Vrije Universiteit Brussel, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Pain in Motion (PAIN) research group, Brussels, Belgium.
Pain in Motion International Research Group, Brussels, Belgium.
Disabil Rehabil. 2022 Sep;44(18):5212-5219. doi: 10.1080/09638288.2021.1931482. Epub 2021 Jun 1.
Upper limb (UL) function is one of the health outcomes that matters the most for women with breast cancer. However, a better understanding of the factors contributing to UL dysfunctions in the late stage after breast cancer surgery is needed. This study explores associations between impairment-related and cognition-related factors and UL function in women with pain and myofascial dysfunctions at the affected UL region in this late stage after breast cancer surgery.
In forty-one women, UL function (dependent variable) was evaluated by the Disabilities of Arm, Shoulder and Hand questionnaire. As independent impairment-related factors, relative excessive arm volume (perimetry), pain intensity (maximum score on the visual analogue scale past week) and humerothoracic elevation and scapular lateral rotation (kinematic analysis) were assessed. As independent cognition-related factors, pain catastrophizing (Pain Catastrophizing Scale) and pain hypervigilance (Pain Vigilance and Awareness Questionnaire) were evaluated. Bi-variable analyses and a stepwise regression analysis were used to explore associations.
A higher pain intensity ( = 0.52; < 0.001), more pain catastrophizing ( = 0.49; < 0.001) and more pain hypervigilance ( = 0.40; = 0.01) were related to more UL dysfunction. Pain intensity ( = 0.029) and pain catastrophizing ( = 0.027) explained furthermore 29.9% of variance in UL function.
Pain intensity and cognition-related factors are significantly associated with UL function in women with pain and myofascial dysfunctions, indicating the need of assessing pain beliefs in women in the late stage after breast cancer surgery.IMPLICATIONS FOR REHABILITATIONPain intensity and pain-related beliefs, including pain attention and catastrophizing, are related to the severity of upper limb dysfunctions in the late stage after breast cancer surgery.Impairments such as lymphedema and movement restrictions seem not related to upper limb function in the assessed sample.To understand upper limb dysfunctions in the late stage after breast cancer, assessing pain beliefs is needed.
上肢（UL）功能是乳腺癌患者最重要的健康结果之一。然而，需要更好地了解乳腺癌手术后晚期导致 UL 功能障碍的因素。本研究探讨了在乳腺癌手术后晚期，与损伤相关和认知相关的因素与受累 UL 区域疼痛和肌筋膜功能障碍女性的 UL 功能之间的关系。
在 41 名女性中，通过残疾手臂、肩部和手问卷评估 UL 功能（因变量）。作为独立的损伤相关因素，评估相对过度的手臂体积（周长测量）、疼痛强度（过去一周视觉模拟量表的最大得分）、肱骨胸廓抬高和肩胛骨外侧旋转（运动分析）。作为独立的认知相关因素，评估疼痛灾难化（疼痛灾难化量表）和疼痛警觉（疼痛警觉和意识问卷）。使用双变量分析和逐步回归分析来探讨相关性。
更高的疼痛强度（=0.52； <0.001）、更多的疼痛灾难化（=0.49； <0.001）和更多的疼痛警觉（=0.40； =0.01）与 UL 功能障碍程度相关。疼痛强度（=0.029）和疼痛灾难化（=0.027）进一步解释了 UL 功能的 29.9%的方差。
疼痛强度和认知相关因素与乳腺癌手术后疼痛和肌筋膜功能障碍女性的 UL 功能显著相关，表明在乳腺癌手术后晚期需要评估女性的疼痛信念。
疼痛强度和与疼痛相关的信念，包括疼痛注意和灾难化，与乳腺癌手术后晚期上肢功能障碍的严重程度相关。在评估的样本中，淋巴水肿和运动受限等损伤似乎与上肢功能无关。为了理解乳腺癌手术后晚期的上肢功能障碍，需要评估疼痛信念。
