Variables associated with upper extremity dysfunction in women with persistent upper extremity pain and myofascial dysfunctions at long term after breast cancer surgery: a cross-sectional study

Abstract

Objectives: The objective of this cross-sectional research is to determine the possible variables which are associated with upper extremity dysfunction after breast cancer surgery. Participants: Forty-three women who underwent breast cancer surgery, with a mean length of time since surgery of 3.34 years, were tested at the University Hospitals Leuven. Patients were included if they had persistent upper extremity pain, with a visual analogue scale (VAS) score of more than 40 out of 100 during the last week and if they also had myofascial dysfunctions in the upper body region. Measurements: All participants completed the Disabilities of Arm, Shoulder and Hand questionnaire (DASH), the pain catastrophizing scale (PCS) and the pain vigilance and awareness questionnaire (PVAQ). Percentage lymphedema (perimetry), weekly maximum VAS and range of humerothoracic abduction and scapulothoracic upward rotation were also measured. To answer the research question, bi-variable analyses and a stepwise regression analysis were used. Results: Through stepwise regression analysis only weekly maximum VAS (p=0.0273) and PCS (p= 0.0272) were found to have a significant influence on dysfunction measured by the DASH (R²= 32.45%). Patients with a higher score on the VAS and/or PCS experienced a higher level of upper extremity dysfunction. Conclusion: Only pain intensity and pain catastrophizing seem to have a significant influence on dysfunction, whereas kinematics do not seem to associate with dysfunction.