Discrepant Trajectories of Impairment, Activity, and Participation Related to Upper-Limb Function in Patients With Breast Cancer.
OBJECTIVE
To explore upper-limb disability with respect to health outcomes, operationalized by Disabilities of the Arm, Shoulder, and Hand, and to identify factors associated with each element of upper-limb disability over a 2-year period in breast cancer survivors.


METHODS
Prospective cohort study.


METHODS
University hospital cancer center.


METHODS
Individuals (N=191) recruited from all the patients with newly diagnosed breast cancer before cancer surgery at a university hospital between April 2006 and March 2007.


METHODS
Not applicable.


METHODS
We evaluated demographics, social variables, and upper-limb disability in a baseline assessment preoperatively. Follow-up evaluations were conducted in outpatient clinics 3 months after surgery and at 12 and 24 months after surgery. Linear regression models with the generalized estimating equations of the compound symmetry covariance structure were used.


RESULTS
Time since surgery was inversely associated with the impairment items score (β=-.20; 95% confidence interval [CI], -.49 to -.08) and positively associated with the activity limitation items score (β=.59; 95% CI, .29-.88). The impact of upper-limb disability preoperatively on the items involving both the activity limitation and participation restrictions scores was positive (β=2.89; 95% CI, .76-5.02) after adjusting for demographic, treatment type, and socioeconomic factors.


CONCLUSIONS
Our study revealed that upper-limb impairment recovered with time after breast cancer surgery; however, upper-limb function-related activity and participation were reduced through 2 years after surgery.
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
Eun Joo
EJ
Yang
Department of Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
Eunyoung
E
Kang
Department of Surgery, Daerim Saint Mary's Hospital, Seoul, Republic of Korea.
Sung-Won
SW
Kim
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea. Electronic address: drlim1@snu.ac.kr.
Jae-Young
JY
Lim
D000203:Activities of Daily Living; D000328:Adult; D001943:Breast Neoplasms / Q000188:drug therapy / Q000601:surgery*; D002173:Cancer Care Facilities; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008408:Mastectomy / Q000009:adverse effects*; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012959:Socioeconomic Factors; D013997:Time Factors; D034941:Upper Extremity / Q000503:physiopathology*
International Classification of Functioning, Disability and Health; Rehabilitation; Upper extremity