Research Interests:
Research Interests:
Research Interests:
Cancer-related fatigue (CRF) is the most common side effect of cancer treatment. Regular surveillance is recommended, but few clinical practice guidelines transparently assess study bias, quality, and clinical utility in deriving... more
Cancer-related fatigue (CRF) is the most common side effect of cancer treatment. Regular surveillance is recommended, but few clinical practice guidelines transparently assess study bias, quality, and clinical utility in deriving recommendations of screening and assessment methods. The purpose of this clinical practice guideline (CPG) is to provide recommendations for the screening and assessment of CRF for health care professions treating individuals with cancer. Following best practices for development of a CPG using the Appraisal of Guidelines for Research and Evaluation (AGREE) Statement and Emergency Care Research Institute (ECRI) Guidelines Trust Scorecard, this CPG included a systematic search of the literature, quality assessment of included evidence, and stakeholder input from diverse health care fields to derive the final CPG. Ten screening and 15 assessment tools supported by 114 articles were reviewed. One screen (European Organisation for Research and Treatment of Canc...
Research Interests:
Research Interests:
Research Interests:
Research Objectives Women treated for breast cancer report ongoing disability in their involved upper extremity, however, often objective measures do not appear to explain the level of perceived dysfunction. The purpose of this study was... more
Research Objectives Women treated for breast cancer report ongoing disability in their involved upper extremity, however, often objective measures do not appear to explain the level of perceived dysfunction. The purpose of this study was to investigate the relationship between perceived stress levels, fear of physical activity and self-reported upper extremity function among women treated for breast cancer. Participants 25 women with a mean age of 52 year (range 31-68) diagnosed with Stage 1-3 breast cancer between 12 and 60 months prior to data collection completed 3 patient-reported outcome scales in a single visit. Data were analyzed with Pearson’s correlation r to determine if there was a relationship between self-reported upper extremity function and/or perceived stress level and fear of physical activity. Main Outcome Measure(s) Disabilities of the Arm, Shoulder and Hand (DASH), a 30-item self-report scale of upper extremity function; Perceived Stress Scale (PSS), a 10-item self-report scale of stress in the past month; and Fear of Physical Activity/Exercise Scale - Breast Cancer (FPAX-B), a 17-item self-report scale concerning participation in physical activity for breast cancer survivors. Results: There was a significant relationship between the DASH and both the PSS , r=.074, p (one-tailed) Conclusions: Results of the study suggest that there is a significant positive relationship between the DASH and both the PSS and FPAX-B among women treated for breast cancer. Perceived stress and fear of physical activity may be impacting self-reported upper extremity functional abilities.https://encompass.eku.edu/swps_facultygallery/1034/thumbnail.jp
Research Interests:
Learning objectives: The participant will be able to: Identify relationships between fear of physical activity and self-reported measures among women with breast cancer. Develop an understanding of the importance of personal factors for... more
Learning objectives: The participant will be able to: Identify relationships between fear of physical activity and self-reported measures among women with breast cancer. Develop an understanding of the importance of personal factors for full functional recovery among women treated for breast cancer. Background/Purpose: Women with breast cancer (WBC) report decreased function and quality of life (QOL) as well as increased anxiety and fear of physical activity (PA) following cancer treatment. This study explored the relationships between fear of PA and self-reported arm function, QOL, perceived stress, and objective measures of range of motion (ROM), strength, and muscular endurance in WBC. Methods: Data from two observational studies were combined for analysis. Women diagnosed with stage 0-3 breast cancer 6-60 months prior to enrollment participated; WBC were excluded with metastatic disease, shoulder pathology, or history of shoulder/neck surgery. Self-reported function was measured with the Disabilities of the Arm, Shoulder, and Hand (DASH; n=24) or the Penn Shoulder Score (PENN; n=30). To combine self-reported shoulder function into one score, DASH and PENN scores were combined by inverting DASH scores, lower=better, to higher=better. Additional variables included FACT-B QOL, Perceived Stress Scale (PSS), Canadian Occupational Performance Measure (COPM), bilateral flexion, external and internal rotation ROM and strength, and muscular endurance. Independent samples t-tests evaluated differences in fear of PA among WBC who received physical therapy (yes/no); had axillary node dissection (yes/no); and limb involved (dominant/non-dominant). Relationships between fear of PA and all variables were explored using Pearson’s correlations. Significance was set ≤0.05 a priori. Results: Mean age and BMI of the 54 participants were 55 (SD12.36) and 28.56 (SD5.87). Mean DASH was 17.7 points (SD15); PENN score was 84.15 points (SD4.8); the combined self-reported function score was 83.67 points (SD10.6). No differences were found among the groups for fear of PA (p\u3e0.05). Fear of PA was significantly correlated to DASH (p Conclusions: Fear of PA was associated with self-reported function, QOL, and perceived stress in this population of WBC, while objective measures were not. These findings suggest that personal factors play a significant role in functional recovery. Clinical Relevance: Rehabilitation professionals must address personal factors to ensure complete and successful functional recovery among WBC
Research Interests:
Research Interests:
Research Interests:
Date Presented 04/05/19 This study provides support for client-centered perceived function evaluation tools compared to nonindividualized physical function assessment to assess breast cancer survivors' function. The COPM detected 30... more
Date Presented 04/05/19 This study provides support for client-centered perceived function evaluation tools compared to nonindividualized physical function assessment to assess breast cancer survivors' function. The COPM detected 30 to 39% perceived impairment (PI) in self-care, 40 to 44% PI in productive activities, and 40 to 47% PI in leisure activities. The DASH detected approximately 8% more physical function impairments and symptoms than the general population (17.8 vs 10.1). Primary Author and Speaker: Anne Fleischer Additional Authors and Speakers: Mary Fisher, Laurie Bunger
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Background Cancer rehabilitation research has accelerated over the last decade. However, closer examination of the published literature reveals that the majority of this work has focused on psychological interventions and cognitive and... more
Background Cancer rehabilitation research has accelerated over the last decade. However, closer examination of the published literature reveals that the majority of this work has focused on psychological interventions and cognitive and behavioral therapies. Recent initiatives have aggregated expert consensus around research priorities, highlighting a dearth in research regarding measurement of and interventions for physical function. Increasingly loud calls for the need to address the myriad of physical functional impairments that develop in people living with and beyond cancer have been published in the literature. A detailed survey of the landscape of published research has not been reported to our knowledge. Purpose This scoping review systematically identified literature published between 2008 and 2018 related to the screening, assessment, and interventions associated with physical function in people living with and beyond cancer. Data Sources PubMed and CINAHL were searched up ...
Research Interests:
Research Interests:
Research Interests:
Breast cancer is one of the most frequently diagnosed cancers among women. Breast cancer treatments often nega-tively impact the function of the arm, and quality of life and upper extremity function does not always return to a... more
Breast cancer is one of the most frequently diagnosed cancers among women. Breast cancer treatments often nega-tively impact the function of the arm, and quality of life and upper extremity function does not always return to a predi-agnosis level. Survivors of breast cancer may also experience feelings of diminished self-efficacy related to functional defi-cits resulting from their physical limitations. The International Classification of Functioning (ICF) provides a framework for rehabilitation practitioners to address physical and psycho-logical impairments, activity limitations, and participation restrictions. Patient outcomes may be improved by fostering self-efficacy through empowerment. This paper explores how the ICF model and theories of self-efficacy and empowerment can interact to promote improved rehabilitation outcomes for women who have survived breast cancer. A model for the role of rehabilitation practitioners to enhance self-efficacy through empowerment in order to m...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Physical therapy (PT) and occupational therapy (OT) professional associations assert the importance that entry-level therapists learn and apply the knowledge and skills necessary for interprofessional collaborative practice; however, the... more
Physical therapy (PT) and occupational therapy (OT) professional associations assert the importance that entry-level therapists learn and apply the knowledge and skills necessary for interprofessional collaborative practice; however, the majority of PT and OT programs do not have the other discipline at their university. A challenge exists for the creation of a transparent active learning opportunity promoting interprofessional student engagement when the two professions do not reside in the same university. This case study provides a model for how to feasibly create an interprofessional experience for students in universities that do not include a complementary or collaborative allied health professional program, using various technologies. While creating this collaborative project, we provided opportunities to meet the Interprofessional Education Collaborative's (IPEC) competencies: a) value/ethics for interprofessional practice, b) roles and responsibilities, c) interprofessi...
Research Interests:
Research Interests:
Background Breast cancer treatments often result in upper extremity functional limitations in both the short and long term. Current evidence makes comparisons against a baseline or contralateral limb, but does not consider changes in... more
Background Breast cancer treatments often result in upper extremity functional limitations in both the short and long term. Current evidence makes comparisons against a baseline or contralateral limb, but does not consider changes in function associated with aging. Objective The objective of this study was to compare upper extremity function between women treated for breast cancer more than 12 months in the past and women without cancer. Design This was an observational cross-sectional study. Methods Women who were diagnosed with breast cancer and had a mean post–surgical treatment time of 51 months (range = 12–336 months) were compared with women who did not have breast cancer (CTRL group). Self-reported upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and shoulder range of motion, strength, and muscular endurance were measured. Participants were divided into 3 groups: breast cancer involving the nondominant limb (BC-ND), breast can...