Abstract：
OBJECTIVE: To evaluate the impact and acceptability of outpatient physical or occupational therapy (PT/OT) for breast cancer survivors (BCS) with varying levels of upper extremity disability (UED).
METHODS: We retrospectively extracted patient and therapy characteristics, UED measured by quick-disabilities of the arm, shoulder and hand (QuickDASH, 0-100 pts.), and patient-rated acceptability (1-item, 0-10 pts) from rehabilitation charts of BCS who completed cancer-specialized PT/OT provided by a single national institution in 2019. We summarized characteristics and acceptability using descriptive statistics, then used established parameters to group BCS by baseline UED severity: high- (QuickDASH > 31.5), moderate- (QuickDASH = 18.5-31.5), or low-UED (QuickDASH = 13-18.5). To evaluate within-group pre-to-post QuickDASH change, we used paired samples t test (p < 0.01), then calculated the proportion who achieved the minimally clinical important difference (MCID, 15.9 points). To compare between-groups difference in QuickDASH improvement, we used Kruskal-Wallis test and Chi-squared test.
RESULTS: Patients (N = 417) were 59.89 ± 12.06 years old, 99% female, and attended approximately 10 PT/OT sessions (IQR = 6.0-16.0). Most had high baseline UED (62%), followed by moderate (25%) or low UED (13%). For each severity group, mean pre-to-post change in QuickDASH was significant: high-UED (M∆ = 25.13 ± 20.33, d = 1.24, p < 0.01), moderate-UED (M∆ = 11.36 ± 11.9, d = 0.95, p < 0.01), and low-UED (M∆ = 4.84 ± 9.15, d = 0.53, p < 0.01). Most with high UED achieved the MCID (n = 176, 68.2%). In the moderate- and low-UED groups 44% (n = 46) and 4% (n = 2) achieved the MCID, respectively. Acceptability was high (n = 167, Median = 10).
CONCLUSIONS: Outpatient cancer rehabilitation is associated with significant improvement in UED for BCS and was acceptable to patients regardless of UED severity at baseline.
METHODS: We retrospectively extracted patient and therapy characteristics, UED measured by quick-disabilities of the arm, shoulder and hand (QuickDASH, 0-100 pts.), and patient-rated acceptability (1-item, 0-10 pts) from rehabilitation charts of BCS who completed cancer-specialized PT/OT provided by a single national institution in 2019. We summarized characteristics and acceptability using descriptive statistics, then used established parameters to group BCS by baseline UED severity: high- (QuickDASH > 31.5), moderate- (QuickDASH = 18.5-31.5), or low-UED (QuickDASH = 13-18.5). To evaluate within-group pre-to-post QuickDASH change, we used paired samples t test (p < 0.01), then calculated the proportion who achieved the minimally clinical important difference (MCID, 15.9 points). To compare between-groups difference in QuickDASH improvement, we used Kruskal-Wallis test and Chi-squared test.
RESULTS: Patients (N = 417) were 59.89 ± 12.06 years old, 99% female, and attended approximately 10 PT/OT sessions (IQR = 6.0-16.0). Most had high baseline UED (62%), followed by moderate (25%) or low UED (13%). For each severity group, mean pre-to-post change in QuickDASH was significant: high-UED (M∆ = 25.13 ± 20.33, d = 1.24, p < 0.01), moderate-UED (M∆ = 11.36 ± 11.9, d = 0.95, p < 0.01), and low-UED (M∆ = 4.84 ± 9.15, d = 0.53, p < 0.01). Most with high UED achieved the MCID (n = 176, 68.2%). In the moderate- and low-UED groups 44% (n = 46) and 4% (n = 2) achieved the MCID, respectively. Acceptability was high (n = 167, Median = 10).
CONCLUSIONS: Outpatient cancer rehabilitation is associated with significant improvement in UED for BCS and was acceptable to patients regardless of UED severity at baseline.
摘要：
目的：评估门诊物理或职业治疗（PT/OT）对上肢残疾（UED）程度不同的乳腺癌幸存者（BCS）的影响和可接受性。
方法：我们回顾性提取了患者和治疗特征，UED通过手臂的快速残疾来衡量，肩膀和手(QuickDASH,0-100分。),和患者评级的可接受性(1-项目，0-10分）来自BCS的康复图，这些BCS在2019年完成了由单个国家机构提供的癌症专用PT/OT。我们使用描述性统计数据总结了特征和可接受性，然后使用已建立的参数按基线UED严重性对BCS进行分组：高（QuickDASH>31.5），中间-（QuickDASH=18.5-31.5），或低UED（QuickDASH=13-18.5）。要评估组内pre-to-postQuickDASH更改，我们使用配对样本t检验(p<0.01)，然后计算实现最小临床重要差异的比例(MCID，15.9分)。要比较QuickDASH改进的组间差异，我们使用了Kruskal-Wallis检验和卡方检验。
结果：患者（N=417）年龄为59.89±12.06岁，99%是女性，并参加了大约10次PT/OT会议（IQR=6.0-16.0）。大多数人具有高基线UED（62％），其次是中度（25%）或低UED（13%）。对于每个严重性组，QuickDASH的平均前后变化显着：高UED（MΔ=25.13±20.33，d=1.24，p<0.01），中度-UED(MΔ=11.36±11.9，d=0.95，p<0.01)，和低UED(MΔ=4.84±9.15，d=0.53，p<0.01)。大多数具有高UED的人获得了MCID(n=176，68.2%)。在中度和低度UED组中，44％（n=46）和4％（n=2）达到了MCID，分别。可接受性高（n=167，中位数=10）。
结论：门诊癌症康复与BCS的UED明显改善相关，无论基线时UED严重程度如何，患者均可接受。
方法：我们回顾性提取了患者和治疗特征，UED通过手臂的快速残疾来衡量，肩膀和手(QuickDASH,0-100分。),和患者评级的可接受性(1-项目，0-10分）来自BCS的康复图，这些BCS在2019年完成了由单个国家机构提供的癌症专用PT/OT。我们使用描述性统计数据总结了特征和可接受性，然后使用已建立的参数按基线UED严重性对BCS进行分组：高（QuickDASH>31.5），中间-（QuickDASH=18.5-31.5），或低UED（QuickDASH=13-18.5）。要评估组内pre-to-postQuickDASH更改，我们使用配对样本t检验(p<0.01)，然后计算实现最小临床重要差异的比例(MCID，15.9分)。要比较QuickDASH改进的组间差异，我们使用了Kruskal-Wallis检验和卡方检验。
结果：患者（N=417）年龄为59.89±12.06岁，99%是女性，并参加了大约10次PT/OT会议（IQR=6.0-16.0）。大多数人具有高基线UED（62％），其次是中度（25%）或低UED（13%）。对于每个严重性组，QuickDASH的平均前后变化显着：高UED（MΔ=25.13±20.33，d=1.24，p<0.01），中度-UED(MΔ=11.36±11.9，d=0.95，p<0.01)，和低UED(MΔ=4.84±9.15，d=0.53，p<0.01)。大多数具有高UED的人获得了MCID(n=176，68.2%)。在中度和低度UED组中，44％（n=46）和4％（n=2）达到了MCID，分别。可接受性高（n=167，中位数=10）。
结论：门诊癌症康复与BCS的UED明显改善相关，无论基线时UED严重程度如何，患者均可接受。
