title: The functional capacity and quality of life of women with advanced breast cancer.
abstract: BACKGROUND
  The rehabilitation needs of patients with metastatic breast cancer (MBC) are poorly studied. The primary aim of the study was to evaluate the functional capacity of women with MBC and quality of life (QoL).
  
  
  METHODS
  The present study is an open, non-randomized, prospective cross-sectional observation study. The functional capacity of 128 MBC patients with ongoing cancer treatments, were studied in Helsinki University Hospital (HUS): Peak expiratory flow (PEF), dynamic and static balance, 6 minute walking distance (6MWD), 10 meter walking, sit-to-stand test, repeated squat, grip strength, shoulder movement, pain, and QoL by Beck's depression scale (BDI), health assessment questionnaire (HAQ), RAND SF-36 and EORTC QLQ-30 items.
  
  
  RESULTS
  The walking capacity was compromised in half and the strength of the lower extremities in one-third of the patients. PEF was below the normal reference in 55 %, static balance in 62 % and dynamic balance in 73 % (≤60 year olds) and 81 % (≥61 year olds). The grip power was lowered in 44/30 % of the patients (right/left) and the shoulder movement was restricted in 30 %. Some disability in physical functioning experienced 55 % (HAQ) and 37 % felt depressive (BDI). The QoL (RAND SF-36) was poor especially in the field of physical, role and social functioning and bodily pain (<0.001). Pain, depression, and a poor 6MWD results independently determined the physical component of QoL (p < 0.001).
  
  
  CONCLUSIONS
  The functional capacity of patients with MBC was significantly lowered. This, in association with distressing symptoms like pain and depression causes a vicious circle further leading to functional disabilities and impaired QoL.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Helsinki University Central Hospital, Helsinki, Finland. kristiina.kokkonen@helsinki.fi.
authors.forename: K
authors.initials: K
authors.lastname: Kokkonen
authors.affiliation: Helsinki University Central Hospital, Cancer Center, University of Helsinki, P.O. Box 180, 00029, Helsinki, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Saarto
authors.affiliation: Department of Physical Medicine and Rehabilitation, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Mäkinen
authors.affiliation: Department of Physical Medicine and Rehabilitation, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: L
authors.initials: L
authors.lastname: Pohjola
authors.affiliation: Unit of Family Practice, Central Finland Central Hospital, Jyväskylä, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Kautio
authors.affiliation: The Medcare Foundation, Äänekoski, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Järvenpää
authors.affiliation: Department of Physical Medicine and Rehabilitation, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: K
authors.initials: K
authors.lastname: Puustjärvi-Sunabacka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D015444:Exercise; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016138:Walking
keywords: Breast cancer; Disability; Metastatic; Quality of life; Rehabilitation