Frequency and Severity of Self-Reported Upper Extremity Impairments, Activity Limitations, and Participation Restrictions Following Breast Cancer Treatment

Abstract

Objective: Upper quarter impairments, activity limitations, and participation restrictions have been commonly reported in breast cancer survivors. However, use of a standardized tool to assess the frequency and severity of these problems has not been performed. Therefore, we sought to identify the type and severity of upper limb problems following breast cancer treatment, and the impact of those impairments on self-reported participation in daily activities. Methods: 76 participants completed a survey regarding their cancer treatment and any upper extremity complaints during that time. If they reported current problems with the affected arm, they were asked to complete the Disabilities of the Shoulder Arm and Hand (DASH) Outcome Measure. Results: 96% of respondents indicated upper extremity problems related to cancer treatment, most commonly: arm weakness (59%), lymphedema (53%), pain (52%), stiffness (21%), and frozen shoulder (20%). Of those reporting problems, only 33% received physical therapy intervention. Mean DASH score was 24 (SD = 18), indicating mild to moderate disability. Conclusion: Problems in the upper extremity are common following breast cancer treatment. Some of these problems, even if rated as mildly disabling, are long-lasting and lead to self-reported activity limitations and participation restrictions. Few women with these complaints received physical therapy intervention.