Effects of Lymphedema Severity on Quality of Life, Upper Limb Function, and Physical Activity Level in Patients with Breast Cancer Treatment-related Lymphedema

Year 2019, Volume: 24 Issue: 3, 189 - 198, 24.10.2019

Ceren Orhan Serap Özgül , Gülbala Nakip , Emine Baran , Esra Üzelpasacı Gamze Nalan Çinar Sercan Aksoy Türkan Akbayrak

https://doi.org/10.21673/anadoluklin.554019

Cited By: 3

Abstract

Aim: The aim of the present study was to
compare the quality of life, the functional status of upper extremity, and physical
activity level among women with mild, moderate, or severe breast cancer
treatment related lymphedema.

Materials
and Methods: Eighty-three women with a diagnosis of lymphedema (24%
mild, 41% moderate, and 35% severe) participated in the present study. The presence
and severity of lymphedema were evaluated by circumferential measurement. The
Turkish versions of the Lymphedema Quality of Life (LYMQOL), Quick Disability
of Arm, Shoulder and Hand (DASH), International Physical Activity
Questionnaire-Short Form (IPAQ-SF) were used to assess quality of life, the
functional status of upper extremity, and physical activity level, respectively.

Results: There were
significant differences in quality
of life and functional status of upper extremity among patients with mild, moderate,
and severe lymphedema (p<0.05). However,
there was no significant difference in physical activity level among the three
groups (p>0.05). Based on the
findings of pairwise analyses, function, appearance, and symptom subscales of quality
of life and the functional status of upper extremity was found to be more
influenced in patients with severe lymphedema than those with mild lymphedema (p<0.016). The significant, but weak
associations between lymphedema severity and the LYMQOL function, and
appearance, and symptom subscales, and the DASH score were found (p≤0.01).

Discussion and
Conclusion: It was found that quality of life and the functional status of upper
extremity were more influenced in patients with severe lymphedema than those in
patients with mild lymphedema. These results indicate that quality of life and
upper extremity functionality may be affected when lymphoedema progress from
mild to severe in patients undergoing breast cancer surgery. Therefore, it is
important to determine and treat lymphedema in the early stages in order to
prevent or reduce this influence.

Keywords

breast cancer, lymphedema, upper extremity, quality of life, function, physical activity

Meme Kanseri Tedavisiyle İlişkili Lenfödemi Olan Hastalarda Lenfödem Şiddetinin Yaşam Kalitesi, Üst Ekstremite Fonksiyonu ve Fiziksel Aktivite Düzeyi Üzerindeki Etkileri

Abstract

Amaç: Bu çalışmanın amacı, meme kanseri
tedavisi ile ilişkili hafif, orta ve şiddetli lenfödemi olan hasta grupları
arasında yaşam kalitesi, üst ekstremitenin fonksiyonel durumu ve fiziksel
aktivite düzeyindeki karşılaştırmaktı.

Gereç ve Yöntemler: Bu çalışmaya, meme
kanseri tedavisi ile ilişkili lenfödem tanısı olan 83 kadın (% 24 hafif, % 41
orta, % 35 şiddetli) katıldı. Lenfödemin varlığı ve şiddeti çevre ölçümü ile
belirlendi. Lenfödem Yaşam Kalite Ölçeği (LYKÖ), Kol, Omuz ve El Sorunları Anketi’nin
kısa versiyonu (DASH) ve Uluslararası Fiziksel Aktivite Anketi’nin kısa formu (UFAA-KF),
sırasıyla yaşam kalitesi, üst ekstremitenin fonksiyonel durumu ve fiziksel
aktivite düzeyinin değerlendirilmesi için kullanıldı.

Bulgular: Hafif,
orta ve şiddetli lenfödemi olan hastalar arasında yaşam kalitesi ve üst
ekstremitenin fonksiyonel durumu açısından istatistiksel olarak anlamlı fark
vardı (p<0.05). Ancak, fiziksel
aktivite düzeyinden üç grup arasında anlamlı fark yoktu (p>0.05). İkili analizlerin sonuçlarına göre, şiddetli lenfödemi
olan hastalarda, yaşam kalitesinin fonksiyon, görünüm ve semptom alt
alanlarının ve üst ekstremitenin fonksiyonel durumunun hafif derecede lenfödemi
olan hastalara göre daha fazla etkilendiği bulundu (p<0.016). Lenfödem şiddeti ile LYKÖ fonksiyon, görünüm ve
semptom alt alanları ve DASH arasında istatistiksel olarak anlamlı ancak zayıf
bir ilişki bulundu (p≤0.01).

Tartışma ve Sonuç: Şiddetli
lenfödemi olan hastalarda yaşam kalitesinin ve üst ekstremitenin fonksiyonel
durumunun hafif lenfödemi olan hastalara göre daha fazla etkilendiği bulundu.
Bu sonuçlar, meme kanseri cerrahisi geçiren bireylerde lenfödem hafif düzeyden
ileri düzeye geçtiğinde yaşam kalitesi ve üst ekstremite fonksiyonelliğinin etkilenebileceğini
göstermektedir. Dolayısıyla bu etkilenimi önlemek veya azaltmak için lenfödemin
erken dönemde belirlenmesi ve tedavi edilmesi önemlidir.

Keywords

meme kanseri, lenfödem, üst ekstremite, yaşam kalitesi, fonksiyon, fiziksel aktivite

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