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Published on: February 6, 2020
Discrepant Trajectories of Impairment, Activity, and Participation Related to Upper-Limb Function in Patients With
Eun Joo Yang1, Eunyoung Kang2, Sung-Won Kim3
1Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
Objectives:
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.
Design:
Prospective cohort study.
Setting:
University hospital cancer center.
Participants:
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.
Interventions:
Not applicable.
Main Outcome Measures:
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.
