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1. Cancer Rehabilitation Publications (2008-2018) With a Focus on Physical Function: A Scoping Review

Author

Harrington, Shana E., Stout, Nicole L., Hile, Elizabeth, Fisher, Mary Insana, Eden, Melissa, Marchese, Victoria, and Pfalzer, Lucinda A.

Subjects
Cancer -- Surveys, Behavioral medicine -- Surveys, Measuring instruments -- Usage -- Surveys, Behavior therapy -- Surveys, Breast cancer, Cancer diagnosis, Time, Cancer research, Conferences and conventions, Disabilities, Health surveys, Diseases, Health
Abstract

Background. Cancer rehabilitation research has accelerated over the last decade. However, closer examination of the published literature reveals that the majority of this work has focused on psychological interventions and cognitive and behavioral therapies. Recent initiatives have aggregated expert consensus around research priorities, highlighting a dearth in research regarding measurement of and interventions for physical function. Increasingly loud calls for the need to address the myriad of physical functional impairments that develop in people living with and beyond cancer have been published in the literature. A detailed survey of the landscape of published research has not been reported to our knowledge. Purpose. This scoping review systematically identified literature published between 2008 and 2018 related to the screening, assessment, and interventions associated with physical function in people living with and beyond cancer. Data Sources. PubMed and CINAHL were searched up to September 2018. Study Selection. Study selection included articles of all levels of evidence on any disease stage and population. A total of 11,483 articles were screened for eligibility, 2507 full-text articles were reviewed, and 1055 articles were selected for final inclusion and extraction. Data Extraction. Seven reviewers recorded type of cancer, disease stage, age of participants, phase of treatment, time since diagnosis, application to physical function, study design, impairments related to physical function, and measurement instruments used. Data Synthesis. Approximately one-third of the articles included patients with various cancer diagnoses (30.3%), whereas the rest focused on a single cancer, most commonly breast (24.8%). Most articles (77%) measured physical function following the completion of active cancer treatment with 64% representing the assessment domain. The most commonly used measures of physical function were the Medical Outcomes Study 36-Item Health Survey Questionnaire (29%) and the European Organization for Research and Treatment of cancer Quality of Life Questionnaire-Cancer 30 (21.5%). Limitations. Studies not written in English, study protocols, conference abstracts, and unpublished data were excluded. Conclusions. This review elucidated significant inconsistencies in the literature regarding language used to define physical function, measurement tools used to characterize function, and the use of those tools across the cancer treatment and survivorship trajectory. The findings suggested that physical function in cancer research is predominantly measured using general health-related quality-of-life tools rather than more precise functional assessment tools. Interdisciplinary and clinician-researcher collaborative efforts should be directed toward a unified definition and assessment of physical function., More than 15.5 million Americans have a history of cancer, and by 2026 the American Cancer Society estimates that this number will increase to 20.3 million. (1) Up to 20% [...]

Published
2020
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2. A quantitative comparison of arm activity between survivors of breast cancer and healthy controls: use of accelerometry.

Author

Fisher, Mary Insana, Davies, Claire C., and Uhl, Timothy L.

Subjects
*CANCER survivors, *ARM, *BREAST cancer, *BRIEF Pain Inventory, *WRIST
Abstract

Purpose: Survivors of breast cancer (BC) on the non-dominant side have more persistent deficits than those with cancer on the dominant limb. What is not known is whether those with BC use their involved upper limbs more, less, or at the same level as women without BC. Accelerometer use offers a quantifiable method to measure activity levels of upper limbs. The purpose of this study was to quantify the activity levels of the non-dominant involved limb among survivors of BC and compare these values to their dominant limb, as well as the non-dominant limb of a control group. Methods: Participants (n = 30) were women with unilateral BC on the non-dominant limb, diagnosed between 6 and 24 months prior to data collection, and a matched healthy group of women as controls. Participants completed the following questionnaires: medical and demographics, Brief Fatigue Inventory, Brief Pain Inventory – Short form, Disabilities of the Arm, Shoulder and Hand (DASH), and Beck Depression Index. Participants wore an accelerometer on each wrist during waking hours for 7 days. Arm activity was measured using vector magnitude activity counts extracted from the accelerometers. Results: There were no significant differences in total vector magnitude activity counts between groups for either limb. Within group dominant to non-dominant comparison was significantly different (p ≤ 0.001). No significant difference in pain was present but significant differences for fatigue (p = 0.002), depression (p = 0.004), and DASH scores (p = 0.035) were present. Conclusions: Women with non-dominant BC use their involved limb similar to healthy controls but less than their dominant limb. [ABSTRACT FROM AUTHOR]

Published
2020
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3. Breast Cancer Rehabilitation.

Author

Stout, Nicole L., Harrington, Shana E., Pfalzer, Luanda A., and Fisher, Mary Insana

Subjects
MOVEMENT disorders, LYMPHEDEMA, BREAST tumors, CANCER patient rehabilitation, EVIDENCE-based medicine, PAIN measurement, DISEASE risk factors
Abstract

Breast cancer is the most commonly diagnosed cancer in women in the United States. The treatment for breast cancer occurs along a protracted time period and includes many different disease treatment modalities. These treatments carry with them a large number of adverse effects that negatively impact function in both the short term and long term. It is necessary for rehabilitation providers to interface with patients being treated for breast cancer throughout the continuum of care so that interval assessments can be conducted to identify emerging impairments and alleviate disability. To achieve this, the rehabilitation provider must have an understanding of the clinical measurement tools best suited for examination and assessment of breast cancer-related impairments and disability. This article aims to provide a comprehensive overview of the evidence supporting the use of various clinical measurement tools for the breast cancer population and highlights the implementation of rehabilitation examination and assessment along the continuum of disease treatment. [ABSTRACT FROM AUTHOR]

Published
2015
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4. A COMPARISON OF UPPER EXTREMITY FUNCTION BETWEEN FEMALE BREAST CANCER SURVIVORS AND HEALTHY CONTROLS: TYPICAL SELF- REPORT OF FUNCTION, MOTION, STRENGTH AND MUSCULAR ENDURANCE

Author

Fisher, Mary Insana

Subjects
Breast cancer, quality of life, upper extremity function, range of motion and strength, muscular endurance, Other Rehabilitation and Therapy, Physical Therapy, Physiotherapy
Abstract

Many women who have experienced breast cancer (BC) report continued impairments in upper extremity (UE) function beyond the time required for normal healing after surgical treatment. Most research supporting this has not made comparisons between survivors of breast cancer (BCS) to a sample of healthy women. This lack of comparison to a healthy cohort prevents an understanding of whether continued deficits in UE function are due to normal aging or the BC treatment. The purpose of this research was to compare quality of life (QOL) and UE function among long term breast cancer survivors and similar aged women without cancer. Both self-report and objective measurements of UE function were used to create an understanding of UE functional abilities in both populations. Data on self-reported QOL and UE function, ROM, strength, and muscular endurance were collected on 79 healthy women ages 30-69, stratified by decade. Comparisons between decades and between dominant and non-dominant limbs were made. Findings supported no effect of aging on measures, and that dominance does affect some objective measures of motion, strength, and muscular endurance. A group of 42 survivors of breast cancer (BCS) were compared to the data from healthy controls on the same measures. BCS reported lower levels of QOL and UE function, and demonstrated less motion and strength than the healthy cohort, particularly when cancer occurred on the non-dominant limb. The values of the measures, however, are not clinically relevant, and reveal that BCS 6 years after treatment recover UE function to levels similar to healthy controls. In view of a lack of clinically feasible measures of UE muscular endurance, a new test to assess this was designed and implemented: the modified Upper Body Strength and Endurance test (mUBSE). It was believed this new test would be less variable than the Functional Impairment Test – Hand and Neck, Shoulder, Arm – FIT-HaNSA. Seventeen BCS and 17 matched controls were compared on the mUBSE and FIT-HaNSA. Findings were similar for both tests. Furthermore, BCS who are 6 years post BC treatment appear to recover muscular endurance levels to normal ranges.

Published
2013

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