Upper extremity impairments in women with or without lymphedema following breast cancer treatment
Identifieur interne : 000D53 ( Pmc/Curation ); précédent : 000D52; suivant : 000D54Upper extremity impairments in women with or without lymphedema following breast cancer treatment
Auteurs : Betty Smoot [États-Unis] ; Josephine Wong [États-Unis] ; Bruce Cooper [États-Unis] ; Linda Wanek [États-Unis] ; Kimberly Topp [États-Unis] ; Nancy Byl [États-Unis] ; Marylin Dodd [États-Unis]Source :
- Journal of Cancer Survivorship [ 1932-2259 ] ; 2010.
Abstract
Breast-cancer-related lymphedema affects ∼25% of breast cancer (BC) survivors and may impact use of the upper limb during activity. The purpose of this study is to compare upper extremity (UE) impairment and activity between women with and without lymphedema after BC treatment.
144 women post BC treatment completed demographic, symptom, and Disability of Arm-Shoulder-Hand (DASH) questionnaires. Objective measures included Purdue pegboard, finger-tapper, Semmes-Weinstein monofilaments, vibration perception threshold, strength, range of motion (ROM), and volume.
Women with lymphedema had more lymph nodes removed (
UE impairments are found in women following treatment for BC. Women with lymphedema have greater UE impairment and limitation in activities than women without. Many of these impairments are amenable to prevention measures or treatment, so early detection by health care providers is essential.
Url:
DOI: 10.1007/s11764-010-0118-x
PubMed: 20373044
PubMed Central: 2882040
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Upper extremity impairments in women with or without lymphedema following breast cancer treatment</title><author><name sortKey="Smoot, Betty" sort="Smoot, Betty" uniqKey="Smoot B" first="Betty" last="Smoot">Betty Smoot</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff4">18787 Gillman Drive, Sonoma, CA 95476 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>18787 Gillman Drive, Sonoma</wicri:cityArea></affiliation></author><author><name sortKey="Wong, Josephine" sort="Wong, Josephine" uniqKey="Wong J" first="Josephine" last="Wong">Josephine Wong</name><affiliation wicri:level="2"><nlm:aff id="Aff2">Department of Physiological Nursing, University of California San Francisco, San Francisco, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Physiological Nursing, University of California San Francisco, San Francisco</wicri:cityArea></affiliation></author><author><name sortKey="Cooper, Bruce" sort="Cooper, Bruce" uniqKey="Cooper B" first="Bruce" last="Cooper">Bruce Cooper</name><affiliation wicri:level="2"><nlm:aff id="Aff2">Department of Physiological Nursing, University of California San Francisco, San Francisco, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Physiological Nursing, University of California San Francisco, San Francisco</wicri:cityArea></affiliation></author><author><name sortKey="Wanek, Linda" sort="Wanek, Linda" uniqKey="Wanek L" first="Linda" last="Wanek">Linda Wanek</name><affiliation wicri:level="2"><nlm:aff id="Aff3">Graduate Program in Physical Therapy, San Francisco State University, San Francisco, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Graduate Program in Physical Therapy, San Francisco State University, San Francisco</wicri:cityArea></affiliation></author><author><name sortKey="Topp, Kimberly" sort="Topp, Kimberly" uniqKey="Topp K" first="Kimberly" last="Topp">Kimberly Topp</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco</wicri:cityArea></affiliation></author><author><name sortKey="Byl, Nancy" sort="Byl, Nancy" uniqKey="Byl N" first="Nancy" last="Byl">Nancy Byl</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco</wicri:cityArea></affiliation></author><author><name sortKey="Dodd, Marylin" sort="Dodd, Marylin" uniqKey="Dodd M" first="Marylin" last="Dodd">Marylin Dodd</name><affiliation wicri:level="2"><nlm:aff id="Aff2">Department of Physiological Nursing, University of California San Francisco, San Francisco, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Physiological Nursing, University of California San Francisco, San Francisco</wicri:cityArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">20373044</idno><idno type="pmc">2882040</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2882040</idno><idno type="RBID">PMC:2882040</idno><idno type="doi">10.1007/s11764-010-0118-x</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">000D54</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000D54</idno><idno type="wicri:Area/Pmc/Curation">000D53</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000D53</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Upper extremity impairments in women with or without lymphedema following breast cancer treatment</title><author><name sortKey="Smoot, Betty" sort="Smoot, Betty" uniqKey="Smoot B" first="Betty" last="Smoot">Betty Smoot</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff4">18787 Gillman Drive, Sonoma, CA 95476 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>18787 Gillman Drive, Sonoma</wicri:cityArea></affiliation></author><author><name sortKey="Wong, Josephine" sort="Wong, Josephine" uniqKey="Wong J" first="Josephine" last="Wong">Josephine Wong</name><affiliation wicri:level="2"><nlm:aff id="Aff2">Department of Physiological Nursing, University of California San Francisco, San Francisco, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Physiological Nursing, University of California San Francisco, San Francisco</wicri:cityArea></affiliation></author><author><name sortKey="Cooper, Bruce" sort="Cooper, Bruce" uniqKey="Cooper B" first="Bruce" last="Cooper">Bruce Cooper</name><affiliation wicri:level="2"><nlm:aff id="Aff2">Department of Physiological Nursing, University of California San Francisco, San Francisco, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Physiological Nursing, University of California San Francisco, San Francisco</wicri:cityArea></affiliation></author><author><name sortKey="Wanek, Linda" sort="Wanek, Linda" uniqKey="Wanek L" first="Linda" last="Wanek">Linda Wanek</name><affiliation wicri:level="2"><nlm:aff id="Aff3">Graduate Program in Physical Therapy, San Francisco State University, San Francisco, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Graduate Program in Physical Therapy, San Francisco State University, San Francisco</wicri:cityArea></affiliation></author><author><name sortKey="Topp, Kimberly" sort="Topp, Kimberly" uniqKey="Topp K" first="Kimberly" last="Topp">Kimberly Topp</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco</wicri:cityArea></affiliation></author><author><name sortKey="Byl, Nancy" sort="Byl, Nancy" uniqKey="Byl N" first="Nancy" last="Byl">Nancy Byl</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco</wicri:cityArea></affiliation></author><author><name sortKey="Dodd, Marylin" sort="Dodd, Marylin" uniqKey="Dodd M" first="Marylin" last="Dodd">Marylin Dodd</name><affiliation wicri:level="2"><nlm:aff id="Aff2">Department of Physiological Nursing, University of California San Francisco, San Francisco, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Physiological Nursing, University of California San Francisco, San Francisco</wicri:cityArea></affiliation></author></analytic><series><title level="j">Journal of Cancer Survivorship</title><idno type="ISSN">1932-2259</idno><idno type="eISSN">1932-2267</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>Breast-cancer-related lymphedema affects ∼25% of breast cancer (BC) survivors and may impact use of the upper limb during activity. The purpose of this study is to compare upper extremity (UE) impairment and activity between women with and without lymphedema after BC treatment.</p></sec><sec><title>Methods</title><p>144 women post BC treatment completed demographic, symptom, and Disability of Arm-Shoulder-Hand (DASH) questionnaires. Objective measures included Purdue pegboard, finger-tapper, Semmes-Weinstein monofilaments, vibration perception threshold, strength, range of motion (ROM), and volume.</p></sec><sec><title>Results</title><p>Women with lymphedema had more lymph nodes removed (<italic>p</italic> < .001), more UE symptoms (<italic>p</italic> < .001), higher BMI (<italic>p</italic> = .041), and higher DASH scores (greater limitation) (<italic>p</italic> < .001). For all participants there was less strength (elbow flexion, wrist flexion, grip), less shoulder ROM, and decreased sensation at the medial upper arm (<italic>p</italic> < .05) in the affected UE. These differences were greater in women with lymphedema, particularly in shoulder abduction ROM (<italic>p</italic> < .05). Women with lymphedema had bilaterally less elbow flexion strength and shoulder ROM (<italic>p</italic> < .05). Past diagnosis of lymphedema, grip strength, shoulder abduction ROM, and number of comorbidities contributed to the variance in DASH scores (<italic>R</italic><sup>2</sup> of 0.463, <italic>p</italic> < .001).</p></sec><sec><title>Implications for cancer survivors</title><p>UE impairments are found in women following treatment for BC. Women with lymphedema have greater UE impairment and limitation in activities than women without. 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article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Cancer Surviv</journal-id><journal-title-group><journal-title>Journal of Cancer Survivorship</journal-title></journal-title-group><issn pub-type="ppub">1932-2259</issn><issn pub-type="epub">1932-2267</issn><publisher><publisher-name>Springer US</publisher-name><publisher-loc>Boston</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">20373044</article-id><article-id pub-id-type="pmc">2882040</article-id><article-id pub-id-type="publisher-id">118</article-id><article-id pub-id-type="doi">10.1007/s11764-010-0118-x</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Upper extremity impairments in women with or without lymphedema following breast cancer treatment</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Smoot</surname><given-names>Betty</given-names></name><address><phone>+1-707-4948262</phone><email>betty.smoot@ucsf.edu</email></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Wong</surname><given-names>Josephine</given-names></name><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Cooper</surname><given-names>Bruce</given-names></name><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Wanek</surname><given-names>Linda</given-names></name><xref ref-type="aff" rid="Aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Topp</surname><given-names>Kimberly</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Byl</surname><given-names>Nancy</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Dodd</surname><given-names>Marylin</given-names></name><xref ref-type="aff" rid="Aff2">2</xref></contrib><aff id="Aff1"><label>1</label>Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA USA</aff><aff id="Aff2"><label>2</label>Department of Physiological Nursing, University of California San Francisco, San Francisco, CA USA</aff><aff id="Aff3"><label>3</label>Graduate Program in Physical Therapy, San Francisco State University, San Francisco, CA USA</aff><aff id="Aff4"><label>4</label>18787 Gillman Drive, Sonoma, CA 95476 USA</aff></contrib-group><pub-date pub-type="epub"><day>7</day><month>4</month><year>2010</year></pub-date><pub-date pub-type="pmc-release"><day>7</day><month>4</month><year>2010</year></pub-date><pub-date pub-type="ppub"><month>6</month><year>2010</year></pub-date><volume>4</volume><issue>2</issue><fpage>167</fpage><lpage>178</lpage><history><date date-type="received"><day>23</day><month>8</month><year>2009</year></date><date date-type="accepted"><day>7</day><month>2</month><year>2010</year></date></history><permissions><copyright-statement>© The Author(s) 2010</copyright-statement></permissions><abstract><sec><title>Introduction</title><p>Breast-cancer-related lymphedema affects ∼25% of breast cancer (BC) survivors and may impact use of the upper limb during activity. The purpose of this study is to compare upper extremity (UE) impairment and activity between women with and without lymphedema after BC treatment.</p></sec><sec><title>Methods</title><p>144 women post BC treatment completed demographic, symptom, and Disability of Arm-Shoulder-Hand (DASH) questionnaires. Objective measures included Purdue pegboard, finger-tapper, Semmes-Weinstein monofilaments, vibration perception threshold, strength, range of motion (ROM), and volume.</p></sec><sec><title>Results</title><p>Women with lymphedema had more lymph nodes removed (<italic>p</italic> < .001), more UE symptoms (<italic>p</italic> < .001), higher BMI (<italic>p</italic> = .041), and higher DASH scores (greater limitation) (<italic>p</italic> < .001). For all participants there was less strength (elbow flexion, wrist flexion, grip), less shoulder ROM, and decreased sensation at the medial upper arm (<italic>p</italic> < .05) in the affected UE. These differences were greater in women with lymphedema, particularly in shoulder abduction ROM (<italic>p</italic> < .05). Women with lymphedema had bilaterally less elbow flexion strength and shoulder ROM (<italic>p</italic> < .05). Past diagnosis of lymphedema, grip strength, shoulder abduction ROM, and number of comorbidities contributed to the variance in DASH scores (<italic>R</italic><sup>2</sup> of 0.463, <italic>p</italic> < .001).</p></sec><sec><title>Implications for cancer survivors</title><p>UE impairments are found in women following treatment for BC. Women with lymphedema have greater UE impairment and limitation in activities than women without. Many of these impairments are amenable to prevention measures or treatment, so early detection by health care providers is essential.</p></sec></abstract><kwd-group><title>Keywords</title><kwd>Lymphedema</kwd><kwd>Breast cancer</kwd><kwd>Movement</kwd><kwd>Impairment</kwd><kwd>Upper extremity</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© Springer Science+Business Media, LLC 2010</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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