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Oncu H, Calik-Kutukcu E, Vardar Yagli N, Inal-Ince D, Saglam M, Unal F, Aksoy S. Reliability and validity of the 6-minute pegboard and ring test for functional exercise capacity in patients with breast cancer. Physiother Theory Pract 2024:1-13. [PMID: 38739486 DOI: 10.1080/09593985.2024.2353260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 05/05/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Chronic pain, sensory disturbances, and lymphedema are frequent after breast cancer, leading to arm dysfunction. There is a need for objective performance-based clinical exercise tests for the upper extremity in patients with breast cancer. OBJECTIVE The aim of this study was to evaluate the validity and reliability of the 6-minute pegboard and ring test (6PBRT) in breast cancer survivors. METHODS Forty-eight women with breast cancer (mean age = 55.40 ± 10.40 years) were included. All patients performed 6PBRT on the first day and one week later to investigate the test-retest reliability of the 6PBRT, and intraclass correlation coefficients (ICC) were calculated. The peak workload (Wpeak) and oxygen consumption level (VO2peak) during the arm ergometer test were used as outcomes for the criterion validity of the 6PBRT. RESULTS The 6PBRT showed good test - retest reliability with an ICC1,2 value of 0.871 [95% confidence interval (CI) 0.769-0.928]. The first 6PBRT score was very strongly correlated with the second test score (r = 0.866, p < .001). The 6PBRT score was significantly correlated with VO2peak (r = 0.634, p < .001), and Wpeak (r = 0.546, p < .001). While the 6PBRT score had less effect on VO2peak, the determination of VO2peak in the model was very good (R2 = 0.832). CONCLUSION The 6PBRT has good test-retest reliability and is a valid test in individuals with breast cancer. These findings suggest that 6PBRT is a practical, useful, valid and reliable assessment tool for determining functional arm exercise capacity in patients with breast cancer.
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Affiliation(s)
- Hacer Oncu
- Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ebru Calik-Kutukcu
- Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Naciye Vardar Yagli
- Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Deniz Inal-Ince
- Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Melda Saglam
- Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ferhat Unal
- Data Management Unit, Middle East Technical University, Ankara, Turkey
| | - Sercan Aksoy
- Institute of Oncology, Department of Medical Oncology, Hacettepe University, Ankara, Turkey
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Itakussu EY, Morita AA, Kakitsuka EE, Kuwahara RM, Anami EHT, Pitta F, Hernandes NA. The Brazilian-Portuguese version of the Upper Extremity Functional Index (UEFI): Translation, cross-cultural adaptation and measurement properties for Brazilian adults after a burn injury. Burns 2024; 50:219-225. [PMID: 37690965 DOI: 10.1016/j.burns.2023.08.015] [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: 08/25/2022] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES To translate, cross-culturally adapt, validate, verify the reliability and estimate the minimal detectable change (MDC) of the UEFI to Brazilian Portuguese (UEFI-Br) for burns. METHODS The study was carried out with 131 Brazilian burn cases at two time points, at discharge and at the first outpatient follow-up (15-21 days after discharge) in a Burn Treatment Center. The adaptation process of the UEFI was based on international recommendations. The Burn Specific Health Scale-Brief-Br (BSHS-B-Br) was also applied in order to analyze construct validity of the UEFI-Br and distribution-based methods were used to estimate its MDC. RESULTS Intra- and inter-rater reliability were good with ICC of 0.986 (CI 95 %: 0.98-0.99) and 0.969 (CI 95 %: 0.955-0.979), respectively, at discharge and 0.997 (CI 95 %: 0.996-0.998) and 0.987 (CI 95 %: 0.981-0.991), respectively, at the first outpatient follow-up appointment. We found good internal consistency with Cronbach's α values of 0.987 and 0.996, respectively, at the two times. The SEM was 4.42 and 2.31 at the first and second time points, respectively. The UEFI-Br scores demonstrated strong correlation with the Burn Specific Health Scale-Brief-Br (BSHS-B-Br) function domain scores (r = 0.87-0.90). No significant correlation was found between UEFI-Br scores and participants' characteristics. The MDC of the UEFI-Br lies between 11 and 13 points. CONCLUSION The Brazilian version of the UEFI-Br, a useful tool to assess upper limb function and disability, is a valid and reliable tool for use with Brazilian burn survivors. The MDC for the instrument was determined to be 11-13 points.
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Affiliation(s)
- Edna Yukimi Itakussu
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Paraná, Brazil; Burn Treatment Center, University Hospital of State University of Londrina (HU-UEL), Londrina, Paraná, Brazil.
| | - Andrea Akemi Morita
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Paraná, Brazil
| | - Emely Emi Kakitsuka
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Paraná, Brazil
| | - Reinaldo Minoru Kuwahara
- Burn Treatment Center, University Hospital of State University of Londrina (HU-UEL), Londrina, Paraná, Brazil
| | - Elza Hiromi Tokushima Anami
- Burn Treatment Center, University Hospital of State University of Londrina (HU-UEL), Londrina, Paraná, Brazil
| | - Fabio Pitta
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Paraná, Brazil
| | - Nidia Aparecida Hernandes
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Paraná, Brazil
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Lizio A, Greco L, Beretta M, Frisoni MC, Becchiati S, Casiraghi J, Sansone VA, Carraro E. The upper extremity functional index (UEFI): Italian validation in patients with Facioscapulohumeral muscular dystrophy. Disabil Rehabil 2023:1-7. [PMID: 37578105 DOI: 10.1080/09638288.2023.2245749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/15/2023]
Abstract
PURPOSE The aim of this study was to adapt the Upper Extremity Functional Index (UEFI) to an Italian population affected by Facioscapulohumeral muscular dystrophy (FSHD) by translating and validating this instrument in an Italian cohort. MATERIALS AND METHODS Five Italian FSHD patients were interviewed regarding the form and content of the translated instrument. Subsequently, fifty-two patients were recruited for the validation purpose by serially completing the UEFI-IT and a battery of clinical assessments and questionnaires. Finally, a subset of thirty-nine patients underwent test-retest reliability. RESULTS The Italian translation of the UEFI was highly relevant to patients, had a level of test-retest reliability from "good" to "excellent" (ICC = 0.90 with 95% confidence interval between 0.82 and 0.95), and a satisfactory internal consistency (Cronbach's alpha = 0.96). Participants confirmed the usefulness and clearness of the tool in cultural validity. In known group validity, the UEFI-IT was significantly lower in patients unable to walk (24.10 ± 11.33 vs 55.71 ± 13.98, p < .0001; AUC = 0.9631) and in patients with longer disease duration (43.43 ± 17.16 vs 58.14 ± 13.71, p = 0.0034; AUC = 0.7359). Finally, the concurrent validity showed strong associations between the UEFI-IT and motor assessments, pain perception, and quality-of-life evaluations. CONCLUSIONS Overall, the UEFI-IT is an appropriate, valid, and reliable outcome measure for Italian-speaking FSHD patients.
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Affiliation(s)
- Andrea Lizio
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
| | - Lucia Greco
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
- NeMO Lab, ASST Niguarda Cà Granda Hospital, Milan, Italy
| | - Maria Beretta
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
| | - Maria Chiara Frisoni
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
| | - Stefano Becchiati
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
| | - Jacopo Casiraghi
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
| | - Valeria Ada Sansone
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
- Neurorehabilitation Unit, University of Milan, Milan, Italy
| | - Elena Carraro
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
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Paraskevopoulos E, Plakoutsis G, Papandreou M. A Pilot Test of the Measures of the Greek Version of Upper Extremity Functional Index in Patients with Lateral Elbow Tendinopathy. Med Sci (Basel) 2023; 11:45. [PMID: 37489461 PMCID: PMC10366735 DOI: 10.3390/medsci11030045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/18/2023] [Accepted: 06/26/2023] [Indexed: 07/26/2023] Open
Abstract
Lateral elbow tendinopathy (LET) is a common upper limb pathology in people involved in manual occupations. The upper extremity functional index (UEFI) was specifically designed to evaluate functional limitations in patients with upper limb pathology. The UEFI was developed in English and has been translated into several languages, including Greek. However, it has been assessed only in patients with shoulder pathology. Thus, the aim of this study was to pilot-test the Greek version of the UEFI (GV-UEFI) questionnaire and assess its measurement properties in patients with LET. Thirty patients with LET were recruited and asked to fill in the GV-UEFI twice and the disabilities of arm, shoulder, and hand questionnaire (DASH) once. The internal consistency and test-retest reliability were examined using Cronbach's alpha and the intraclass correlation coefficient (ICC). The standard error of measurement (SEM) and the minimum detectable change (MDC) were calculated and possible ground or ceiling effects were also examined. Convergent validity was evaluated with the Greek DASH using Pearson's correlation. Lastly, the unidimensionality of the scale was examined through principal component analysis to verify construct validity. Internal consistency was high for the GV-UEFI (Cronbach's a = 0.98) and test-retest reliability was excellent (ICC = 0.98). The SEM was 2.95 and the MDC was 6.85. Test-retest reliability of each item was good (ICC > 0.87). The correlation analysis demonstrated a strong correlation between the GV-UEFI and the DASH. No floor or ceiling effects were found. Principal component analysis verified the construct validity and the unidimensionality of the scale. The GV-UEFI was successfully tested in patients with LET. It seems that the GV-UEFI can be used reliably in Greek-speaking patients with LET. However, the measurement properties of this scale should be examined in a larger sample of LET patients.
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Affiliation(s)
- Eleftherios Paraskevopoulos
- Department of Physiotherapy, University of West Attica, 12243 Athens, Greece
- Department of Physiotherapy, University of Peloponnese, 23100 Sparta, Greece
| | - George Plakoutsis
- Department of Physiotherapy, University of West Attica, 12243 Athens, Greece
| | - Maria Papandreou
- Department of Physiotherapy, University of West Attica, 12243 Athens, Greece
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Martín-Martín J, Pajares-Hachero B, Alba-Conejo E, Ribelles N, Cuesta-Vargas AI, Roldán-Jiménez C. Validation of the Upper Limb Functional Index on Breast Cancer Survivor. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4997. [PMID: 36981904 PMCID: PMC10049349 DOI: 10.3390/ijerph20064997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED Breast cancer survivors (BCS) may face functional alterations after surgical intervention. Upper Limb Disorders (ULDs) are highly prevalent even years after a diagnosis. Clinicians may assess the upper limbs after breast cancer. The Upper Limb Functional Index (ULFI) has been validated across different populations and languages. This study aimed to assess the psychometric properties of the Upper Limb Functional Index Spanish version (ULFI-Sp) in the BCS. METHODS A psychometric validation study of the ULFI-Sp was conducted on 216 voluntary breast cancer survivors. The psychometric properties were as follows: analysis of the factor structure by maximum likelihood extraction (MLE), internal consistency, and construct validity by confirmatory factor analysis (CFA). RESULTS The factor structure was one-dimensional. ULFI-Sp showed a high internal consistency for the total score (α = 0.916) and the regression score obtained from MLE (α = 0.996). CFA revealed a poor fit, and a new 14-item model (short version) was further tested. The developed short version of the ULFI-SP is preferable to assess upper limb function in Spanish BCS. CONCLUSIONS Given the high prevalence of ULD in this population and the broader versions of ULFI across different languages, this study's results may be transferred to clinical practice and integrated as part of upper limb assessment after breast cancer.
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Affiliation(s)
- Jaime Martín-Martín
- Legal and Forensic Medicine Area, Department of Human Anatomy, Legal Medicine and History of Science, Faculty of Medicine, University of Malaga, 29010 Málaga, Spain
- Grupo Clinimetría en Fisioterapia (F-14), Instituto de Investigación Biomédica de Málaga (IBIMA), 29590 Málaga, Spain
| | - Bella Pajares-Hachero
- UGCI Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29590 Málaga, Spain
| | - Emilio Alba-Conejo
- UGCI Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29590 Málaga, Spain
| | - Nuria Ribelles
- UGCI Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29590 Málaga, Spain
| | - Antonio I. Cuesta-Vargas
- Grupo Clinimetría en Fisioterapia (F-14), Instituto de Investigación Biomédica de Málaga (IBIMA), 29590 Málaga, Spain
- Department Physiotherapy, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
- School of Clinical Science, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Cristina Roldán-Jiménez
- Grupo Clinimetría en Fisioterapia (F-14), Instituto de Investigación Biomédica de Málaga (IBIMA), 29590 Málaga, Spain
- Department Physiotherapy, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
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Alnahdi AH. Responsiveness of the Arabic Upper Extremity Functional Index in Patients with Upper Extremity Musculoskeletal Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4370. [PMID: 36901380 PMCID: PMC10001837 DOI: 10.3390/ijerph20054370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to examine the ability of the Arabic Upper Extremity Functional Index (UEFI) to detect change over time in upper extremity function (responsiveness) in patients with upper extremity musculoskeletal disorders. Patients receiving physical therapy care for their upper extremity musculoskeletal disorders completed the Arabic UEFI; Disabilities of the Arm, Shoulder and Hand (DASH); Numeric Pain Rating Scale (NPRS); Global Assessment of Function (GAF); and the Global Rating of Change Scale (GRC) at the initial visit and later at a follow-up assessment. Responsiveness was examined by testing predefined hypotheses regarding the correlations between the change scores in the Arabic UEFI and the other measures. The Arabic UEFI change scores demonstrated a significant positive correlation with the change in the DASH (r = 0.94), GAF (r = 0.65), NPRS (r = 0.63), and GRC (r = 0.73), which was in line with the predefined hypotheses. The Arabic UEFI change scores demonstrated a pattern of correlation with changes in other outcome measures that are consistent with the argument that the Arabic UEFI change scores represent a change in upper extremity function. The responsiveness of the Arabic UEFI was supported, and its use to monitor changes in upper extremity function in patients with upper extremity musculoskeletal disorders was supported.
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Affiliation(s)
- Ali H Alnahdi
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
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Pan H, Ng SSM, Liu TW, Tsoh J, Wong TWL. Psychometric properties of the Chinese (Cantonese) version of the Upper Extremity Functional Index in people with chronic stroke. Front Neurol 2023; 14:989403. [PMID: 36908608 PMCID: PMC9998711 DOI: 10.3389/fneur.2023.989403] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 02/03/2023] [Indexed: 03/14/2023] Open
Abstract
Objective To culturally adapt and examine the psychometric properties of the Chinese (Cantonese) version of the Upper Extremity Functional Index (C-UEFI) in people with chronic stroke. Design Cross-sectional study. Settings University-affiliated neurorehabilitation research laboratory. Participants The participants (N = 151) were people with chronic stroke (N = 101) and healthy controls (n = 50). Main outcome measures We assessed the C-UEFI, Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Wolf Motor Function Test (WMFT), Six-Minute Walk Test (6MWT), Motor Activity Log (MAL), Activity-Specific Balance Confidence (ABC) scale, Lawton Instrumental Activities of Daily Living (IADL) scale, Survey of Activities and Fear of Falling in the Elderly (SAFFE), Stroke Impact Scale (SIS) and Community Integration Measure (CIM) as outcome measures. Results The C-UEFI items demonstrated good test-retest reliability (intraclass correlation coefficient [ICC]3, 1 = 0.872) and excellent internal consistency (Cronbach's α = 0.922). People with chronic stroke had poorer C-UEFI scores than the healthy controls. The overall C-UEFI mean score of 101 people with stroke was significantly correlated with the mean scores of the FMA-UE, WMFT, MAL, ABC scale, IADL scale, SAFFE, SIS and CIM and the distance covered in the 6MWT. The C-UEFI cut-off score to distinguish between people with chronic stroke and healthy older adults according to upper extremity function was 57.5 out of 59 (sensitivity: 88.1%; specificity: 84%). The C-UEFI had good content validity, with an acceptable fit to the two-factor structure model. Conclusions The C-UEFI is reliable and valid for assessing functional recovery of upper extremity activity in Chinese people with chronic stroke.
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Affiliation(s)
- Hong Pan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Tai Wa Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, Hong Kong SAR, China
| | - Joshua Tsoh
- Department of Psychiatry, Prince of Wales Hospital and Shatin Hospital, Hong Kong, Hong Kong SAR, China
| | - Thomson W L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
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Kahán Z, Szántó I, Dudás R, Kapitány Z, Molnár M, Koncz Z, Mailáth M. Breast Cancer Survivorship Programme: Follow-Up, Rehabilitation, Psychosocial Oncology Care. 1st Central-Eastern European Professional Consensus Statement on Breast Cancer. Pathol Oncol Res 2022; 28:1610391. [PMID: 35721327 PMCID: PMC9200958 DOI: 10.3389/pore.2022.1610391] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/29/2022] [Indexed: 02/04/2023]
Abstract
Follow-up includes ongoing contact with and health education of the patient, surveillance and control of the adverse effects of surgery, oncological therapies or radiotherapy, screening of metachronous cancers, and comprehensive (physical, psychological and social) patient rehabilitation, which may be enhanced by a healthy lifestyle. Primary attention should be paid to early detection and, when needed, curative treatment of local/regional tumour recurrences. Similarly, with the hope of curative solution, it is important to recognize the entity of a low-mass and relatively indolent recurrence or metastasis (oligometastasis); however, there is still no need to investigate distant metastases by routine diagnostic imaging or assess tumour markers. Below there is a list of possible sources of support, with respect to adjuvant hormone therapy continued during long-term care, social support resources, pivotal points and professional opportunities for physical and mental rehabilitation. Individual solutions for specific issues (breast cancer risk/genetic mutation, pregnancy) are provided by constantly widening options. Ideally, a complex breast cancer survivorship programme is practised by a specially trained expert supported by a cooperative team of oncologists, surgeons, breast radiologists, social workers, physiotherapists, psycho-oncologists and psychiatrists. The approach of follow-up should be comprehensive and holistic.
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Affiliation(s)
- Zsuzsanna Kahán
- Department of Oncotherapy, University of Szeged, Szeged, Hungary
| | - István Szántó
- St. George's General Teaching Hospital, Székesfehérvár, Hungary
| | - Rita Dudás
- Department of Oncotherapy, University of Szeged, Szeged, Hungary
| | | | - Mária Molnár
- Oncoradiology Centre, Bács-Kiskun County Hospital, Kecskemét, Hungary
| | - Zsuzsa Koncz
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Mónika Mailáth
- Institute of Oncology, University of Debrecen, Debrecen, Hungary
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Assessing the content based on ICF and quality based on COSMIN criteria of patient-reported outcome measures of functioning in breast cancer survivors: a systematic review. Breast Cancer 2022; 29:377-393. [PMID: 35233732 DOI: 10.1007/s12282-022-01340-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/03/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE To identify currently used patient-reported outcome measures (PROMs) to evaluate disability in breast cancer survivors (BC) and critically evaluate their content and measurement properties. METHODS Four electronic databases (PubMed, EMBASE, CINAHL, Scopus and Google Scholar) were searched from 2001 to February 2021. PRISMA guidelines were followed. The content of the included PROM was evaluated by linking the items of the questionnaires to the International Classification of Functioning, Disability and Health (ICF) Core Set for BC using standard linking rules. Methodological quality and measurement properties were assessed using the COSMIN checklist. Qualitative synthesis was used to summarize the evidence on content validity and measurement properties. The overall quality of evidence on each measurement property was provided using GRADE principles. RESULTS Ten eligible studies reported measurement properties of seven PROMs. The content of included PROMs mostly focused on disability (70% of items), and less on body function and structure (23%) or environmental factors (6%). There was high linkage to The Comprehensive Core Set for BC, Q-DASH (100%), UEFI (95%) and DASH (92%). The Core Set Unique Disability Representation for DASH, and WHODAS2 was 39% and BCSQ-BC, Lymph-ICF was 34%. BCSQ-BC, and Lymph-ICF represented 32, and 20% of the content of the Core Set for BC, respectively, however, the other questionnaires covered less than 20% of the content of the Core Set. High quality of evidence supports sufficient results for internal consistency, testretest, and measurement error for BCSQ-BC, Lymph-ICF, DASH and WHODAS2. CONCLUSIONS Despite a lack of evidence on all-important clinical measurement, two generic (DASH and WHODAS2) and two disease-specific (BCSQ-BC, Lymph-ICF) PROM demonstrated emerging evidence of adequate measurement properties. The stronger alignment of the BCSQ-BC to the breast cancer ICF core set makes it preferable is a disease-specific measure. The Lymph-ICF is recommended where lymphedema is a specific focus. The DASH and WHODAS2 might be most useful where patients with a variety of upper extremity conditions, including breast cancer survivors, are being evaluated in the clinic or research study.
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The Upper Extremity Functional Index: Reliability and Validity in Patients with Chronic Obstructive Pulmonary Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010608. [PMID: 34682352 PMCID: PMC8535980 DOI: 10.3390/ijerph182010608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/03/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022]
Abstract
The aim of the current study was to examine the psychometric properties of the upper extremity functional index (UEFI) in patients with chronic obstructive pulmonary disease (COPD). Seventy patients with stable COPD completed the UEFI and St. George Respiratory Questionnaire (SGRQ) and performed lung function tests in the first testing session. They completed the UEFI and the Global Rating of Change Scale in the second session, which was within ten days of the first session. The UEFI floor and ceiling effects, internal consistency, test–retest reliability, measurement error, and construct validity were examined. The UEFI was found to have no floor and ceiling effects. The UEFI was also found to have an excellent internal consistency (Cronbach’s alpha = 0.955) and an excellent test–retest reliability (ICC2,1 = 0.91). Totals of 4.85 points and 11.32 points represent the scale’s standard error of measurement, and a minimal detectable change at 90% confidence was used. The UEFI scores showed a significant correlation with the SGRQ activity domain (r = −0.66, p < 0.001) and differed significantly between participants with severe disease and those with mild disease (p = 0.03). The UEFI had no floor or ceiling issues, an excellent internal consistency, a good test–retest reliability, and an acceptable measurement error. The UEFI also demonstrated evidence supporting its construct validity as a measure of upper extremity-related activity limitations in patients with COPD.
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Aljathlani MF, Alshammari MO, Alsuwaygh MA, Al-Mutairi MS, Aljassir FF, Bindawas SM, Alnahdi AH. Cross-cultural adaptation and validation of the Arabic version of the upper extremity functional index. Disabil Rehabil 2021; 44:5656-5662. [PMID: 34227453 DOI: 10.1080/09638288.2021.1947396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study was to translate and cross-culturally adapt the UEFI into Modern Standard Arabic language and to examine its psychometric properties among patients with upper extremity musculoskeletal disorders. MATERIALS AND METHODS Translation and cross-cultural adaptation were done following Beaton's guidelines. Internal consistency, test-retest reliability, measurement error and floor and ceiling effects for the Arabic UEFI were tested among 109 patients with upper extremity musculoskeletal disorders. Construct validity of the Arabic UEFI was also examined. RESULTS Translation and cross-cultural adaptation processes were generally smooth with no major issues. The Arabic UEFI was considered appropriate and comprehensible by the participants. Internal consistency for Arabic UEFI was adequate (Cronbach's alpha = 0.96). Test-retest reliability for Arabic UEFI was excellent with ICC2,1=0.92. Measurement error was acceptable with a standard error of measurement of 5.5 and minimal detectable change of 12.8 points. Arabic UEFI shows no floor or ceiling effects. The results supported the majority of the construct validity predefined hypotheses (78%) supporting the construct validity of Arabic UEFI as a measure of upper extremity function. CONCLUSION The Arabic UEFI is an appropriate, valid and reliable outcome measure for Arabic-speaking patients with upper extremity musculoskeletal disorders.Implication for Rehabilitation:The Arabic UEFI is an acceptable, clear and comprehensible outcome measure.The Arabic UEFI has excellent internal consistency, test-retest reliability, and acceptable measurement error with no floor and ceiling effects.The Arabic UEFI is a valid measure of upper extremity activity limitation.
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Affiliation(s)
- Mohamed F Aljathlani
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Majed O Alshammari
- Department of Rehabilitation, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Mashael A Alsuwaygh
- Department of Rehabilitation, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | | | - Fawzi F Aljassir
- Department of Orthopaedics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saad M Bindawas
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ali H Alnahdi
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Luz CMD, Prim AC, Deitos J, Heck APF, Recchia TL, Mayer AF. Reliability and validity of the Upper Limb Functional Test (ULIFT) for women after breast cancer surgery. Disabil Rehabil 2021; 44:4096-4103. [PMID: 33749472 DOI: 10.1080/09638288.2021.1897885] [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: 10/21/2022]
Abstract
PURPOSE To evaluate the reliability and convergent validity of the Upper Limb Functional Test (ULIFT) in women after breast cancer surgery. MATERIALS AND METHODS A cross-sectional study with 25 women (mean age 50 ± 7.3 years) with breast cancer submitted to a surgery intervention within a minimum period of three years. Intraclass correlation coefficients (ICCs) were calculated to assess the test-retest reliability. A Bland-Altman plot examined the agreement between the times to complete two tests. Validity was established by correlating the ULIFT and DASH total score. The receiver operating characteristic (ROC) curve was used to determine the cut-off point for ULIFT in order to discriminate patients with some level of upper limb dysfunction. RESULTS The ULIFT showed high reproducibility (ICC = 0.89; p < 0.001), learning effect of 7.21%, and a moderate correlation with the DASH total score (r = 0.536; R2 = 0.28; p = 0.006). The standard error of measurement was 6.9 s and the smallest real difference was 19.1 s. The ROC curve indicated a cut-off point of 109.2 s (sensitivity = 68.7%; specificity = 77.8%; area under ROC curve = 0.77). CONCLUSIONS The ULIFT could be a valid and reliable test to assess upper limb functionality in patients submitted to breast cancer surgery.Implications for rehabilitationThe ULIFT is a reliable and valid test to assess upper limb function in women after breast cancer surgery, considering specifically the lifting and range of motion construct of unilateral upper limb function.The ULIFT could help identify those most at risk of developing upper limb dysfunction after breast cancer surgery and could benefit the follow-up of a postoperative rehabilitation program.Two ULIFTs should be performed in order to achieve patient's best performance.
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Affiliation(s)
- Clarissa Medeiros da Luz
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil
| | - Amably Cristiny Prim
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil
| | - Julia Deitos
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil
| | - Ailime Perito Feiber Heck
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil
| | - Thaís Lunardi Recchia
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil
| | - Anamaria Fleig Mayer
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil
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Lang AE, Kim SY, Dickerson CR, Milosavljevic S. Measurement of objective shoulder function following breast cancer surgery: a scoping review. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1851439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Angelica E. Lang
- School of Rehabilitation Sciences, University of Saskatchewan, Saskatoon, Canada
| | - Soo Y. Kim
- School of Rehabilitation Sciences, University of Saskatchewan, Saskatoon, Canada
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Meeting the Rehabilitation and Support Needs of Patients With Breast Cancer During COVID-19: Opening New Frontiers in Models of Care. REHABILITATION ONCOLOGY 2020. [DOI: 10.1097/01.reo.0000000000000237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lam KC, Marshall AN, Snyder Valier AR. Patient-Reported Outcome Measures in Sports Medicine: A Concise Resource for Clinicians and Researchers. J Athl Train 2020; 55:390-408. [PMID: 32031883 DOI: 10.4085/1062-6050-171-19] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Despite the importance of assessing patient outcomes during patient care, current evidence suggests relatively limited use of patient-reported outcome measures (PROMs) by athletic trainers (ATs). Major barriers to PROM use include lack of knowledge, navigating the intricate process of assessing a wide variety of PROMs, and selecting the most appropriate PROM to use for care. A concise resource for ATs to consult when selecting and implementing PROMs may help facilitate the use of PROMs in athletic health care. OBJECTIVE To review the instrument essentials and clinical utility of PROMs used by ATs. METHODS We studied 11 lower extremity region-specific, 10 upper extremity region-specific, 6 generic, and 3 single-item PROMs based on the endorsement of at least 10% of ATs who use PROMs, as reported in a recent investigation of PROM use in athletic training. A literature search was conducted for each included PROM that focused on identifying and extracting components of the instrument essentials (ie, instrument development, reliability, validity, responsiveness and interpretability, and precision) and clinical utility (ie, acceptability, feasibility, and appropriateness). Through independent review and group consensus, we also classified each PROM question by International Classification of Functioning, Disability and Health domain and health-related quality-of-life dimensions. KEY FINDINGS The PROMs contained in this report generally possessed appropriate instrument essentials and clinical utility. Moreover, the PROMs generally emphasized body structure and function as well as the physical functioning of the patient. Athletic trainers aiming to assess patients via a whole-person approach may benefit from combining different PROMs for use in patient care to ensure broader attention to disablement health domains and health-related quality-of-life dimensions.
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Affiliation(s)
| | - Ashley N Marshall
- Dr Marshall is now in the Department of Health and Exercise Science, Appalachian State University, Boone, NC
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Tan C, Wilson CM. Clinical Outcomes After Physical Therapy Treatment for Secondary Lymphedema After Breast Cancer. Cureus 2019; 11:e4779. [PMID: 31367497 PMCID: PMC6666846 DOI: 10.7759/cureus.4779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Breast cancer is the most commonly diagnosed cancer in women and approximately 33% of survivors will develop lymphedema. Untreated lymphedema may be limb threatening or cause substantial functional limitations. The purpose of this case report is to detail the physical therapy (PT) management and outcomes for a patient with right upper extremity and breast lymphedema. The goal of this case report is to provide rehabilitation clinicians with an example of effective treatment management and the underlying treatment rationale. A 64-year-old female with stage 2A breast cancer underwent neoadjuvant chemotherapy, a lumpectomy with 18 lymph nodes removed, and radiation therapy. She subsequently developed secondary lymphedema of the right breast and upper extremity. Physical therapy interventions included instruction on a complete decongestive therapy program, which consists of manual lymphatic drainage and compression bandaging and exercises to improve shoulder range of motion (ROM), posture, and strength. As a result of PT, her right shoulder ROM and anthropometric measurements improved and the patient achieved independence with self-lymphatic massage and compression bandaging techniques to maintain these gains. This case report is unique as it details the clinical decision making required during a complex course of cancer care that necessitated adjustments to the PT plan of care for sustainable outcomes.
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Affiliation(s)
- Cynthia Tan
- Physical Therapy, Beaumont Health, Royal Oak, USA
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