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Hao J, He Z, Li Y, Huang B, Remis A, Yao Z, Zhu D. Virtual reality-based supportive care interventions for patients with cancer: an umbrella review of systematic reviews and meta-analyses. Support Care Cancer 2024; 32:603. [PMID: 39167153 DOI: 10.1007/s00520-024-08813-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 08/14/2024] [Indexed: 08/23/2024]
Abstract
PURPOSE This umbrella review aimed to identify, critically appraise, and synthesize current evidence from systematic reviews and meta-analyses on the applications of virtual reality-based supportive care interventions in cancer. METHODS Three bibliographic databases were searched from inception to February 1, 2024. Two independent reviewers screened the titles and abstracts of 421 records and retrieved 26 full-text systematic reviews. Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) was used for quality assessment. Qualitative syntheses were performed to investigate the effects of virtual reality-based supportive care interventions on quality of life and physical, psychological, cognitive, and functional outcomes. Meta-analysis was performed based on data from the distinct primary studies that were extracted from the included reviews. RESULTS This umbrella review included 20 systematic reviews that were published between 2018 and 2023; nine of them conducted meta-analyses. A total of 86 distinct primary studies were identified. According to the AMSTAR-2 assessment, two reviews were evaluated as moderate quality, nine as low, and nine as critically low. Meta-analyses of primary studies revealed significant effects of virtual reality on anxiety (p < 0.001), depression (p < 0.001), and pain (p < 0.001), but not fatigue (p = 0.263). Qualitative syntheses revealed positive effects of virtual reality on physical function, cognitive function, and quality of life. Limited evidence was reported regarding outcomes of balance, gait, mobility, and activities of daily living. CONCLUSION Virtual reality has proven to be a safe and feasible approach to deliver supportive care in cancer. Virtual reality can be implemented in various stages and settings of the cancer care continuum to support patients undergoing painful procedures, during or after chemotherapy, and after surgical interventions. Virtual reality can serve as an effective supportive care intervention to manage anxiety, pain, and depression for patients with cancer.
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Affiliation(s)
- Jie Hao
- Department of Physical Therapy and Rehabilitation, Southeast Colorado Hospital, Springfield, CO, USA.
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Zhengting He
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Yanfei Li
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
| | - Biying Huang
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
| | - Andréas Remis
- Health Research Association of Keck Medicine, University of Southern California, Los Angeles, CA, USA
| | - Zixuan Yao
- Department of Rehabilitation Medicine, Beijing Hospital, National Center of Gerontology, Institution of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, P.R. China
| | - Dongqi Zhu
- Department of Rehabilitation Medicine, Shanghai Sixth People's Hospital, Shanghai, P.R. China
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Doubblestein D, Koehler L, Anderson E, Scheiman N, Stewart P, Schaverien M, Armer J. Development of a core set of outcome measures to be applied toward breast cancer-related lymphedema core outcome domains. Breast Cancer Res Treat 2024; 205:439-449. [PMID: 38517603 PMCID: PMC11101581 DOI: 10.1007/s10549-024-07298-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/14/2024] [Indexed: 03/24/2024]
Abstract
PURPOSE For breast cancer survivors (BCS) living with breast cancer-related lymphedema (BCRL), what outcome measures (OMs) are recommended to be used to measure standardized outcome domains to fully assess the burden of the disease and efficacy of interventions? An integral component of a standardized core outcome set (COS) are the OMs used to measure the COS. METHODS A supplemental online survey was linked to a Delphi study investigating a COS for BCRL. OMs were limited to a maximum of 10 options for each outcome domain (OD). There were 14 ODs corresponding to the International Classification of Functioning, Disability, and Health (ICF) framework and respondents rated the OMs with a Likert level of recommendation. The feasibility of the listed OMs was also investigated for most outpatient, inpatient, and research settings. RESULTS This study identified 27 standardized OMs with a few ODs having 2-3 highly recommended OMs for proper measurement. A few of the recommended OMs have limitations with reliability due to being semi-quantitative measures requiring the interpretation of the rater. CONCLUSION Narrowing the choices of OMs to 27 highly recommended by BCRL experts may reduce selective reporting, inconsistency in clinical use, and variability of reporting across interdisciplinary healthcare fields which manage or research BCRL. There is a need for valid, reliable, and feasible OMs that measure tissue consistency. Measures of upper extremity activity and motor control need further research in the BCS with BCRL population.
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Affiliation(s)
| | - Linda Koehler
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | | | - Nicole Scheiman
- Occupational Therapy Assistant Program, Huntington University, Huntington, IN, USA
| | - Paula Stewart
- Parkridge Medical Center - Wound Care/Lymphedema Clinic, Parkridge Medical Center, Chattanooga, TN, USA
| | - Mark Schaverien
- Division of Surgery, Department of Plastic Surgery, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Jane Armer
- Professor Emerita, Sinclair School of Nursing, University of Missouri, Columbia, MO, USA
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Haynam ML, Chaplow ZL, DeScenza VR, Bowman JD, Dispennette K, Zhang X, Kilar M, Hohn S, Fairman CM, Lustberg MB, Focht BC. Design and methods of a translational, community-based, lifestyle weight management pilot intervention trial in breast cancer survivors with overweight or obesity. Contemp Clin Trials Commun 2023; 33:101154. [PMID: 37250507 PMCID: PMC10220259 DOI: 10.1016/j.conctc.2023.101154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 05/03/2023] [Accepted: 05/14/2023] [Indexed: 05/31/2023] Open
Abstract
Background Breast cancer survivors (BCS) with overweight or obesity are at heightened risk of cancer recurrence, cardiometabolic disease, and compromised quality of life. Given the prevalence of significant weight gain during and following breast cancer treatment, there is growing recognition of the need to develop efficacious, widely-accessible, weight management programs for BCS. Unfortunately, access to evidence-based weight management resources for BCS remains limited and little is known of the optimal theoretical basis, program components, and mode of delivery for community-based interventions. The primary aim of the Healthy New Albany Breast Cancer (HNABC) pilot trial was to determine the safety, feasibility, and preliminary efficacy of delivering a translational, evidence-based, and theory-driven lifestyle weight management intervention to BCS with overweight or obesity in the community setting. Methods HNABC was a single-arm, pilot trial evaluating a 24-week, multi-component intervention leveraging exercise, dietary modification, and group-mediated cognitive behavioral (GMCB) counseling components designed to facilitate lifestyle behavior change and promote sustained independent adherence. Assessments of various objectively-determined and patient-reported outcomes and theory-derived determinants of behavioral adoption and maintenance were obtained at baseline, 3- and 6-month follow-up. Measures of trial feasibility were calculated prospectively throughout the study. Conclusion Findings from the HNABC pilot trial will provide evidence demonstrating the feasibility and preliminary efficacy of a multi-component, community-based, GMCB lifestyle weight management intervention for BCS. Results will inform the design of a future, large-scale, randomized controlled efficacy trial. If successful, this approach could offer a widely accessible, community-based intervention model for weight management programs in BCS.
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Affiliation(s)
| | | | | | | | | | | | - Megan Kilar
- The Ohio State University, Columbus, OH, USA
| | | | | | | | - Brian C. Focht
- The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
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Morishita S, Kasahara R, Yamamoto Y, Jinbo R, Takano A, Yasuda M, Tsubaki A, Aoki O, Fu JB, Tsuji T. Differences in the Relationships Between Muscle Strength, Muscle Mass, Balance Function, and Quality of Life for Middle-Aged and Older Breast Cancer Survivors. Integr Cancer Ther 2022; 21:15347354221138574. [PMID: 36511322 PMCID: PMC9751175 DOI: 10.1177/15347354221138574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the differences in muscle strength, muscle mass, balance function, and quality of life (QOL) among middle-aged breast cancer survivors (BCSs) and older BCSs. METHODS The study included 53 middle-aged (<65 years old) BCSs and 49 older (≥65 years old) BCSs. Muscle strength was evaluated via handgrip and knee extensor strength, and muscle mass was assessed using a body composition test. Balance function was assessed using the Timed Up and Go test and the body sway test. QOL was assessed using the Medical Outcome Study 36-item Short-Form Health Survey. RESULTS The older BCSs had significantly lower right grip strength, right knee extension strength, and muscle mass (P < .05) than the middle-aged BCSs. In addition, the body sway test showed that older BCSs had a significant increase in the length of center of pressure compared to middle-aged BCSs (P < .05). Older BCSs showed significantly lower physical functioning subscales in QOL compared to middle-aged BCSs (P < .05). The associations among muscle strength, muscle mass and QOL were more significantly observed in the older BCSs (P < .05). Furthermore, a significant correlation between QOL and balance function was observed in the older BCSs, but not in the middle-aged BCSs (P < .05). CONCLUSION There may be associations among muscle strength, muscle mass, balance and QOL in older BCSs, but not in middle-aged BCSs. We believe that the findings of this study will be relevant in the context of planning rehabilitation for older BCSs.
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Affiliation(s)
- Shinichiro Morishita
- Fukushima Medical University, Fukushima, Japan,Shinichiro Morishita, Department of Physical Therapy, School of Health Sciences, Fukushima Medical University, 10-6 Sakaemachi, Fukushima City 960-8516, Japan.
| | | | | | | | - Aya Takano
- Kita-Fukushima Medical Center, Fukushima, Japan
| | | | | | - Osamu Aoki
- Shijonawate Gakuen University, Osaka, Japan
| | - Jack B. Fu
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Wechsler S, Kneiss J, Adams B, Wood Magee LJ. Persistent cancer-related fatigue after breast cancer treatment predicts postural sway and post-exertional changes in sit-to-stand strategy. REHABILITATION ONCOLOGY 2022; 40:162-171. [PMID: 36212795 PMCID: PMC9534381 DOI: 10.1097/01.reo.0000000000000308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
Background Chemotherapy-induced peripheral neuropathy (CIPN) is considered a primary mechanism of imbalance among women diagnosed with breast cancer. Recent evidence, however, suggests that cancer-related fatigue (CRF) may also influence balance. Purpose Examine the contributions of CRF and CIPN to static and dynamic balance before and after a period of fatiguing exercise. Methods This is a secondary analysis of data examining functional differences between women with breast cancer with and without persistent CRF. Postural sway was measured during static standing and the rising phase of an instrumented sit-to-stand (ISTS) before and after exercise. Regression analyses were performed to determine how CRF and severity of CIPN predicted sway and how much variance was attributable to each. Results Greater CRF predicted increased pre-, p=.04, and post-exertional, p=.02, static sway in the anterior-posterior plane. CRF accounted for 10.5% and 9.5% of the variance in pre- and post-exertional sway (respectively) compared to the 0.9% and 1.4% accounted for by CIPN severity which was not a significant predictor. After exercise, greater CRF predicted smaller, more conservative, anterior weight shifting during the ISTS, p=.01, and accounted for 6.6% of the variance in sway compared to 3% attributed to CIPN which was not a significant predictor. Limitations This analysis is limited by its small and demographically homogenous sample. Conclusions These results suggest that CRF may influence balance independent of CIPN symptoms. While CIPN remains a risk factor for imbalance in this population, CRF warrants consideration in clinical practice and research as a mechanism of postural instability.
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Affiliation(s)
- Stephen Wechsler
- MGH Institute of Health Professions, 36 1 Avenue, Charlestown, MA 02129
| | | | - Benjamin Adams
- MGH Institute of Health Professions, 36 1 Avenue, Charlestown, MA 02129
| | - Lisa J Wood Magee
- William F. Connell School of Nursing, Boston College, Chestnut Hill MA 02647
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Koralewska A, Domagalska-Szopa M, Łukowski R, Szopa A. Influence of the external breast prosthesis on the postural control of women who underwent mastectomy: Cross-sectional study. Front Oncol 2022; 12:920211. [PMID: 36106098 PMCID: PMC9465318 DOI: 10.3389/fonc.2022.920211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
Women after mastectomy may decide to either have a breast reconstruction or use an external breast prosthesis. AIM The aim of the presented research was to evaluate the influence of external breast prosthesis on postural stability in women after mastectomy. METHODS AND PROCEDURES In the study 52 women after unilateral mastectomy took part. The study consisted of 4 parts: 1) anthropometric measurements; 2) measurements of upper limb circumference; 3) assessment of weight-bearing (WB); and 4) posturographic tests (PT). OUTCOMES AND RESULTS Differences in the arm circumferences on the amputated (A) and non-amputated (NA) sides did not confirm the occurrence of lymphedema in limb on amputated side. The results of the WB between the A and NA body sides in both tested conditions, i.e., with open and closed eyes, showed no significant differences between the test with and without an external prosthesis. No statistically differences have been observed between posturometric parameters with and without breast prosthesis during both PT. In comparing the posturometric parameters between the PT with open and closed eyes, the sway path of the center of pressure was statistically significantly longer when eyes were closed in both conditions, i.e., with and without breast prosthesis. CONCLUSION AND IMPLICATIONS The finding show that 1) external breast prosthesis does not have a significant influence on the symmetry of loading on the A and NA body sides and on the postural stability of women after unilateral mastectomy and 2) exclusion visual control during PT increases postural instability in women after unilateral mastectomy.
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Affiliation(s)
- Anna Koralewska
- Department of Developmental Age Physiotherapy, Medical University of Silesia, Katowice, Poland
| | | | | | - Andrzej Szopa
- Department of Physiotherapy, Medical University of Silesia, Katowice, Poland
- Neuromed, Rehabilitation and Medical Center, Katowice, Poland
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Anderson C, Olshan A, Bae-Jump V, Park J, Brewster W, Kent E, Nichols HB. Falls, walking or balance problems, and limitations in activities of daily living (ADLs) among older endometrial cancer survivors. Support Care Cancer 2022; 30:6339-6351. [PMID: 35477811 DOI: 10.1007/s00520-022-07087-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/21/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Functional status deficits are important quality of life concerns for older cancer survivors. We examined the prevalence of falls, walking/balance problems, and limitations in activities of daily living (ADLs) among older women with a history of endometrial cancer. METHODS Cancer registry records from the Surveillance, Epidemiology, and End Results (SEER) program linked with Medicare Health Outcomes Survey (MHOS) data were used to identify endometrial cancer survivors aged ≥ 65 years who completed a survey ≥ 1 year after their cancer diagnosis (N = 3766), as well as an age- and race-matched group of women without a cancer history (N = 3766). We estimated prevalence ratios (PRs) to compare the prevalence of falls, walking or balance problems, and limitations in ADLs (bathing, dressing, eating, getting in/out of chairs, walking, using the toilet) between groups. RESULTS Difficulty with walking or balance was more common among survivors than the noncancer group (43% vs 36%; PR = 1.19; 95% CI: 1.10-1.27). Fall prevalence was similar between groups (endometrial cancer: 25%; noncancer: 26%; PR = 0.98; 95% CI: 0.89-1.08). Nearly half of endometrial cancer survivors (47%) reported at least one ADL limitation, with several activities (getting in/out of a chair, walking, bathing, using the toilet) more often limited among survivors than among women without cancer. CONCLUSION Functional impairments, especially problems with walking and/or balance, are common among older endometrial cancer survivors. Our results highlight the importance of addressing functional problems during the ongoing survivorship care of women with a history of endometrial cancer, with referral to rehabilitation or other relevant services when indicated.
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Affiliation(s)
- Chelsea Anderson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599, USA.
| | - Andrew Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599, USA
| | - Victoria Bae-Jump
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA
| | - Jihye Park
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599, USA
| | - Wendy Brewster
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA
| | - Erin Kent
- Department of Health Policy and Management, University of North Carolina, Chapel Hill, NC, USA
| | - Hazel B Nichols
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599, USA
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ZABİT ÖZDEMİR F, İYİGÜN G. IS THERE A DIFFERENCE BETWEEN BREAST CANCER SURVIVOR WOMEN AND HEALTHY WOMEN IN TERMS OF BALANCE FUNCTIONS? TÜRK FIZYOTERAPI VE REHABILITASYON DERGISI 2022. [DOI: 10.21653/tjpr.1024868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose: Various physical problems and balance disorders are observed after mastectomy surgery in breast cancer survivors (BCSs). The study aimed to compare the balance functions in BCS women who had a mastectomy with healthy women.
Methods: Sixty-six individuals, BCSs (study group, n=33) and healthy (control group, n=33) women were included. Subjective balance problems and falling characteristics, static balance (Tandem Romberg Test-TRT) and, dynamic balance (Y Balance Test-YDT and computer-based dynamic balance platform-Technobody) were used in this study as outcome measures to compare the groups.
Results: The individuals in the study group (48.48%) experienced more balance problems than the control group (6.06%), but there was no difference between the two groups in terms of falling characteristics. Static balance (TRT) eyes-closed results were lower in the study group than the control group (t=-2.21, p=0.03), but there was no difference between the groups in TRT eyes-open results. There was no difference in any sub-parameter in dynamic balance measurements between the groups.
Conclusion: Subjective balance problems and static balance functions are affected more in BCSs than in healthy individuals. It is recommended that balance functions should be evaluated and followed up with appropriate treatment methods in BCS women who had a mastectomy.
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Riani Costa LA, F Barreto R, de Leandrini SMM, Gurgel ARB, de Sales GT, Voltarelli VA, de Castro G, Fenton SAM, Turner JE, Klausener C, Neves LM, Ugrinowitsch C, Farah JC, Forjaz CLDM, Brito CMM, Brum PC. The influence of a supervised group exercise intervention combined with active lifestyle recommendations on breast cancer survivors' health, physical functioning, and quality of life indices: study protocol for a randomized and controlled trial. Trials 2021; 22:934. [PMID: 34922621 PMCID: PMC8684206 DOI: 10.1186/s13063-021-05843-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 11/18/2021] [Indexed: 12/09/2022] Open
Abstract
Background Most cancer patients, under active treatment or not, are sedentary, despite increasing scientific and clinical understanding of the benefits of exercise and physical activity, such as improving quality of life, limiting disease symptoms, decreasing cancer recurrence, and increasing overall survival. Studies have shown that both supervised exercise and unsupervised physical activity programs have low adherence and limited long-term benefits among cancer survivors. Therefore, interventions focused on increasing physical activity levels have clinical and psychological relevance. The present study will examine the feasibility and efficacy of an intervention that combines supervised group exercise with active lifestyle recommendations, analyzing its clinical, psychological, physiological, functional, and immunological effects in breast cancer survivors. Methods Women aged 35–75 years who have completed chemotherapy, radiotherapy, and surgery for breast cancer will be recruited from the Cancer Institute of the State of Sao Paulo (ICESP) and take part in a 16-week, parallel-group, randomized, and controlled trial. They will receive a booklet with recommendations for achieving a physically active lifestyle by increasing overall daily movement and undertaking at least 150 min/week of structured exercise. Then, they will be randomized into two groups: the supervised group will take part in two canoeing group exercise sessions every week, and the unsupervised group will increase their overall physical activity level by any means, such as active commuting, daily activities, or home-based exercise. Primary outcome includes aerobic capacity. Secondary outcomes are physical activity, physical functioning, self-reported quality of life, fatigue, presence of lymphedema, body composition, immune function, adherence to physical activity guidelines, and perceptions of self-image. Discussion Results should contribute to advance knowledge on the impact of a supervised group exercise intervention to improve aspects related to health, physical functioning, and quality of life in female breast cancer survivors. Trial registration Brazilian Registry of Clinical Trials Number: RBR-3fw9xf. Retrospectively Registered on 27 December 2018. Items from the World Health Organization Trial Registration Data Set can be accessed on http://www.ensaiosclinicos.gov.br/rg/RBR-3fw9xf/. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05843-z.
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Affiliation(s)
- Luiz Augusto Riani Costa
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Raphael F Barreto
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Sarah Milani Moraes de Leandrini
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Aline Rachel Bezerra Gurgel
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Gabriel Toledo de Sales
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Vanessa Azevedo Voltarelli
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Gilberto de Castro
- Instituto do Cancer do Estado de Sao Paulo, ICESP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Sally A M Fenton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | | | - Christian Klausener
- Centro de Práticas Esportivas da Universidade de Sao Paulo (CEPEUSP), Sao Paulo, Brazil
| | - Lucas Melo Neves
- Master's Program in Health Sciences at Santo Amaro University - UNISA, Sao Paulo, Brazil.,Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo - USP, Sao Paulo, Brazil
| | - Carlos Ugrinowitsch
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Jose Carlos Farah
- Centro de Práticas Esportivas da Universidade de Sao Paulo (CEPEUSP), Sao Paulo, Brazil
| | - Cláudia Lúcia de Moraes Forjaz
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Christina May Moran Brito
- Instituto do Cancer do Estado de Sao Paulo, ICESP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Patricia Chakur Brum
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil. .,Departamento de Biodinamica do Movimento do Corpo Humano, Escola de Educação Física e Esporte da Universidade de São Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil.
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Overcash J, Riffle H, Sinnott L, Williams N. Self-Reported and Performance-Based Evaluations of Functional Status in Older Women With Breast Cancer. Oncol Nurs Forum 2021; 48:657-668. [PMID: 34673762 DOI: 10.1188/21.onf.657-668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To evaluate self-reported and performance-based functional status (FS) in older women with breast cancer according to stage and time of visit during treatment. SAMPLE & SETTING 72 women with breast cancer aged 78 years or older and receiving any type of treatment at a midwestern outpatient clinic. METHODS & VARIABLES FS was evaluated using grip strength, the Index of Activities of Daily Living (ADLs), the instrumental ADLs (IADLs) scale, and the Timed Up and Go Test (TUGT). Mixed models were fit for grip strength and the TUGT, and generalized estimating equations were used to fit binary logistic regressions for the Index of ADLs and the IADLs scale. Continuous FS outcomes were evaluated using means and standard deviations. RESULTS Cancer stage and time of visit did not affect self-reported or performance-based FS scores. Most participants were considered independent on the Index of ADLs, the IADLs scale, and the TUGT, which did not change significantly between visits. Self-reported measures revealed less impairment. IMPLICATIONS FOR NURSING Monitoring FS using self-reported and performance-based measures can ensure that older patients receive timely support.
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Blackwood J, Rybicki K. Assessment of Gait Speed and Timed Up and Go Measures as Predictors of Falls in Older Breast Cancer Survivors. Integr Cancer Ther 2021; 20:15347354211006462. [PMID: 33784836 PMCID: PMC8020039 DOI: 10.1177/15347354211006462] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Older breast cancer survivors are at an increased risk of loss of postural balance and accidental falls, however, the ability of clinical mobility measures to predict falls has not been determined. The purpose of this study was to examine the prognostic ability, sensitivity, and specificity to predict accidental falls in measures of gait speed and functional mobility in older breast cancer survivors. METHODS Thirty-four breast cancer survivors 65 years and older performed 3 measures of gait speed (GS) (usual, fast, dual-task) and Timed Up and Go (TUG) (TUG, TUG-Cognitive, TUG-Manual). Follow-up calls were made 3 months after testing to track falls. RESULTS The area under the curve (AUC) was below 0.5 for all GS measures, indicating poor predictive ability and all GS measures had low sensitivity and specificity to predict falls. All TUG measures had AUC values above 0.5. The cutoff score with the best sensitivity/specificity to predict falls was: TUG-Cognitive = 11.32 seconds, Sens = 0.64, Spec = 0.80; TUG-Manual = 9.84 seconds, Sens = 0.71, Spec = 0.65. CONCLUSION When assessing fall risk in older breast cancer survivors, performance on the TUG and TUG-Cognitive are able to predict falls.
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Abstract
PURPOSE The aim of the study was to examine the reliability, validity, and measurement error of balance confidence and fall-related self-efficacy measures in older breast cancer survivors. DESIGN A cross-sectional study was performed. METHODS The Activities-Specific Balance Confidence Scale (ABC), the shorter, six-item version of the ABC (ABC-6), and the Modified Falls Efficacy Scale (MFES) were completed by 35 older breast cancer survivors. Absolute reliability was examined with Cronbach's alpha, test-retest reliability with intraclass correlation coefficient, and Pearson's correlation coefficient for construct validity. FINDINGS Absolute reliability was good for the ABC. Test-retest reliability was good for the ABC and the ABC-6 and moderate for the MFES. Construct validity was present for all measures. CONCLUSIONS Breast cancer survivors' balance confidence measures should be assessed with either the ABC or the ABC-6, whereas falls self-efficacy should be examined with the MFES. CLINICAL RELEVANCE Nurses and other health professionals who treat breast cancer survivors should include assessing psychological factors associated with falls using the ABC, the ABC-6, or the MFES as low balance confidence or falls self-efficacy contribute to increased falls risk.
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