Implementing the Prospective Surveillance Model (PSM) of Rehabilitation for Breast Cancer Patients with 1-Year Postoperative Follow-up, a Prospective, Observational Study
| Autor: | Stephanie Kirkpatrick, Lisa Lai, Amanjyot Sidhu, Winifred Wilkins Thompson, Veronica Jones, Cathy Furbish, Joel Okoli, Derrick J. Beech, Paul W. Stratford, Sheryl G. A. Gabram, Clara R. Farley, Jill M. Binkley |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Breast surgery Pain Breast Neoplasms Mastectomy Segmental Upper Extremity 03 medical and health sciences Postoperative Complications 0302 clinical medicine Breast cancer Patient Education as Topic Intervention (counseling) medicine Humans Prospective Studies 030212 general & internal medicine Range of Motion Articular Prospective cohort study Pain Measurement Univariate analysis Rehabilitation Sentinel Lymph Node Biopsy business.industry Middle Aged Models Theoretical medicine.disease Exercise Therapy Oncology Population Surveillance 030220 oncology & carcinogenesis Axilla Physical therapy Lymph Node Excision Female Surgery Observational study business Mastectomy Follow-Up Studies |
| Zdroj: | Annals of Surgical Oncology. 23:3379-3384 |
| ISSN: | 1534-4681 1068-9265 |
| DOI: | 10.1245/s10434-016-5315-z |
| Popis: | The Prospective Surveillance Model (PSM) of rehabilitation for patients with breast cancer aims for early identification, treatment, and support of physical impairments postoperatively. The purpose of this study was to describe the incidence of impairments during the first postoperative year and the differences between the patients requiring rehabilitation intervention versus those not requiring intervention. A total of 120 patients were enrolled. Impairment measures included: pain, range of motion, and self-reported measures of function using the Upper Extremity Functional Index (UEFI) and Quick Disability of the Arm, Shoulder and Hand (QuickDASH) questionnaires. These measures were performed at designated intervals during the first postoperative year. All patients received exercise and education, and patients with identified impairments underwent individualized rehabilitation intervention. Clinical factors associated with need for intervention were determined using univariate analysis. Thirty-six patients required rehabilitation intervention. There were no statistically significant differences between intervention and no-intervention groups for body mass index, breast surgery type, reconstruction type, or radiotherapy. Statistically significant differences were found between intervention and no-intervention groups in early postoperative UEFI, QuickDASH, pain scores, age, number of lymph nodes removed [9.3 (intervention) vs. 5.6 (no-intervention)], axillary surgery type, chemotherapy, and breast cancer stage. Survivorship practitioners should have heightened awareness for rehabilitation intervention in patients with greater axillary surgery and burden of disease. Patients with more activity restriction and lower levels of function in the early postoperative period may benefit from rehabilitation intervention. Future studies should focus on implementing a screening tool to identify patients in need of rehabilitation referral. |
| Databáze: | OpenAIRE |
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