Physiotherapy

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/6

Browse

Now showing 1 - 5 of 5

25. Upper limb morbidity after treatment for breast cancer: A cross-sectional study of lymphedema and function
(2012-11) Bulley, Catherine; Coutts, Fiona; Blyth, Christine; Jack, Wilma; Chetty, Udi; Tan, Chee-Wee; Barber, Matthew; Breast Cancer Institute
Introduction: This study explored the prevalence of impaired upper limb function (ULF) and lymphoedema (LO) after breast cancer treatment, their relationships with each other, quality of life, and with patient/treatment characteristics.
A Morbidity Screening Tool for identifying fatigue, pain, upper limb dysfunction and lymphedema after breast cancer treatment: A validity study
(Elsevier, 2013-11-15) Bulley, Catherine; Coutts, Fiona; Blyth, Christine; Jack, Wilma; Chetty, Udi; Barber, Matthew; Tan, Chee-Wee
Purpose: This study aimed to investigate validity of a newly developed Morbidity Screening Tool (MST) to screen for fatigue, pain, swelling (lymphedema) and arm function after breast cancer treatment. Methods: A cross-sectional study included women attending reviews after completing treatment (surgery, chemotherapy and radiotherapy), without recurrence, who could read English. They completed the MST and comparator questionnaires: Disability of the Arm, Shoulder and Hand questionnaire (DASH), Chronic Pain Grade Questionnaire (CPGQ), Lymphedema and Breast Cancer Questionnaire (LBCQ) and Functional Assessment of Cancer Therapy questionnaire with subscales for fatigue (FACT F) and breast cancer (FACT B + 4). Bilateral combined shoulder ranges of motion were compared (upward reach; hand behind back) and percentage upper limb volume difference (%LVD =/>10% diagnosed as lymphedema) measured with the vertical perometer (400T). Results: 613 of 617 participants completed questionnaires (mean age 62.3 years, SD 10.0; mean time since treatment 63.0 months, SD 46.6) and 417 completed objective testing. Morbidity prevalence was estimated as 35.8%, 21.9%, 19.8% and 34.4% for fatigue, impaired upper limb function, lymphedema and pain respectively. Comparing those self-reporting the presence or absence of each type of morbidity, statistically significant differences in comparator variables supported validity of the MST. Statistically significant correlations resulted between MST scores focussing on impact of morbidity, and comparator variables that reflect function and quality of life. Conclusion: Analysis supports the validity of all four short-forms of the MST as providing indications of both presence of morbidity and impacts on participants' lives. This may facilitate early and appropriate referral for intervention. 2013 Elsevier Ltd. All rights reserved.
Comparison of breast cancer-related lymphedema (Upper Limb Swelling) prevalence estimated using objective and subjective criteria and relationship with quality of life
(Hindawi, 2013-05) Bulley, Catherine; Gaal, S.; Coutts, Fiona; Blyth, Christine; Jack, W.; Chetty, U.; Barber, M.; Tan, Chee-Wee
This study aimed to investigate lymphedema prevalence using three different measurement/diagnostic criterion combinations and explore the relationship between lymphedema and quality of life for each, to provide evaluation of rehabilitation. Cross-sectional data from 617 women attending review appointments after completing surgery, chemotherapy, and radiotherapy included the Morbidity Screening Tool (MST; criterion: yes to lymphedema); Lymphedema and Breast Cancer Questionnaire (LBCQ; criterion: yes to heaviness and/or swelling); percentage limb volume difference (perometer: %LVD; criterion: 10%+ difference); and the Functional Assessment of Cancer Therapy breast cancer-specific quality of life tool (FACT B+4). Perometry measurements were conducted in a clinic room. Between 341 and 577 participants provided sufficient data for each analysis, with mean age varying from 60 to 62 (SD 9.95-10.03) and median months after treatment from 49 to 51. Lymphedema prevalence varied from 26.2% for perometry %LVD to 20.5% for the MST and 23.9% for the LBCQ; differences were not significant. Limits of agreement analysis between %LVD and the subjective measures showed little consistency, while moderate consistency resulted between the subjective measures. Quality of life differed significantly for women with and without lymphedema only when subjective measurements were used. Results suggest that subjective and objective tools investigate different aspects of lymphedema. 2013 Catherine Bulley et al.
Prevalence and impacts of upper limb morbidity after treatment for breast cancer: a cross-sectional study of lymphedema and function.
(2013) Bulley, Catherine; Coutts, Fiona; Blyth, Christine; Jack, W.; Chetty, U.; Barber, M.; Tan, Chee-Wee; Breast Cancer Institute
A cross-sectional study screened lymphedema, impaired upper limb function (ULF) and quality of life (QOL) in women post-breast cancer. Women attending review appointments who had completed surgery, chemotherapy and radiotherapy, were without recurrence, and could complete questionnaires in English were invited. Medical records were reviewed and questionnaires completed: the Morbidity Screening Tool (MST), Disability of the Arm, Shoulder and Hand questionnaire (DASH), and Functional Assessment of Cancer Therapy for breast cancer QOL questionnaire (FACTB+4). The vertical perometer (400T) measured percentage upper limb volume difference (%LVD), with 10% or greater difference diagnosed as lymphedema. Of 617 participants (mean age 62.3y, SD 10.0; mean time since treatment 63.0 months, SD 46.6), sufficient questionnaire data were available for 613 and perometry data for 417. Using the MST, 21.9% self-reported impaired ULF, 19.8% lymphedema, and 9.2% both. Based on %LVD, 26.5% had lymphedema. Histogram analysis for individuals in the first eight twelve-month intervals after treatment found impaired ULF prevalence peaked at three to five years and lymphedema at three years. Significantly worse function (DASH) and QOL (FACT B+4) resulted for those with morbidity (p<0.000). This provides evidence that impaired ULF and lymphedema negatively affect QOL years after treatment and are not necessarily linked.
Screening for morbidity following breast cancer
(Wounds UK, 2012-12) Bulley, Catherine; Coutts, Fiona; Blyth, Christine; Tan, Chee-Wee; Hamilton, L.; Jack, W.; Chetty, U.
Background: A screening tool was developed to identify morbidity emerging in the years after breast cancer treatment. Aims: This project aimed to investigate patient responses to a newly developed screening tool for lymphoedema, reduced arm function, fatigue and pain. Methods: Interviews were conducted following completion of the screening tool by 40 women attending review appointments post-treatment for breast cancer (86% response rate). Questions addressed ease of completion and administration. Results: On average, participants were 5.8 years post-treatment (1-28) and 64 years of age (38-79). It took eight to 20 minutes to complete the screening tool, with five participants needing assistance. Ninety-eight per cent of participants generally understood the instructions and 76% were able to answer all questions. There was some confusion about unfamiliar terminology (i.e. 'the axilla') and a question was raised relating to experiences of pain (people had difficulty differentiating pain relating to breast cancer and other conditions). Twenty per cent of respondents would prefer to receive the questionnaire by post, with 41% preferring paper to electronic completion. Conclusions: With minor modifications and further pilot testing of validity and reliability, this screening tool has the potential to enable rapid identification of morbidity, enabling appropriate action to be taken as well as facilitating service planning. Declaration of interest: None.