title: Impairments, activity limitations and participation restrictions 6 and 12 months after breast cancer operation.
abstract: OBJECTIVE
  To describe the impairments of upper body and limbs, activity limitations and participation restrictions 6 and 12 months after operation for breast cancer and to examine the impact of impairments on activity limitations.
  
  
  METHODS
  A prospective survey 6 and 12 months after operation.
  
  
  METHODS
  Ninety-six breast cancer patients.
  
  
  METHODS
  A questionnaire for assessing the impairments, activity limitations and participation restrictions was developed.
  
  
  RESULTS
  The most common impairments 6 months after operation were breast and axilla scar tightness, axilla oedema and neck-shoulder pain. At 12-month follow-up the breast scar tightness (p=0.008) and axilla oedema (p=0.023) decreased, and limb ache (p=0.005) increased significantly. The most limiting impairments were axilla oedema and limb numbness 6 months after operation, and at 12-month follow-up axilla oedema. Lifting, carrying and reaching out caused worsening of impairments to more than half of the respondents at 6-month follow-up. Regression analysis showed that many impairments together were determinants of activity limitations and sleep impairment. Participation restrictions were constant. Respondents had not given up participation in activities in the home, but some had abandoned leisure activities and felt that their work ability had decreased.
  
  
  CONCLUSIONS
  Impairments and their impact on activities were frequent and constant. There is an urgent need for developing rehabilitation protocols for breast cancer patients.
authors.affiliation: Department of Public Health, University of Jyväskylä, Finland. anne.karki@samk.fi
authors.forename: Anne
authors.initials: A
authors.lastname: Kärki
authors.forename: Riitta
authors.initials: R
authors.lastname: Simonen
authors.forename: Esko
authors.initials: E
authors.lastname: Mälkiä
authors.forename: James
authors.initials: J
authors.lastname: Selfe
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008209:Lymphedema / Q000209:etiology; D008408:Mastectomy / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis; D011183:Postoperative Complications / Q000175:diagnosis; D011446:Prospective Studies; D020127:Recovery of Function; D020069:Shoulder Pain / Q000209:etiology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires