Bolette S Rafn1, Stanley Hung1, Alison M Hoens1, Margaret L McNeely2, Chiara A Singh3, Winkle Kwan4, Carol Dingee5, Elaine C McKevitt5, Urve Kuusk5, Jinsi Pao5, Nancy Van Laeken5, Charlie H Goldsmith6,7, Kristin L Campbell1. 1. 1 Department of Physical Therapy, The University of British Columbia, Vancouver, BC, Canada. 2. 2 Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada. 3. 3 Fraser Health Authority, Surrey, BC, Canada. 4. 4 Fraser Valley Centre, BC Cancer Agency, Vancouver, BC, Canada. 5. 5 Department of Surgery, The University of British Columbia, Vancouver, BC, Canada. 6. 6 Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada. 7. 7 Department of Occupational Science & Occupational Therapy, The University of British Columbia, Vancouver, BC, Canada.
Abstract
OBJECTIVE: To evaluate prospective surveillance and targeted physiotherapy (PSTP) compared to education (EDU) on the prevalence of arm morbidity and describe the associated program cost. DESIGN: Pilot randomized single-blinded controlled trial. SETTING: Urban with assessments and treatment delivered in hospitals. PARTICIPANTS: Women scheduled for breast cancer surgery. INTERVENTIONS: Participants were randomly assigned (1:1) to PSTP ( n = 21) or EDU ( n = 20) and assessed presurgery and 12 months postsurgery. All participants received usual care, namely, preoperative education and provision of an education booklet with postsurgical exercises. The PSTP group was monitored for arm morbidity every three months and referred for physiotherapy if arm morbidity was identified. The EDU group received three education sessions on nutrition, stress and fatigue management. MAIN OUTCOME MEASURES: Arm morbidity was based on changes in the surgical arm(s) from presurgery in four domains: (1) shoulder range of motion, (2) strength, (3) volume, and (4) upper body function. Complex arm morbidity indicated ≥2 domains impaired. Second, the cost of the PSTP program was described. RESULTS: At 12 months, 18 (49%) participants (10 PSTP and 8 EDU) had arm morbidity, with EDU participants presenting more complex arm morbidity compared to PSTP participants. PSTP participants attended 4.4 of 5 assessments with 90% retention. The PSTP program cost was $150 covered by the Health Care Provider and the Patient Out-of-Pocket Travel cost was CAN$40. CONCLUSION: Our results suggest that PSTP is feasible among women with breast cancer for early identification of arm morbidity. A larger study is needed to determine the cost and effectiveness benefits.
RCT Entities:
OBJECTIVE: To evaluate prospective surveillance and targeted physiotherapy (PSTP) compared to education (EDU) on the prevalence of arm morbidity and describe the associated program cost. DESIGN: Pilot randomized single-blinded controlled trial. SETTING: Urban with assessments and treatment delivered in hospitals. PARTICIPANTS: Women scheduled for breast cancer surgery. INTERVENTIONS:Participants were randomly assigned (1:1) to PSTP ( n = 21) or EDU ( n = 20) and assessed presurgery and 12 months postsurgery. All participants received usual care, namely, preoperative education and provision of an education booklet with postsurgical exercises. The PSTP group was monitored for arm morbidity every three months and referred for physiotherapy if arm morbidity was identified. The EDU group received three education sessions on nutrition, stress and fatigue management. MAIN OUTCOME MEASURES: Arm morbidity was based on changes in the surgical arm(s) from presurgery in four domains: (1) shoulder range of motion, (2) strength, (3) volume, and (4) upper body function. Complex arm morbidity indicated ≥2 domains impaired. Second, the cost of the PSTP program was described. RESULTS: At 12 months, 18 (49%) participants (10 PSTP and 8 EDU) had arm morbidity, with EDU participants presenting more complex arm morbidity compared to PSTPparticipants. PSTPparticipants attended 4.4 of 5 assessments with 90% retention. The PSTP program cost was $150 covered by the Health Care Provider and the Patient Out-of-Pocket Travel cost was CAN$40. CONCLUSION: Our results suggest that PSTP is feasible among women with breast cancer for early identification of arm morbidity. A larger study is needed to determine the cost and effectiveness benefits.
Entities:
Keywords:
Breast cancer; arm morbidity; physiotherapy; rehabilitation; surveillance model
Authors: Nicole L Stout; Justin C Brown; Anna L Schwartz; Timothy F Marshall; Anna M Campbell; Larissa Nekhlyudov; David S Zucker; Karen M Basen-Engquist; Grace Campbell; Jeffrey Meyerhardt; Andrea L Cheville; Kelley R Covington; Jennifer A Ligibel; Jonas M Sokolof; Kathryn H Schmitz; Catherine M Alfano Journal: Cancer Date: 2020-03-25 Impact factor: 6.860
Authors: Silvia Beatríz García-González; María Raquel Huerta-Franco; Israel Miguel-Andrés; José de Jesús Mayagoitia-Vázquez; Miguel León-Rodríguez; Karla Barrera-Beltrán; Gilberto Espinoza-Macías Journal: Healthcare (Basel) Date: 2022-04-11