured interviews the Brief Pain Inventory (BPI), the McGill Pain Questionnaire (MPQ), the Neuropathic Pain Diagnostic Questionnaire (DN4), the Neuropathic Pain Symptoms Inventory (NPSI), the Hospital Anxiety and Depression Scale (HAD), the WHOQOL-BREF quality of life questionnaire, the Disabilities of Arm, Shoulder, and Hand Functional Assessment Questionnaire (DASH), and the range of movements (ROM) were the tools used for evaluation. RESULTS: Sixty-three patients were eligible, 42 were included, and 36 patients with CRPS I, lasting six months or longer completed the study. TSB 17 patients and 19 control block. There were no statistical differences in demographic or clinical characteristics between the patients of both groups. There was a significant improvement of pain according to the BPI items \"current pain\" and \"general activity\"; MPQ sum of points and NPSI questions four, seven, nine, 11 in patients treated with TSB relation to the control group shortterm (one and two months alter the block). One year after procedure according to the BPI \"average pain\", MPQ sum of points, NPSI questions four, eight and ten there was also significant pain improvement in the patients TSB treated . After one year patients treated with TSB had significant improvement of the quality of life, according to the WHOQOL-bref (items four, 11, 19, and 21), in relation to the control group, and patients of the control group had a higher depression score significant on the HAD scale in relation to those TSB treated. There was a greater incidence of blurred vision sensation, just after block, in the TSB patients. There was no statistical difference in short-term in relation to the upper limb function between the groups. CONCLUSIONS: TSB associated with drug and physical therapy treatment resulted in greater reduction of pain perception compared to control block, both in short-term (one and two months) and long-term (one year). After one year, TSB have improved quality of life and decreased the incidence of mood disorders relative to control group. TSB is a safe and effective procedure

A revascularização linfática é um desafio e o estabelecimento de novas estratégias terapêuticas podem melhorar a qualidade de vida de pessoas que sofrem de distúrbios linfáticos. O objetivo deste estudo foi verificar a capacidade de tratamento com VEGFC exógeno na melhoria da vascularização linfática de uma maneira dependente do tempo em membros pélvicos (MP) de camundongos após a remoção do linfonodo inguinal. O linfonodo inguinal esquerdo foi removido cirurgicamente para mimetizar patologias com diminuição da vascularização linfática. Densidade vascular linfática (Vv) e de comprimento (Lv) foram avaliadas por imunohistoquímica, seguidas de estereologia, após a cirurgia com ou sem o tratamento com VEGFC exógeno. O grupo controle não foi manipulado, mas recebeu soro fisiológico em vez de tratamento com VEGFC exógeno. As expressões do VEGFC e FLT4 local foram avaliadas por qPCR. Houve efeito do tempo sobre Vv e Lv no Grupo Cirurgia e diferença significativa entre os grupos Controle e Cirurgia nas três regiões estudadas (região proximal, média e distal) do MP esquerdo (MPE). A Lv mostrou diferença significativa entre os grupos Controle e Cirurgia somente na região média do MPE. A Vv e a Lv para o Grupo Tratamento foram maiores do que os outros grupos em todas as regiões do MPE. A expressão gênica do VEGFC e do FLT4 apresentou efeito do tempo em todas as regiões do MPE para os grupos Cirurgia e Tratamento. Ambas as expressões gênicas do VEGFC e do FLT4 apresentaram diferença significativa entre os grupos Controle e Cirurgia, entre os grupos Cirurgia e Tratamento e entre os grupos Controle e Tratamento. Os resultados mostraram que os camundongos são bons modelos experimentais para o uso de VEGFC exógeno como terapia de revascularização linfática, e o tratamento com VEGFC exógeno aumenta vascularização linfática já após 3 dias de dano linfático. / Lymphatic revascularization is a challenge and the establishment of new therapeutic strategies may improve quality of life from those suffering from lymphatic disorders. The objective of this study was to verify the VEGFC treatment capacity in improving lymphatic vascularization in a time-dependent manner in mouse hind limb (HL) after removal of inguinal lymphnode. The left inguinal lymphnode was surgically removed to mimetize pathologies with decreased lymphatic vascularization. Lymphatic vascular density (Vv) and length (Lv) were evaluated by immunohistochemistry followed by stereology after surgery and/or VEGFC treatment. Control group was not manipulated but received saline instead of VEGFC treatment. VEGFC and FLT4 local expression were assessed by qPCR. There was effect of time over Vv and Lv in the SG and significant difference between CG and SG in the three studied regions (proximal, medium and distal region) of the left HL (LHL). The Lv showed significant difference between CG and SG only in the medium region. The Vv and the Lv for TG were higher than the other groups in all regions of LHL. VEGFC and FLT4 gene expression presented time effect in all regions of the LHL for SG and TG. Both VEGFC and FLT4 gene expression presented significant difference between CG and SG, between SG and TG, and between CG and TG. The results show that mice are good experimental models for VEGFC use as therapy for lymphatic revascularization, and VEGFC treatment increased the lymphatic vasculature already after 3 days of lymphatic damage.

Os objetivos desta pesquisa consistiram em contribuir para o projeto das órteses, realizar a análise cinemática do movimento de flexão/extensão do cotovelo, além de avaliar qualitativamente a independência na execução de atividades de vida diária e o ganho neurológico decorrente de um período de 6 meses de estimulação elétrica neuro-muscular (EENM). Participaram desta pesquisa oito tetraplégicos e um sujeito saudável. As órteses foram projetadas e os primeiros protótipos desenvolvidos. As avaliações cinemáticas foram realizadas durante dez tentativas do movimento de flexão/extensão do cotovelo em diferentes atividades. As avaliações qualitativas foram realizadas com os Protocolos ASIA e FIM. As órteses mostraram eficácia e funcionalidade. A avaliação cinemática mostrou que durante os movimentos com EENM houve repetibilidade, mudança no tipo de onda (de pico para retangular) e aumento do tempo de execução da atividade, comparado ao movimento voluntário. Com preensão de objeto e adição de cargas, houve alteração no padrão cinemático do movimento para a maioria dos pacientes, que indica insegurança em relação a preensão, fraqueza muscular, bem como, perturbação e incoordenação do movimento; em outros casos, houve aumento da amplitude de onda e predominância do tipo em rampa durante a EENM, o que possivelmente indica ação sinergista. Os resultados dos protocolos ASIA e FIM mostraram ganho neurológico e aumento no índice de independência funcional, para a maioria dos pacientes, decorrentes dos efeitos terapêuticos da EENM / The objectives of this research consisted of contributing for the orthosis project, to asses the knematics of the elbow flexion and extension, besides the qualitative evaluations of the independence to perform activities of daily living and neurological improvements due to a period of six months of neuromuscular electrical stimulation (NMES). Eight tetraplegics and one healthy subject participated in this study. The orthosis was projected and the first prototypes were developed. The kinematic assessment consisted of ten trials of elbow flexion and extension in different activities. The qualitative evaluations were accomplished with the ASIA and FIM Protocols. The orthosis showed effectiveness and functionality. The kinematics analysis showed that during movements with NMES there was repeatability, change in the wave form (peak to rectangular) and increase in time of performed trials, compared to the voluntary movement. With prehension of object and addition of loads, there was alteration in the kinematics pattern of the movement for most of the patients, which indicates insecurity during the prehension, muscular weakness, as well as perturbation and movement incoordination. On the others cases, there were higher wave amplitudes and wave forms mostly in ramp during NMES, which possibly indicates synergist action. The results of the ASIA e FIM Protocols showed neurological improvements and also in the index of functional independence for most of the patients due to the therapeutic effects of NMES

Em geral, indivíduos com disfunções motoras nos membros superiores apresentam dificuldades para executar a movimentação de objetos, a qual é essencial para a execução das atividades de vida diária. Dessa forma, esses indivíduos não a executam ou a fazem de maneira ineficiente. Para que essa manipulação seja realizada de maneira satisfatória, fazem-se necessários os movimentos de alcance e preensão de objetos controlados voluntariamente pelo indivíduo, e também a aquisição sensorial da força empregada durante a preensão. Portanto, este trabalho apresenta o desenvolvimento, a aplicação e a avaliação de um protótipo de sistema híbrido visando à reabilitação parcial da capacidade sensório-motora do membro superior direito de tetraplégicos. Tal sistema engloba uma órtese dinâmica para cotovelo utilizada em conjunto com a estimulação elétrica neuromuscular, e uma luva instrumentada que possibilita a realimentação qualitativa da força de preensão. Os resultados das avaliações clínicas mostraram que o sistema auxilia os tetraplégicos em tarefas que envolvem o alcance e a preensão de objetos, bem como trazê-los para próximo do corpo. O aumento da faixa de alcance, a geração de preensão e a restauração artificial da habilidade de movimentar um objeto para próximo do corpo representam esse auxílio proporcionado pelo sistema. Assim o protótipo de sistema híbrido representa uma estratégia alternativa para a reabilitação de lesados medulares (níveis C5-C6). / Generally, individuals with motor impairments in the upper limbs have difficulties performing the movement of objects, which is essential for the execution of activities of daily living. Thus, these individuals do not perform these activities or perform them inefficiently. Toward satisfactory manipulation, reach and grasp movements of objects performed with voluntary control, and grasp force feedback are necessary. Therefore, this work presents the development, application and evaluation of a hybrid system prototype aiming at partial rehabilitation of sensory-motor ability of quadriplegic\'s right upper limb. Such system includes an elbow dynamic orthosis combined with neuromuscular electrical stimulation, and an instrumented glove that allows the qualitative grasp force feedback. The results of clinical assessment showed that the system aids quadriplegic in tasks that involve reaching and grasping of objects, as well as bringing them close to the body. The improvement of reaching range, grasping generation and artificial restoration of the ability to move an object close to the body represent this aid provided by the system. Thus, the hybrid system prototype represents an alternative strategy for the rehabilitation of individuals with spinal cord injury (C5-C6 level).

As décadas de 80 e 90 caracterizaram-se por ações intensas na área de saúde ocupacional. Porém os índices de acometimentos e queixas álgicas em MMSS continuam sendo um grande problema. Os trabalhadores que realizam atividades de preparação de alimentos apresentam uma grande sobrecarga em MMSS. O objetivo deste estudo foi analisar a sobrecarga musculoesquelética e o desconforto postural em trabalhadores de duas cozinhas industriais através do Método RULA e do mapa de desconforto postural. Foram filmadas e avaliadas 151 tarefas durante 10 dias em cada restaurante. Cada tarefa foi avaliada por dois observadores independentes visando a identificação do escore do método RULA e fatores que pudessem influenciar na sobrecarga musculoesquelética como mobiliário, instrumentos de trabalho, mecanização do processo de trabalho, postura (análise cinesiológica e biomecânica) e utilização de alimentos pré-processados. Os trabalhadores preencheram também o mapa de desconforto postural. Como resultado evidenciou-se que não houve diferença significativa nos escores do método RULA entre os restaurantes estudados. Porém ocorreram diferenças quando comparadas as tarefas que envolviam o preprocessamento existente em um dos restaurantes, onde foram identificados escores menores, que determinaram menor sobrecarga musculoesquelética a estes funcionários. Estes dados não provocaram diferenças significativas no resultado final de todas as tarefas, devido a influências de outros fatores fundamentais nesta análise: o mobiliário, o instrumento de trabalho e a orientação postural, não determinando diferença significativa no mapa de desconforto postural entre estas populações exceto em antebraço direito e perna direita / The decades of 80 and 90 had been characterized for intense actions in the area of occupational health. However the index of attacks and complaints in upper limbs continue being a huge problem. The workers who carry out activities of food preparation present a great overload in upper limbs. The aim of this study was to analyze the musculoskeletal overload and the postural discomfort in workers of two industrial kitchens through the RULA method and the postural discomfort map. The tasks were filmed and evaluated during 10 days in each restaurant. Each task was evaluated by two independent observers aiming to identify the results of the RULA method and factors that could influence the musculoskeletal overload, such as furniture, tools of work, mechanization of the work process, posture, and processed food use. The workers had also filled the postural discomfort map. It was seen that there was not any significant difference in the results of the RULA method between the two studied restaurants. However it was observed some differences when we compare the tasks that involved the processed food use in one of the restaurants, where it had been identified minor musculoskeletal overload to these employees. These data did not cause significant differences in the final result of all the tasks, due to the influence of other basic factors in this analysis: the furniture, the tools of work and the postural orientation. It was not determined significant difference in the postural discomfort map among these populations except right forearm and right leg

Em geral, indivíduos com disfunções motoras nos membros superiores apresentam dificuldades para executar a movimentação de objetos, a qual é essencial para a execução das atividades de vida diária. Dessa forma, esses indivíduos não a executam ou a fazem de maneira ineficiente. Para que essa manipulação seja realizada de maneira satisfatória, fazem-se necessários os movimentos de alcance e preensão de objetos controlados voluntariamente pelo indivíduo, e também a aquisição sensorial da força empregada durante a preensão. Portanto, este trabalho apresenta o desenvolvimento, a aplicação e a avaliação de um protótipo de sistema híbrido visando à reabilitação parcial da capacidade sensório-motora do membro superior direito de tetraplégicos. Tal sistema engloba uma órtese dinâmica para cotovelo utilizada em conjunto com a estimulação elétrica neuromuscular, e uma luva instrumentada que possibilita a realimentação qualitativa da força de preensão. Os resultados das avaliações clínicas mostraram que o sistema auxilia os tetraplégicos em tarefas que envolvem o alcance e a preensão de objetos, bem como trazê-los para próximo do corpo. O aumento da faixa de alcance, a geração de preensão e a restauração artificial da habilidade de movimentar um objeto para próximo do corpo representam esse auxílio proporcionado pelo sistema. Assim o protótipo de sistema híbrido representa uma estratégia alternativa para a reabilitação de lesados medulares (níveis C5-C6). / Generally, individuals with motor impairments in the upper limbs have difficulties performing the movement of objects, which is essential for the execution of activities of daily living. Thus, these individuals do not perform these activities or perform them inefficiently. Toward satisfactory manipulation, reach and grasp movements of objects performed with voluntary control, and grasp force feedback are necessary. Therefore, this work presents the development, application and evaluation of a hybrid system prototype aiming at partial rehabilitation of sensory-motor ability of quadriplegic\'s right upper limb. Such system includes an elbow dynamic orthosis combined with neuromuscular electrical stimulation, and an instrumented glove that allows the qualitative grasp force feedback. The results of clinical assessment showed that the system aids quadriplegic in tasks that involve reaching and grasping of objects, as well as bringing them close to the body. The improvement of reaching range, grasping generation and artificial restoration of the ability to move an object close to the body represent this aid provided by the system. Thus, the hybrid system prototype represents an alternative strategy for the rehabilitation of individuals with spinal cord injury (C5-C6 level).

O câncer de mama é a neoplasia maligna que mais acomete as mulheres na população brasileira. Atualmente o tratamento para o câncer de mama está fundamentado em três pilares: radioterapia, cirurgia em suas diversas técnicas, quimioterapia/hormonioterapia. A qualidade de vida pode ser afetada de uma forma geral, envolvendo os aspectos físicos, psicológicos, sociológicos, emocionais, entre outros. O objetivo deste estudo foi comparar a função do membro superior em pacientes com câncer de mama que foram submetidas à biópsia de linfonodo sentinela com as submetidas à dissecção axilar, e que não foram acompanhadas por um protocolo de reabilitação pré-estabelecido. Pacientes e métodos: foram avaliadas 36 pacientes que passaram por dissecção axilar (grupo DA), 29 que foram submetidas à biópsia de linfonodo sentinela (grupo BLS) e 11 sujeitos normais (grupo SN). Resultados: Verificamos que o grupo DA apresenta um risco de ter perda funcional para os movimentos de flexão e abdução de ombro na ordem de 5 e 3,7 vezes maior que o grupo BLS, respectivamente. Encontramos também que pacientes submetidas à BLS evoluem com disfunção significativa para a flexão e abdução de ombro quando não submetidas à intervenção fisioterápica. Conclusão: A DA apresenta uma maior disfunção em membro superior quando comparada com BLS. A reabilitação de pacientes submetidas à BLS não pode ser ignorada, pois esta intervenção cirúrgica pode levar a disfunção significativa do membro superior ipsilateral / Breast cancer is a malignancy that affects more women in the Brazilian population. Currently the treatment for breast cancer is based on three pillars: radiotherapy, surgery in its various techniques, chemotherapy / hormone therapy. Quality of life may be affected in general, involving the physical, psychological, sociological, emotional, and others. The aim of this study was to compare the upper limb function in patients with breast cancer who underwent sentinel lymph node biopsy with axillary dissection underwent, and were not accompanied by a rehabilitation protocol pre-established. Patients and methods: we evaluated 36 patients who underwent axillary dissection (group DA), 29 who underwent sentinel lymph node biopsy (SNB group) and 11 normal subjects (group SN). Results: We found that the DA group presents a risk of loss of function for flexion and shoulder abduction in the order of 5 and 3.7 times higher than the BLS group, respectively. We also found that patients who underwent SNB evolve with significant dysfunction for flexion and shoulder abduction when not undergoing physiotherapy intervention. Conclusion: The DA has a higher dysfunction in upper limb when compared with BLS. The rehabilitation of patients who underwent SNB can not be ignored because this surgery can lead to significant dysfunction of the ipsilateral upper limb