Impairments, activity limitations and participation restrictions 6 and 12 months after breast cancer operation
Anne Kärki A1, A2, Riitta Simonen A3, Esko Mälkiä A1, James Selfe A4
A1 Department of Health Sciences, University of Jyväskylä
A2 The Rehabilitation Education, Satakunta Polytechnic
A3 Department of Public Health, University of Helsinki, Finland
A4 Allied Health Professions Unit, University of Central Lancashire, UK
Objective: To describe the impairments of upper body and limbs, activity limitations and participation restrictions 6 and 12 months after operation for breast cancer and to examine the impact of impairments on activity limitations.Design: A prospective survey 6 and 12 months after operation.Patients: Ninety-six breast cancer patients.Methods: A questionnaire for assessing the impairments, activity limitations and participation restrictions was developed.Results: The most common impairments 6 months after operation were breast and axilla scar tightness, axilla oedema and neck-shoulder pain. At 12-month follow-up the breast scar tightness (p=0.008) and axilla oedema (p=0.023) decreased, and limb ache (p=0.005) increased significantly. The most limiting impairments were axilla oedema and limb numbness 6 months after operation, and at 12-month follow-up axilla oedema. Lifting, carrying and reaching out caused worsening of impairments to more than half of the respondents at 6-month follow-up. Regression analysis showed that many impairments together were determinants of activity limitations and sleep impairment. Participation restrictions were constant. Respondents had not given up participation in activities in the home, but some had abandoned leisure activities and felt that their work ability had decreased.Conclusion: Impairments and their impact on activities were frequent and constant. There is an urgent need for developing rehabilitation protocols for breast cancer patients.
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