Relationship of Hand Grip Strength on The Upper Extremity Function, Activities of Daily Living and Physical Activity Level ın Patients with Postmastectomy Lymphedema: A Pilot Study

Yıl 2021, Cilt: 4 Sayı: 2, 140 - 151, 20.12.2021

Özlem Üçel Filiz Eyüboğlu Ayşe Reyhan Çeliker

https://doi.org/10.33438/ijdshs.982589

Öz

This study aimed to investigate the relationship of hand grip strength on upper extremity functionality, activities of daily living, and physical activity level in female patients with lymphedema who have undergone breast cancer surgery. A total of 15 female patients with a diagnosis of lymphedema associated with breast cancer treatment were included in the study. The presence and severity of lymphedema were determined by circumference measurement. A hand dynamometer was used to evaluate the hand grip strength. Disabilities of Arm, Shoulder and Hand Questionnaire (DASH); Milliken Activities of Daily Living Scale (MAS);and the long form of the International Physical Activity Questionnaire(IPAQ) were used to evaluate upper extremity functionality, daily living activity, and physical activity level, respectively. The mean age of the patients was 51±10.6 years. DASH score was significantly related with age (r:0.639; p:0,010). The relationship between the hand grip strength of the affected side and the hand grip strength of the unaffected side was statistically positively significant (r:0.756; p:0.001).It was determined that hand grip strength was related to the total MAS value and the DASH score (r:0.609;p:0.016 and r:-0.624; p:0.013, respectively). The relationship between postoperative lymphedema development time with affected side hand grip strength and total MAS score was statistically significant (r:0.574; p:0.025 and r:0.766; p:0.001, respectively). There were no correlations between IPAQ score and hand grip strength, DASH, and MAS values (p>0.05). Considering these results, we concluded that improving hand grip strength in the early period may increase upper extremity functionality and quality of life for these patients.

Anahtar Kelimeler

breast cancer, lymphedema, hand grip strenght, activities of daily living, physical activity

Kaynakça

• Ahmed, RL., Prizment, A., Lazovich, D., Schmitz, KH., Folsom, AR. (2008). Lymphedema and quality of life in breast cancer survivors: the Iowa Women’s Health Study. J Clin Oncol;26(35):5689-5696.
• Akel, BS., Oksuz, C., Kayihan, H. (2010). Adaptation and validation of Turkish version of the Milliken ADL Scale (MAS). Journal of Hand Therapy; 23: e12.
• Atalay, NŞ., Taflan Selçuk, S., Ercidoğan, Ö. ve ark. (2011). The presence of upper extremity problems and the effect on quality of life in breast cancer patients who undergone breast surgery and axillary dissection. Turk J Phys Med Rehab; 57:186-192.
• Beaulac, SM., McNair, LA., Scott, TE., LaMorte, WW., Kavanah, MT. (2002). Lymphedema and quality of life in survivors of early-stage breast cancer. Arch Surg;137(11):1253-1257. Brach, M., Cieza, A., Stucki, G., et al. (2004). ICF core sets for breast cancer. J Rehabil Med; (44 Suppl): 121-127.
• Büyükakıncak, Ö., Akyol, Y., Özen, N. ve ark. (2014). Quality of Life in Patients with Breast Cancer at Early Postoperative Period: Relationship to Shoulder Pain, Handgrip Strength, Disability, and Emotional Status. Turk J Phys Med Rehab; 60:1-6.
• Cantarero-Villanueva, I., Fernandez-Lao, C., Diaz-Rodriguez, L., Fernandez-deLas-Penas, C., Ruiz, JR., Arroyo-Morales, M. (2012). The handgrip strength test as a measure of function in breast cancer survivors: relationship to cancer-related symptoms and physical and physiologic parameters. Am J Phys Med Rehabilitation; 91(9):774e82.
• Chen, X., Lu, W., Zheng, W., Gu, K., Matthews, CE., Chen, Z., Zheng, Y., Shu, XO. (2011). Exercise after diagnosis of breast cancer in association with survival. Cancer Prev Res (Phila); 4(9):1409–1418.
• Collins, LG. (2004). Perceptions of upper-body problems during recovery from breast cancer treatment. Supportive Care in Cancer; 106-113.
• Committee, I.R., (2005). Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ) short and long forms. Retrieved September. 17:2008.
• Craig, C. L., Marshall, A. L., Sjostrom, M., Bauman, A. E., Booth, M. L., Ainsworth, B. E., Pratt, M., Ekelund, U., Yngve, A., Sallis, J. F., & Oja, P. (2003). International Physical Activity Questionnaire: 12-country reliability and validity. Medicine & Science in Sports & Exercise, 35, 1381-1395.
• De Vrieze, T., Gebruers, N., Nevelsteen, I., Tjalma, WAA., Thomis, S., De Groef, A., Dams, L., Van der Gucht, E., Devoogdt, N. (2020). Physical activity level and age contribute to functioning problems in patients with breast cancer-related lymphedema: a multicentre cross-sectional study. Support Care Cancer: off J Multinatl Assoc Support Care Cancer. https://doi.org/10.1007/s00520-020-05375-3
• DiSipio, T., Rye, S., Newman, B., Hayes, S. (2013). Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and metaanalysis. Lancet Oncol;14(6):500–15. Dourado, V. Z., Antunes, L. C., Tanni, S. E., de Paiva, S. A., Padovani, C. R. & Godoy, I. (2006). Relationship of upper-limb and thoracic muscle strength to 6-min walk distance in COPD patients. Chest; 129 (3), 551–557.
• Düger, T., Yakut, E., Öksüz, Ç., Yörükan, S., Bilgütay, BS., Ayhan, Ç., Leblebicioğlu, G., Kayıhan, H., Kırdı, N., Yakut, Y., Güler, Ç. (2006). Reliability and validity of the Turkish version of the Disabilities of the Arm. Shoulder and Hand (DASH) Questionnaire. Turk J Phys Med Rehab; 17(3): 99-107.
• Duijts, SF., Faber, MM., Oldenburg, HS., van Beurden, M., Aaronson, NK. (2011). Effectiveness of behavioral techniques and physical exercise on psychosocial functioning and health-related quality of life in breast cancer patients and survivors-a meta-analysis. Psychooncology; 20(2):115–126.
• Fairey, AS., Courneya, KS., Field, CJ., Mackey, JR. (2002), Physical exercise and immune system function in cancer survivors: a comprehensive review and future directions. Cancer; 94(2):539–551.
• Fleissig, A., Fallowfield, LJ., Langridge, CI., Johnson, L., Newcombe, RG., Dixon, JM., et al. (2006). Post-operative arm morbidity and quality of life. Results of the ALMANAC randomised trial comparing sentinel node biopsy with standard axillary treatment in the management of patients with early breast cancer. Breast Cancer Res Treat; 95(3):279e93.
• Fu, MR. (2014). Breast cancer-related lymphedema: symptoms, diagnosis, risk reduction, and management. World J Clin Oncol;5(3):241–7.
• Furmaniak, AC., Menig, M., Markes, MH. (2016). Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev; 9(9): Cd005001.
• Gary, DE. (2007). Lymphedema diagnosis and management. J Am Acad Nurse Pract. 2007; 19(2):72-78.
• Gebruers, N., Verbelen, H., De Vrieze, T., Vos, L., Devoogdt, N., Fias, L., Tjalma, W. (2017). Current and future perspectives on the evaluation, prevention and conservative management of breast cancer related lymphoedema: a best practice guideline. Eur J Obstet Gynecol Reprod Biol; 216:245–253.
• Gummesson, C., Ward, MM., Atroski, I. (2006). The shortened disabilities of the arm shoulder and hand questionnaire (Quick-DASH): validity and reliability based on responses within the full- length DASH. BMC Musculoskelet Disord; 7:44.
• Hayes, SC., Battistutta, D., Parker, AW., Hirst, C., Newman, B. (2005). Assessing task “burden” of daily activities requiring upper body function among women following breast cancer treatment. Support Care Cancer; 13: 255- 265.
• Hayes, SC., Rye, S., Disipio, T., Yates, P., Bashford, J., Pyke, C., Saunders, C., Battistutta, D., Eakin, E. (2013). Exercise for health: a randomized, controlled trial evaluating the impact of a pragmatic, translational exercise intervention on the quality of life, function and treatmentrelated side effects following breast cancer. Breast Cancer Res Treat; 137:175–186.
• Herrera, JE., Stubblefield, MD. (2004). Rotator cuff tendonitis in lymphedema: a retrospective case series. Arch Phys Med Rehabil;85(12):1939–42.
• Herrero, F., San Juan, AF., Fleck, SJ., Balmer, J., Perez, M., Canete, S., Earnest, CP., Foster, C., Lucia, A. (2006). Combined aerobic and resistance training in breast cancer survivors: A randomized, controlled pilot trial. Int J Sports Med; 27:573–580.
• Hladiuk, M., Huchcroft, S., Temple, W., Schnurr, BE. (1992). Arm function after axillary dissection for breast cancer: a pilot study to provide parameter estimates. J Surg Oncol; 50:47-52.
• Hudak, PL., Amadio, PC., Bombardier, C. (1996). Development of an upper extremity outcome measure: The DASH (Disabilities of the Arm Shoulder and Hand). Am J Indust Med;29: 602–8
• Irwin, ML., Crumley, D., McTiernan, A., Bernstein, L., Baumgartner, R., Gilliland, FD., Kriska, A., Ballard-Barbash, R. (2003). Physical activity levels before and after a diagnosis of breast carcinoma: the Health, Eating, Activity, and Lifestyle (HEAL) study. Cancer; 97(7):1746– 1757.
• Kangas, M., Bovbjerg, DH., Montgomery, GH. (2008). Cancer-related fatigue: a systematic and meta-analytic review of nonpharmacological therapies for cancer patients. Psychol Bull; 134(5):700–741.
• Karadibak, D., Yıldırım, Y., Kara, B., Saydam, S. (2009). Effect of complex decongestive therapy on upper extremity lymphedema. Fizyoter Rehabil;20(1):03- 08.
• Karki, A., Simonen, R., Malkia, E., Selfe, J. (2005). Impairments, activity limitations and participation restrictions 6 and 12 months after breast cancer operation. J Rehabil Med; 37(3):180e8. Keramopoulos, A., Tsionou, C., Minaretzis, D., Michalas, S., Aravantinos, D. (1993). Arm morbidity following treatment of breast cancer with total axillary dissection: A multivariated approach. Oncol; 50(6): 445-449
• Khan, F., Amatya, B., Pallant, JF., Rajapaksa, I. (2012). Factors associated with long-term functional outcomes and psychological sequelae in women after breast cancer. Breast;21(3):314–20. Kilbreath, SL., Refshauge, KM., Beith, JM., Ward, LC., Lee, M., Simpson, JM., Hansen, R. (2012). Upper limb progressive resistance training and stretching exercises following surgery for early breast cancer: a randomized controlled trial. Breast Cancer Res Treat; 133:667–676.
• Kim do S., Sim, YJ., Jeong HJ., Kim GC. (2010). Effect of active resistive exercise on breast cancer-related lymphedema: a randomized controlled trial. Arch Phys Med Rehabil; 91:1844–1848. Kim, JK., Park, MG., Shin, SJ. (2014). What is the minimum clinically important difference in grip strength? Clin Orthop Relat Res; 472(8):2536e41.
• Klernas, P., Johnsson, A., Horstmann, V., Kristjanson, LJ., Johansson, K. (2015). Lymphedema Quality of Life Inventory (LyQLI)-Development and investigation of validity and reliability. Qual Life Res;24(2):427–39.
• Kootstra, JJ., Hoekstra-Weebers, JE., Rietman, JS., de Vries, J., Baas, PC., Geertzen, JH., et al. (2010). A longitudinal comparison of arm morbidity in stage I-II breast cancer patients treated with sentinel lymph node biopsy, sentinel lymph node biopsy followed by completion lymph node dissection, or axillary lymph node dissection. Ann Surg Oncol; 17(9):2384e94.
• Korucu, TS., Ucurum, SG., Tastaban, E., Ozgun, H., Kaya, DO. (2020). Comparison of Shoulder-Arm Complex Pain, Function, and Scapular Dyskinesia in Women With and Without Unilateral Lymphedema After Breast Cancer Surgery. Clin Breast Cancer; Oct 29:S1526-8209(20)30267-6.
• Kümmel J, Kramer A, Giboin LS, Gruber M. (2016). Specificity of balance training in healthy individuals: a systematic review and meta-analysis. Sports Med. Sep;46(9):1261–71.
• Kwan, W., Jackson, J., Weir, LM., Dingee, C., McGregor, G., Olivotto, IA. (2002). Chronic arm morbidity after curative breastcancer treatment: prevalence and impact on quality of life. J Clin Oncol;20(20):4242-4248.
• Lee, D., Hwang, JH., Chu, I., Chang, HJ., Shim, YH., Kim, JH. (2015). Analysis of factors related to arm weakness in patients with breast cancer-related lymphedema. Support Care Cancer. 2015 Aug;23(8):2297–304.
• Lee, TS., Kilbreath, SL., Refshauge, KM., Beith, JM., Harris, LM. (2008). Prognosis of the upper limb following surgery and radiation for breast cancer. Breast Cancer Res Treatment;110:19–37. Lee, Y., Mak, S., Tse, S., Chan, S. (2001). Lymphedema care of breast cancer patients in a breast care a. clinic: a survey of knowledge and health practise. Support Care Cancer; 9(8): 634-641.
• Liu, CQ., Guo, Y., Shi, JY., Sheng, Y. (2009). Late morbidity associated with a tumournegative sentinel lymph node biopsy in primary breast cancer patients: a systematic review. Eur J Cancer (Oxford, Engl 1990);45(9):1560e8.
• Orhan, C., Ozgul, S., Nakip, G., Baran, E., Uzelpasacı, E., Çinar, GN., Aksoy, S., Akbayrak, T. (2019). Effect of Lymphedema Severity on Quality of Life, Upper Limb Function, and Physical Activity Level in Patients with Breast Cancer Treatment-related Lymphedema. Anadolu Klin; 24 (3).
• Petersen, P., Petrick, M., Connor, H., Conklin, D. (1989). Grip strength and hand dominance: challenging the 10 % rule. Am J Occup Ther;43: 444–447
• Quiron, E. (2010). Recognizing and treating upper extremity lymphedema in postmastectomy/lumpectomy patients: A guide for primary care providers. J Am Acad Nurse Pract;22(9):450-459
• Radina, E., Armer, J., Culbertson, S., Dusold, J. (2004). Post-breast cancer lymphedema: understanding women’s knowledge of their condition. Oncol Nurs Forum;31(1):97-104.
• Ridner, SH. (2005). Quality of life and a symptom cluster associated with breast cancer treatment-related lymphedema. Support Care Cancer;13(11):904-911.
• Rietman, JS., Geertzen, JH., Hoekstra, HJ., Baas, P., Dolsma, WV., de Vries, J., et al. (2006). Long term treatment related upper limb morbidity and quality of life after sentinel lymph node biopsy for stage I or II breast cancer. Eur J Surg Oncol; 32(2): 148e52.
• Sagen, A., Kaaresen, R., Sandvik, L., Thune, I., Risberg, MA. (2014). Upper limb physical function and adverse effects after breast cancer surgery: a prospective 2.5-year follow-up study and preoperative measures. Arch Phys Med Rehabil;95:875–881
• Sağlam, M., Arıkan, H., Savcı, S., Inal-İnce, D., Boşnak- Güçlü, M., Karabulut, E. (2012). International physical activity questionnaire: reliability and validity of the Turkish version. Perceptual and Motor Skills. 111,278-284.
• Sakorafas, GH., Peros, G., Cataliotti, L., Vlastos, G. (2006). Lymphedema following axillary lymph node dissection for breast cancer. Surg Oncol; 15:153-65.
• Sayaca, Ç., Simsek, M. (2020). Scapular Dyskinesia After Modified Radical Mastectomy Surgery and Breast Conserving Surgery. Hacettepe University Faculty of Health Sciences Journal; 7(3), 310-323.
• Schmitz, KH., Speck, RM., Rye, SA., DiSipio, T., Hayes, SC. (2012). Prevalence of breast cancer treatment sequelae over 6 years of follow-up: the Pulling Through Study. Cancer;118(8 Suppl):2217–25.
• Schmitz, KH., Troxel, AB., Cheville, A., Grant, LL., Bryan, CJ., Gross, CR., ve ark. (2009). Physical Activity and Lymphedema (the PAL trial): assessing the safety of progressive strength training in breast cancer survivors. Contemp Clin Trials;30(3):233–45.
• Sclafani, LM., Baron, RH. (2008). Sentinel lymph node biopsy and axillary dissection: added morbidity of the arm, shoulder and chest wall after mastectomy and reconstruction. Cancer J;14(4):216–22.
• Seaton, MK., Groth, GN., Matheson, L., Feely, C. (2005). Reliability and validity of the Milliken Activities of Daily Living Scale. J Occup Rehabil; 15:343–51. Shamley D, Lascurain-Aguirrebeña I, Oskrochi R, Srinaganathan R. (2012). Shoulder morbidity after treatment for breast cancer is bilateral and greater after mastectomy. Acta Oncol; 51(8):1045–1053.
• Swenson, KK., Nissen, MJ., Ceronsky, C., Swenson, L., Lee, MW., Tuttle, TM. (2002). Comparison of side effects between sentinel lymph node and axillary lymph node dissection for breast cancer. Ann Surg Oncol; 9(8):745e53
• Taghian, NR., Miller, CL., Jammallo, LS., O’Toole, J., Skolny, MN. (2014). Lymphedema following breast cancer treatment and impact on quality of life: a review. Crit Rev Oncol Hematol;92(3):227–34.
• Taylor, R., Jayasinghe, UW., Koelmeyer, L., et al. (2006). Reliability and validity of arm volume measurements for assessment of lymphedema. Phys Ther; 86:205-214.
• Ververs, JM., Roumen, RM., Vingerhoets, AJ., Vreugdenhil, G., Coebergh, JW., Crommelin, MA., et al. (2001). Risk, severity and predictors of physical and psychological morbidity after axillary lymph node dissection for breast cancer. Eur J Cancer; 37(8):991e9.
• Voogd, AC., Ververs, JM., Vingerhoets, AJ., Roumen, RM., Coebergh, JW., Crommelin, MA. (2003). Lymphoedema and reduced shoulder function as indicators of quality of life after axillary lymph node dissection for invasive breast cancer. Br J Surg;90(1):76-81.
• Winningham, ML., MacVicar, MG. (1988). The effect of aerobic exercise on patient reports of nausea. Oncol Nurs Forum; 15(4):447– 450.
• Zhu, YQ., Xie, YH., Liu, FH., Guo, Q., Shen, PP., Tian, Y. (2014). Systemic analysis on risk factors for breast cancer related lymphedema. Asian Pac J Cancer Prev; 15:6535-41.