title: Analysis of factors related to arm weakness in patients with breast cancer-related lymphedema.
abstract: OBJECTIVE
  The aim of this study was to evaluate the ratio of significant weakness in the affected arm of breast cancer-related lymphedema patients to their unaffected side. Another purpose was to identify factors related to arm weakness and physical function in patients with breast cancer-related lymphedema.
  
  
  METHODS
  Consecutive patients (n = 80) attended a single evaluation session following their outpatient lymphedema clinic visit. Possible independent factors (i.e., lymphedema, pain, psychological, educational, and behavioral) were evaluated. Handgrip strength was used to assess upper extremity muscle strength and the disabilities of arm, shoulder, and hand (DASH) questionnaire was used to assess upper extremity physical function. Multivariate logistic regression was performed using factors that had significant differences between the handgrip weakness and non-weakness groups.
  
  
  RESULTS
  Out of the 80 patients with breast cancer-related lymphedema, 29 patients (36.3 %) had significant weakness in the affected arm. Weakness of the arm with lymphedema was not related to lymphedema itself, but was related to the fear of using the affected limb (odds ratio = 1.76, 95 % confidence interval = 1.30-2.37). Fears of using the affected limb and depression significantly contributed to the variance in DASH scores.
  
  
  CONCLUSIONS
  Appropriate physical and psychological interventions, including providing accurate information and reassurance of physical activity safety, are necessary to prevent arm weakness and physical dysfunction in patients with breast cancer-related lymphedema.
authors.affiliation: Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea.
authors.forename: Daegu
authors.initials: D
authors.lastname: Lee
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Hwang
authors.forename: Inho
authors.initials: I
authors.lastname: Chu
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Chang
authors.forename: Young Hun
authors.initials: YH
authors.lastname: Shim
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000503:physiopathology; D001943:Breast Neoplasms / Q000150:complications / Q000503:physiopathology*; D005260:Female; D018737:Hand Strength; D006801:Humans; D008209:Lymphedema / Q000209:etiology / Q000503:physiopathology*; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D011795:Surveys and Questionnaires