Hayes Sandi, Battistutta Diana, Newman Beth
School of Public Health, Queensland University of Technology, Kelvin Grove, Qld, Australia.
Breast Cancer Res Treat. 2005 Nov;94(1):1-10. doi: 10.1007/s10549-005-5991-z.
Whether based on self-reported disability or direct physical measurements, studies of upper body function (UBF) among women with breast cancer consistently reveal high prevalence of limitation. Unfortunately, limited research and conflicting results undermine the ability to identify those factors that contribute to these UBF problems. This study describes the influence of selected personal and treatment characteristics on UBF, six-months following treatment for unilateral breast cancer, in a population-based sample of women residing in Southeast Queensland, Australia (n = 214). UBF was assessed by three objective measures (upper body strength and endurance, flexibility and hand grip strength) and two subjective measures (Disability of the Arm, Shoulder and Hand questionnaire and arm morbidity scale of the Functional Assessment of Cancer Treatment, Breast questionnaire). Modest correlations between the various UBF measures suggest that each captures a somewhat different dimension of physical function and disability. Advancing age, being treated on the non-dominant side, more childcare responsibilities, lower socioeconomic status, more extensive lymph node removal, having lymphoedema, and UBF scores of the untreated side emerged as significant correlates depending on whether UBF was assessed objectively or subjectively. There also was evidence that the relationships between the UBF measure of flexibility and (i) radiation treatment and (ii) side of treatment were modified depending on dominance. These results highlight the necessity of taking dominance into account when assessing functional impairment among breast cancer survivors. The findings also highlight the importance of considering whether subjective or objective UBF measures are more relevant in the design of future studies.
无论是基于自我报告的残疾情况还是直接的身体测量,对乳腺癌女性上肢功能(UBF)的研究一直显示功能受限的患病率很高。不幸的是,有限的研究和相互矛盾的结果削弱了识别导致这些上肢功能问题的因素的能力。本研究描述了在澳大利亚昆士兰州东南部的一个基于人群的女性样本(n = 214)中,单侧乳腺癌治疗六个月后,选定的个人和治疗特征对上肢功能的影响。通过三项客观测量指标(上身力量和耐力、柔韧性和握力)和两项主观测量指标(手臂、肩部和手部残疾问卷以及癌症治疗功能评估、乳房问卷的手臂发病量表)对上肢功能进行评估。各种上肢功能测量指标之间的适度相关性表明,每个指标都捕捉到了身体功能和残疾的某种不同维度。根据上肢功能是通过客观还是主观评估,年龄增长、在非优势侧接受治疗、更多的育儿责任、较低的社会经济地位、更广泛的淋巴结切除、患有淋巴水肿以及未治疗侧的上肢功能得分成为显著的相关因素。也有证据表明,柔韧性的上肢功能测量指标与(i)放射治疗和(ii)治疗侧之间的关系会根据优势情况而改变。这些结果强调了在评估乳腺癌幸存者的功能损害时考虑优势情况的必要性。研究结果还强调了在未来研究设计中考虑主观或客观的上肢功能测量指标哪一个更相关的重要性。