Responsiveness and Minimal Clinically Important Changes for the Upper Limb Functional Index, Shoulder Pain and...

This study assessed responsiveness of the Lymphedema Life Impact Scale (LLIS), Upper Limb Functional Index (ULFI), and Shoulder Pain and Disability Index (SPADI) instruments in patients with upper limb lymphedema undergoing complete decongestive therapy (CDT). The prospective cohort study was conducted from March 2024 to May 2025. Participants were patients with unilateral upper limb lymphedema secondary to breast cancer. All patients completed the LLIS, ULFI, and SPADI at baseline and again after 10 sessions of physiotherapy delivered over a 20-day period. Additionally, a 7-point Global Rating of Change scale (GRC) was administered as an external anchor. Paired t-tests or Wilcoxon tests were utilized to examine differences between pre- and post-intervention scores. A total of 110 patients were enrolled. The ULFI, LLIS, and SPADI demonstrated acceptable responsiveness, as indicated by an area under the curve (AUC) exceeding 0.70. Furthermore, the change scores for all three instruments exhibited strong correlations with patients' GRC scales, with Spearman correlation coefficients greater than 0.60. The results support the use of the LLIS, ULFI, and SPADI as reliable tools to monitor treatment outcomes in patients with upper limb lymphedema due to breast cancer.