TurningPoint Breast Cancer Rehabilitation, Atlanta, GA.
Institute for Applied Health Sciences, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
Clin Breast Cancer. 2018 Dec;18(6):e1261-e1267. doi: 10.1016/j.clbc.2018.02.008. Epub 2018 Feb 21.
Activity limitations as well as impairments such as pain, numbness, limitation of shoulder range of motion, and weakness are common and well documented during and after treatment for breast cancer. There is limited information regarding the measurement properties of patient-reported outcome measures of upper extremity activity limitation in this population. This study examined the reliability and validity of the Upper Extremity Functional Index (UEFI) in patients after surgery for breast cancer.
Measures of function, shoulder flexion range of motion, and pain were obtained for 53 women before and 2 weeks after surgery for breast cancer. To estimate UEFI test-retest reliability, a convenience sample of 20 patients was assessed on a second occasion within 48 hours of their 2-week postsurgery assessment. Convergent and discriminant construct validation methods were applied by examining correlations between UEFI scores and change scores with those of the shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH), Functional Assessment of Cancer Therapy-Breast (FACT-B) +4 items, shoulder flexion range, and pain.
UEFI test-retest reliability was estimated to be 0.87 (95% confidence interval, 0.69, 0.94), and the standard error of measurement was 4.8 (95% confidence interval, 3.7, 7.1) scale points. The 90% confidence interval for a given UEFI score was ±7.9 and minimal detectable change at 90% confidence (MDC) was ±11.1 points. UEFI correlations with the QuickDASH (cross-sectional -0.79 and longitudinal -0.62) were greater than with the FACT-B+4 and impairment measures.
These results support and guide the use of the UEFI in patients after breast cancer surgery.
在乳腺癌治疗期间和治疗后，活动受限以及疼痛、麻木、肩部活动范围受限和虚弱等功能障碍较为常见，且有大量文献记载。关于该人群上肢活动受限的患者报告结局测量的测量特性，相关信息有限。本研究旨在检验乳腺癌手术后患者使用上肢功能指数（UEFI）的可靠性和有效性。
对 53 名接受乳腺癌手术的女性在手术前和手术后 2 周时进行了功能、肩前屈活动范围和疼痛的测量。为了评估 UEFI 的测试-重测信度，对 20 例患者进行了便利抽样，在其术后 2 周评估后 48 小时内进行了第二次评估。通过考察 UEFI 评分和变化评分与上肢残疾问卷（QuickDASH）缩短版、癌症治疗功能评估-乳房（FACT-B）+4 项、肩前屈活动范围和疼痛之间的相关性，应用了收敛和判别结构验证方法。
UEFI 的测试-重测信度估计值为 0.87（95%置信区间，0.69，0.94），测量误差为 4.8（95%置信区间，3.7，7.1）个量表点。特定 UEFI 评分的 90%置信区间为±7.9，90%置信区间下的最小可检测变化（MDC）为±11.1 个点。UEFI 与 QuickDASH 的相关性（横断面-0.79，纵向-0.62）大于与 FACT-B+4 和损伤测量的相关性。
这些结果支持并指导了 UEFI 在乳腺癌手术后患者中的使用。
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