Miedema Baukje, Hamilton Ryan, Tatemichi Sue, Thomas-MacLean Roanne, Towers Anna, Hack Thomas F, Tilley Andrea, Kwan Winkle
Dalhousie University Family Medicine Teaching Unit, Dr. Everett Chalmers Regional Hospital, 700 Priestman Street, Fredericton, NB, Canada.
J Cancer Surviv. 2008 Dec;2(4):262-8. doi: 10.1007/s11764-008-0068-8. Epub 2008 Oct 24.
A Canadian research team is conducting a multi-centered, non-interventional national study with the objective of charting the course of arm morbidity after breast cancer surgery. This paper examined the relationship between arm morbidity and leisure and recreational activities of affected women.
Five hundred and forty seven women with stage I-III breast cancer were recruited in four centers across Canada: Surrey (BC); Winnipeg (MB), Montreal (QB) and Fredericton (NB). Participants were enrolled in the study 6-12 months post surgery. Physical examination was used to assess arm and shoulder functioning and questionnaires were used to assess disability, pain, and participation in recreational and leisure activities.
At the first clinical assessment (T1), the mean number of months post breast cancer surgery was 8.4. At T1 49% of women reported difficulty with recreational activities that involved "some force or impact" and 29% experienced negative changes to their involvement in leisure activities. A hierarchical multiple regression analysis found that several arm morbidity variables were significant predictors of difficulty with participation in recreational activities. A second hierarchical regression found also that arm morbidity factors were significant predictors of negative changes in leisure activities. Follow-up analyses found that arm morbidity, was most closely related to difficulty with recreational activities requiring free movement of the arm and using force.
Many women treated for breast cancer experience arm morbidity. Arm morbidity is related to difficulties with recreational activities and negative changes in leisure activity participation.
Breast cancer survivors should engage in recreational and leisure activities that are compatible with reduced range of motion and pain, and avoid those that exacerbate their arm morbidity.
一个加拿大研究团队正在开展一项多中心、非干预性的全国性研究，目的是描绘乳腺癌手术后手臂发病情况的发展过程。本文研究了患侧女性手臂发病情况与休闲及娱乐活动之间的关系。
在加拿大的四个中心招募了547名患有I - III期乳腺癌的女性：萨里（不列颠哥伦比亚省）；温尼伯（曼尼托巴省）、蒙特利尔（魁北克省）和弗雷德里克顿（新不伦瑞克省）。参与者在术后6 - 12个月被纳入研究。通过体格检查评估手臂和肩部功能，使用问卷评估残疾、疼痛以及参与娱乐和休闲活动的情况。
在首次临床评估（T1）时，乳腺癌手术后的平均月数为8.4个月。在T1时，49%的女性报告在涉及“一定力量或撞击”的娱乐活动中有困难，29%的女性在参与休闲活动方面经历了负面变化。分层多元回归分析发现，几个手臂发病变量是参与娱乐活动困难的显著预测因素。第二次分层回归还发现，手臂发病因素是休闲活动负面变化的显著预测因素。后续分析发现，手臂发病情况与需要手臂自由活动和用力的娱乐活动困难最为密切相关。
许多接受乳腺癌治疗的女性存在手臂发病情况。手臂发病与娱乐活动困难以及休闲活动参与的负面变化有关。
乳腺癌幸存者应参与与活动范围受限和疼痛相适应的休闲及娱乐活动，避免那些会加重其手臂发病情况的活动。
