Self-reported Upper Extremity Function, Active Range Of Motion And Shoulder Isometric Strength In Breast Cancer Survivors

Abstract

Post-surgical rehabilitation from mastectomy in breast cancer patients may be challenged by compromised range of motion range of motion and functional strength associated with disuse. The PENN Shoulder Scale (PSS) and the Disability of the Arm, Shoulder and Hand (DASH) questionnaires have been developed to assess and quantify self-reported upper limb impairment. PURPOSE: To examine the associations between self-reported upper extremity function reported with DASH and PSS, with active range of motion (AROM) and isometric strength (IS) of surgically affected limb in breast cancer survivors (BCS). METHODS: Thirty-one (52.4±9.4 years) BCS were recruited from LA County Hospital and Norris Comprehensive Cancer Center at USC as a part of a larger ongoing exercise study. Investigators measured AROM of the surgically affected limb, completed during external rotation (ER) at 90° abduction and shoulder forward flexion (SFF) using a standard goniometer. Scapular elevation (SE) and external rotation (ER) IS was measured using a hand-held dynamometer (Hoggan Health Industries) on the participants’ surgically affected arm. Participants then completed DASH and PSS questionnaires. Pearson correlations were used to determine associations between DASH, PSS, and AROM and IS. RESULTS: Mean PSS and DASH scores (±SD) were reported as 72.8±19.8 (out of 100 points) and 18.9±15.9 (out of 100 points). No statistically significant relationship was detected between PSS scores and AROM (ER, p=0.14, r=−0.26; SFF, p=0.08, r=−0.30) or IS(ER, p=0.46, r=−0.12; SE, p=0.39, r=−0.15). Pearson correlations revealed no statistically significant association between DASH scores and AROM (ER, p=0.28, r=0.17; SFF, p=0.50, r=0.10) or IS(ER, p=0.60, r=0.13; SE, p=0.76, r=−0.05). CONCLUSION: The PSS and DASH assessments of shoulder disability were not related to AROM or IS in BCS. These self-reported assessment tools may not be appropriate for predicting upper body strength or range of motion in BCS.