Research Article
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Functional balance and quality of life in breast cancer survivors

Year 2024, Volume: 5 Issue: 5, 226 - 230, 26.10.2024

Abstract

Aims: Breast cancer is an important health problem with the second mortality rate in cancer-related deaths in women. After mastectomy and radiotherapy, shoulder and upper extremity mobility may decrease, trunk and upper extremity muscles may weaken, and biomechanical and functional balance may be impaired in women who have survived breast cancer. In addition, increased limb volume due to breast cancer-related lymphedema (BCRL) may impair static and dynamic balance. To date, studies investigating the effect of lymphedema on balance in BCRL are limited. We aimed to examine the impact of lymphedema on balance and quality of life in breast cancer survivors.
Methods: In this prospective study, age, education, marital status, body mass index (BMI) (kg/m2), affected lymphedema limb (right-left), and extremity volume difference were evaluated. Fullerton Advanced Balance Scale (FAB-Scale) was applied to the patients to measure their level of balance. The Lymphedema Quality of Life Questionnaire (LYMQOL-Arm) was applied.
Results: The mean age of the 40 patients included in the study was 59.02±7.50 years. The proportion of patients with a Fab-scale ≤25 who were at risk of falls was 55%. There was no statistical difference between patients with Fab-scale ≤25 and patients with Fab-scale 250.05).
Conclusion: In our study, balance deteriorated and the risk of falls increased especially in elderly patients. Every woman with BCRL should be informed about balance and gait impairment and encouraged to receive lymphoedema treatment as soon as possible. We think that future studies examining functional stability, quality of life, and fall risk in the treatment of lymphedema and the development of special interventions related to balance will contribute to the oncological rehabilitation protocol.

Ethical Statement

Tüm hastalara çalışma hakkında bilgi verildi ve bilgilendirilmiş onam formları alındı. Çalışmamız Helsinki ilkelerine uygun olarak gerçekleştirildi. Çalışma protokolü Etik Kurul tarafından onaylandı (Protokol numarası 2022-06/92).

References

  • Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics. CA Cancer J Clin. 2023;73(1): p.17-48.
  • De Groef A, Van Kampen M, Tieto E, et al. Arm lymphoedema and upper limb impairments in sentinel node-negative breast cancer patients: a one year follow-up study. Breast. 2016;29:p. 102-108.
  • Schmidt T, Berner J, Jonat W, et al. Influence of arm crank ergometry on development of lymphedema in breast cancer patients after axillary dissection: a randomized controlled trail. J Rehabil Med. 2017;49(1):78-83. doi:10.2340/16501977-2167
  • Kalder M, Hadji P. Breast cancer and osteoporosis - management of cancer treatment-induced bone loss in postmenopausal women with breast cancer. Breast Care (Basel). 2014;9(5):312-317. doi:10.1159/000368843
  • Armer JM, Stewart BR. A comparison of four diagnostic criteria for lymphedema in a post-breast cancer population. Lymphat Res Biol. 2005;3(4):208-217. doi:10.1089/lrb.2005.3.208
  • Terada M, Yoshimura A, Sawaki M, et al. Patient-reported outcomes and objective assessments with arm measurement and bioimpedance analysis for lymphedema among breast cancer survivors. Breast Cancer Res Treat. 2020;179(1):91-100. doi:10.1007/s10549-019-05443-1
  • Iyigun G, Kirmizigil B, Angin E, et al. The reliability and validity of the Turkish version of Fullerton Advanced Balance (FAB-T) scale. Arch Gerontol Geriatr. 2018;78:38-44. doi:10.1016/j.archger. 2018.05.022
  • Hernandez D, Rose DJ. Predicting which older adults will or will not fall using the fullerton advanced balance scale. Arch Phys Med Rehabil. 2008;89(12):2309-2315.
  • Muir-Hunter SW, Clark J, McLean S, et al. Identifying balance and fall risk in community-dwelling older women: the effect of executive function on postural control. Physiother Can. 2014;66 (2):179-186. doi:10.3138/ptc.2013-16
  • Rose DJ, Lucchese N, Wiersma LD. Development of a multidimensional balance scale for use with functionally independent older adults. Arch Phys Med Rehabil. 2006;87(11): 1478-1485. doi:10.1016/j.apmr.2006.07.263
  • Yoosefinejad AK, Hadadi M, Eslamloo P. Evaluating the responsiveness of the fullerton advanced balance scale in patients with lymphedema secondary to breast cancer surgery. Lymphology. 2019;52(2):61-70.
  • Selcuk Yilmaz S, Ayhan FF. The randomized controlled study of low-level laser therapy, kinesio-taping and manual lymphatic drainage in patients with stage ii breast cancer-related lymphedema. Eur J Breast Health. 2023;19(1):34-44. doi:10.4274/ejbh.galenos.2022.2022-6-4
  • Huang MH, Lytle T, Miller KA, Smith K, Fredrickson K. History of falls, balance performance, and quality of life in older cancer survivors. Gait Posture. 2014;40(3):451-456. doi:10.1016/j.gaitpost. 2014.05.015
  • Winters-Stone KM, Dobek J, Bennett JA, Nail LM, Leo MC, Schwartz A. The effect of resistance training on muscle strength and physical function in older, postmenopausal breast cancer survivors: a randomized controlled trial. J Cancer Surviv. 2012; 6(2):189-199. doi:10.1007/s11764-011-0210-x
  • Foley Michael P, Scott M. Hasson. “Effects of a community-based multimodal exercise program on health-related physical fitness and physical function in breast cancer survivors: a pilot study.” Integr Cancer Ther. 2016;15(4):446-454.
  • Lee CE, Warden SJ, Szuck B, Lau YJ. A preliminary study on the efficacy of a community-based physical activity intervention on physical function-related risk factors for falls among breast cancer survivors. Am J Physical Med Rehab. 2016;95(8):561-570.
  • Evans ES, Ketcham CJ, Hibberd JC, Cullen ME, Basiliere JG, Murphy DL. Examination of clinical and laboratory measures of static and dynamic balance in breast cancer survivors. Physiother Theory Pract. 2021;37(11):1199-1209. doi:10.1080/09593985.2019.1692391
  • Basar S, Bakar Y, Keser I, et al. Does lymphedema affect the postural stability in women after breast cancer? Topics in Geriatr Rehab. 2012; 28(4): p. 287-294.
  • Angin S, Karadibak D, Yavuzşen T, Demirbüken I. Unilateral upper extremity lymphedema deteriorates the postural stability in breast cancer survivors. Contemp Oncol (Pozn). 2014;18(4):279-284. doi:10.5114/wo.2014. 44120
  • Balzarini A, Lualdi P, Lucarini C, et al. Biomechanical evaluation of scapular girdle in patients with chronic arm lymphedema. Lymphology. 2006;39(3):132-140.
  • Singh D, Park W, Levy MS, Jung ES. The effects of obesity and standing time on postural sway during prolonged quiet standing. Ergonomics. 2009;52(8):977-986. doi:10.1080/ 00140130902777636
  • Fabris de Souza SA, Faintuch J, Valezi AC, et al. Postural changes in morbidly obese patients. Obes Surg. 2005;15(7):1013-1016. doi: 10.1381/0960892054621224
  • Wang L, Chen H, Li Y, et al. Body mass index increases the risk of breast cancer-related lymphedema at 6-18 months after surgery: a retrospective study. Support Care Cancer. 2023;31(5):278. doi:10.1007/s00520-023-07721-7
  • Shen A, Lu Q, Fu X, et al. Risk factors of unilateral breast cancer-related lymphedema: an updated systematic review and meta-analysis of 84 cohort studies. Support Care Cancer. 2022;31(1):18. doi:10.1007/s00520-022-07508-2

Meme kanserı̇ hastalarında fonksı̇yonel denge ve yaşam kalı̇tesı̇

Year 2024, Volume: 5 Issue: 5, 226 - 230, 26.10.2024

Abstract

Giriş: Meme kanseri, kadınlarda kanser bağlı ölümlerde ikinci ölüm oranına sahip önemli bir sağlık sorunudur. Meme kanserini atlatan kadınlarda mastektomi ve radyoterapi sonrası omuz ve üst ekstremite hareketliliği azalabilir, gövde ve üst ekstremite kasları zayıflayabilir, biyomekanik ve fonksiyonel denge bozulabilir. Buna ek olarak, meme kanserine bağlı lenfödem (MKBL) nedeniyle artan ekstremite hacmi statik ve dinamik dengeyi bozabilir. Bugüne kadar, meme kanserini hastalarında lenfödemin denge üzerindeki etkisini araştıran çalışmalar sınırlıdır. Bu çalışmanın amacı, meme kanserini hastalarında lenfödemin denge ve yaşam kalitesi üzerindeki etkisini incelemektir.

Yöntemler: Bu prospektif çalışmada yaş, eğitim, medeni durum, vücut kitle indeksi (VKİ) (kg/m2), etkilenen lenfödem ekstremitesi (sağ-sol) ve ekstremite hacim farkı değerlendirildi. Hastalara denge düzeylerini ölçmek için Fullerton İleri Denge Skalası (FAB-Scale) uygulandı. Lenfödem Yaşam Kalitesi Anketi (LYMQOL-Arm) uygulandı.

Bulgular: Çalışmaya dahil edilen 40 hastanın yaş ortalaması 59.02±7.50 yıl idi. Fab-skalası ≤ 25 olan ve düşme riski taşıyan hastaların oranı %55 idi. Fab ölçeği ≤ 25 olan hastalar ile Fab ölçeği 25< olan hastalar arasında yaşam kalitesi skoru (LYMQOL-Arm) açısından istatistiksel bir fark yoktu (p=0,344). Etkilenen lenfödem tarafı ile denge düzeyi arasında istatistiksel olarak anlamlı bir fark yoktu (p=0.563). Yaş ile denge düzeyi arasında anlamlı bir negatif korelasyon vardı (p=0.0138). Ekstremite hacim farkı, VKİ, yaşam kalitesi ve denge düzeyi arasında anlamlı bir korelasyon görülmedi (p>0.05).

Sonuç: Çalışmamızda özellikle yaşlı hastalarda dengenin bozulmuş olduğu ve düşme riskinin arttığı tespit edildi. MKBL'li her kadın denge ve yürüme bozukluğu hakkında bilgilendirilmeli ve mümkün olan en kısa sürede lenfödem tedavisi almaya teşvik edilmelidir. Lenfödem tedavisinde fonksiyonel stabilite, yaşam kalitesi ve düşme riskini inceleyen gelecekteki çalışmaların ve denge ile ilgili özel müdahalelerin geliştirilmesinin onkolojik rehabilitasyon protokolüne katkı sağlayacağını düşünüyoruz.

Ethical Statement

Tüm hastalara çalışma hakkında bilgi verildi ve bilgilendirilmiş onam formları alındı. Çalışmamız Helsinki ilkelerine uygun olarak gerçekleştirildi. Çalışma protokolü Etik Kurul tarafından onaylandı (Protokol numarası 2022-06/92).

References

  • Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics. CA Cancer J Clin. 2023;73(1): p.17-48.
  • De Groef A, Van Kampen M, Tieto E, et al. Arm lymphoedema and upper limb impairments in sentinel node-negative breast cancer patients: a one year follow-up study. Breast. 2016;29:p. 102-108.
  • Schmidt T, Berner J, Jonat W, et al. Influence of arm crank ergometry on development of lymphedema in breast cancer patients after axillary dissection: a randomized controlled trail. J Rehabil Med. 2017;49(1):78-83. doi:10.2340/16501977-2167
  • Kalder M, Hadji P. Breast cancer and osteoporosis - management of cancer treatment-induced bone loss in postmenopausal women with breast cancer. Breast Care (Basel). 2014;9(5):312-317. doi:10.1159/000368843
  • Armer JM, Stewart BR. A comparison of four diagnostic criteria for lymphedema in a post-breast cancer population. Lymphat Res Biol. 2005;3(4):208-217. doi:10.1089/lrb.2005.3.208
  • Terada M, Yoshimura A, Sawaki M, et al. Patient-reported outcomes and objective assessments with arm measurement and bioimpedance analysis for lymphedema among breast cancer survivors. Breast Cancer Res Treat. 2020;179(1):91-100. doi:10.1007/s10549-019-05443-1
  • Iyigun G, Kirmizigil B, Angin E, et al. The reliability and validity of the Turkish version of Fullerton Advanced Balance (FAB-T) scale. Arch Gerontol Geriatr. 2018;78:38-44. doi:10.1016/j.archger. 2018.05.022
  • Hernandez D, Rose DJ. Predicting which older adults will or will not fall using the fullerton advanced balance scale. Arch Phys Med Rehabil. 2008;89(12):2309-2315.
  • Muir-Hunter SW, Clark J, McLean S, et al. Identifying balance and fall risk in community-dwelling older women: the effect of executive function on postural control. Physiother Can. 2014;66 (2):179-186. doi:10.3138/ptc.2013-16
  • Rose DJ, Lucchese N, Wiersma LD. Development of a multidimensional balance scale for use with functionally independent older adults. Arch Phys Med Rehabil. 2006;87(11): 1478-1485. doi:10.1016/j.apmr.2006.07.263
  • Yoosefinejad AK, Hadadi M, Eslamloo P. Evaluating the responsiveness of the fullerton advanced balance scale in patients with lymphedema secondary to breast cancer surgery. Lymphology. 2019;52(2):61-70.
  • Selcuk Yilmaz S, Ayhan FF. The randomized controlled study of low-level laser therapy, kinesio-taping and manual lymphatic drainage in patients with stage ii breast cancer-related lymphedema. Eur J Breast Health. 2023;19(1):34-44. doi:10.4274/ejbh.galenos.2022.2022-6-4
  • Huang MH, Lytle T, Miller KA, Smith K, Fredrickson K. History of falls, balance performance, and quality of life in older cancer survivors. Gait Posture. 2014;40(3):451-456. doi:10.1016/j.gaitpost. 2014.05.015
  • Winters-Stone KM, Dobek J, Bennett JA, Nail LM, Leo MC, Schwartz A. The effect of resistance training on muscle strength and physical function in older, postmenopausal breast cancer survivors: a randomized controlled trial. J Cancer Surviv. 2012; 6(2):189-199. doi:10.1007/s11764-011-0210-x
  • Foley Michael P, Scott M. Hasson. “Effects of a community-based multimodal exercise program on health-related physical fitness and physical function in breast cancer survivors: a pilot study.” Integr Cancer Ther. 2016;15(4):446-454.
  • Lee CE, Warden SJ, Szuck B, Lau YJ. A preliminary study on the efficacy of a community-based physical activity intervention on physical function-related risk factors for falls among breast cancer survivors. Am J Physical Med Rehab. 2016;95(8):561-570.
  • Evans ES, Ketcham CJ, Hibberd JC, Cullen ME, Basiliere JG, Murphy DL. Examination of clinical and laboratory measures of static and dynamic balance in breast cancer survivors. Physiother Theory Pract. 2021;37(11):1199-1209. doi:10.1080/09593985.2019.1692391
  • Basar S, Bakar Y, Keser I, et al. Does lymphedema affect the postural stability in women after breast cancer? Topics in Geriatr Rehab. 2012; 28(4): p. 287-294.
  • Angin S, Karadibak D, Yavuzşen T, Demirbüken I. Unilateral upper extremity lymphedema deteriorates the postural stability in breast cancer survivors. Contemp Oncol (Pozn). 2014;18(4):279-284. doi:10.5114/wo.2014. 44120
  • Balzarini A, Lualdi P, Lucarini C, et al. Biomechanical evaluation of scapular girdle in patients with chronic arm lymphedema. Lymphology. 2006;39(3):132-140.
  • Singh D, Park W, Levy MS, Jung ES. The effects of obesity and standing time on postural sway during prolonged quiet standing. Ergonomics. 2009;52(8):977-986. doi:10.1080/ 00140130902777636
  • Fabris de Souza SA, Faintuch J, Valezi AC, et al. Postural changes in morbidly obese patients. Obes Surg. 2005;15(7):1013-1016. doi: 10.1381/0960892054621224
  • Wang L, Chen H, Li Y, et al. Body mass index increases the risk of breast cancer-related lymphedema at 6-18 months after surgery: a retrospective study. Support Care Cancer. 2023;31(5):278. doi:10.1007/s00520-023-07721-7
  • Shen A, Lu Q, Fu X, et al. Risk factors of unilateral breast cancer-related lymphedema: an updated systematic review and meta-analysis of 84 cohort studies. Support Care Cancer. 2022;31(1):18. doi:10.1007/s00520-022-07508-2
There are 24 citations in total.

Details

Primary Language English
Subjects Clinical Sciences (Other)
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Songül Keskin Kavak 0000-0003-4409-4996

Lale Aktekin 0000-0001-9853-4753

Publication Date October 26, 2024
Submission Date August 24, 2024
Acceptance Date September 15, 2024
Published in Issue Year 2024 Volume: 5 Issue: 5

Cite

AMA Keskin Kavak S, Aktekin L. Functional balance and quality of life in breast cancer survivors. J Med Palliat Care / JOMPAC / jompac. October 2024;5(5):226-230.

TR DİZİN ULAKBİM and International Indexes (1d)

Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS]



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