Journal CME, February 2023: Factors associated with upper limb function in breast cancer survivors-Journal CME, February 2023: Factors associated with upper limb function in breast cancer survivors

Journal CME, February 2023: Factors associated with upper limb function in breast cancer survivors

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The study explores the factors influencing upper limb function in breast cancer survivors, particularly post-surgery. This cross-sectional study involved 174 women who had undergone surgery for a primary breast tumor. Upper limb function was assessed using the Upper Limb Functional Index (ULFI-Sp). Other variables measured included handgrip strength via a Jamar dynamometer, fear avoidance through the Fear-Avoidance Components Scale (FACS-Sp), and central sensitization symptoms using the Central Sensitisation Inventory (CSI-Sp).<br /><br />The regression model, which explained 45% of the variance in upper limb function, revealed that higher handgrip strength, lower fear-avoidance behavior, and fewer central sensitization symptoms were significantly associated with better upper limb function. These findings align with previous research indicating that psychological and physical factors contribute to upper limb functionality among breast cancer survivors. Importantly, this study is noted to be the first to show an association between fear avoidance and upper limb function.<br /><br />The study emphasizes the importance of assessing these variables to improve upper limb function in breast cancer survivors. It suggests that both patient-reported outcomes (such as FACS and CSI) and objective measures (like grip strength) are crucial in identifying patients who would benefit from a biopsychosocial approach to rehabilitation, potentially incorporating pain neuroscience education and graded activity rehabilitation. These findings have significant implications for clinical practice, underscoring the necessity of a holistic assessment framework aimed at enhancing therapeutic outcomes.<br /><br />Acknowledgments were given to the participants and the project funders, notably a contract between Novartis Oncology and IBIMA. The study's limitations include not accounting for all factors associated with upper limb function (e.g., surgical types) and psychological factors like post-traumatic stress disorder. Future research should delve deeper into a broader range of contributing factors to upper limb functionality in breast cancer survivors.

Keywords

upper limb function

breast cancer survivors

post-surgery

handgrip strength

fear avoidance

central sensitization

biopsychosocial approach

rehabilitation

patient-reported outcomes

therapeutic outcomes