A comparison of the upper limb lift test between women with breast cancer and healthy control subjects

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Methods: One hundred and forty-three BC (53.1 ± 11.7 years with a body mass index of 26.7 ± 6.1 kg/m3 ) completed the Flip test pre-operatively and at 1-3 months and 12+ months post-operatively. Fifty-two healthy control participants (HC) (51.4 ± 13.6 years with a body mass index of 26.3 ± 5.7 kg/m3 ) were tested using the Flip test during a single visit. The Flip test was measured by a physical therapist. Shoulder impairment (+ Flip test) at baseline, 1–3 months, and 12+ months was analyzed using a repeated measures analysis of variance, group by time. Results: Baseline characteristics of age and body mass index were not significantly different between groups (p > 0.05). At baseline, the right Flip test was positive in 21% HC (n = 11) and 40% BC (n = 57) (p = 0.091); the left Flip test was positive in 4% (n = 2) HC and 33% (n = 47) BC (p = 0.001). At the 1-3 month and 12+ months post-operative times compared to HC, the right Flip test for BC was positive in 24% (n = 13, p = 0.517) and 29% (n = 9, p = 0.225), respectively; the left Flip test was positive in 31% (n = 16, p = 0.003) and 26% (n = 8, p = 0.019), respectively. Left side Flip test results at baseline, 1–3 months, and 12+ months post-operatively, were significantly different for the BC as compared to the HC. Conclusion(s): The Flip test on the left was positive in a significantly higher number of women with BC than HC. These findings suggest that shoulder impairment among this group may be greater than that seen in a sample of HC. Implications: Women diagnosed with BC should be screened for shoulder impairment. Using the Scapular Flip test may be able to identify women with BC who would benefit from rehabilitation for shoulder impairment. Keywords: Shoulder impairment; Scapular dyskinesis; Upper limb Funding acknowledgements: Funding was provided by the National Institutes of Health (NIH) and Walter Reed National Military Medical Center (WRNMMC). Ethics approval: This study was an NIH and WRMMC IRB approved trial, and informed consent was obtained from all participants. http://dx.doi.org/10.1016/j.physio.2015.03.2129

Research Report Poster Presentation Number: RR-PO-14-23-Mon Monday 4 May 2015 12:15 Exhibit halls 401–403 A COMPARISON OF THE UPPER LIMB LIFT TEST BETWEEN WOMEN WITH BREAST CANCER AND HEALTHY CONTROL SUBJECTS M. Fisher 1 , L. Pfalzer 2 , E. Levy 3 , S. Harrington 4 , L. Gerber 5 , N. Stout 6 1 University

of Dayton, Department of Physical Therapy, Dayton, USA; 2 University of Michigan-Flint, Physical Therapy Department, Flint, USA; 3 Walter Reed National Military Medical Center, Breast Care Center, Bethesda, USA; 4 Creighton University, Department of Physical Therapy, Omaha, USA; 5 George Mason University, Fairfax, USA; 6 National Institutes of Health, Rehabilitation Medicine Department, Bethesda, USA Background: Objective measures of upper limb (UL) function specific to breast cancer survivors (BC) are limited. Motion, strength, and muscular endurance are measurable components of UL function. A clinical test that quantifies these components is needed. Purpose: This study compares the Upper Limb Lift Test (ULLT) between women with BC and healthy control subjects (HC) at baseline, 1–3 months, and 12+ months postoperatively enrolled in a prospective surveillance trial with early intervention. A secondary purpose was to validate the ULLT by comparing findings to self-reported UL function, symptom distress, and shoulder motion in a group of women with BC and healthy control subjects. Methods: One hundred sixty BC (53.1 ± 11.7 years with a body mass index of 26.7 ± 6.1 kg/m3 ) completed ULLT and self-reports of UL function, symptom distress, and shoulder motion pre-operatively and at 1-3 months and 2 months post-operatively. Fifty-nine HC subjects (51.4 ± 13.6 years with a body mass index of 26.3 ± 5.7 kg/m3 ) completed the same measures during a single visit. Each subject completed ULLT on each limb (right = RULLT and left = LULLT). The ULLT is a series of repeated shoulder elevations against resistance, moving a dumbbell anthropometrically scaled to the participant weight from a scaled height. Perceived exertion (RPE) using BORG20 was measured post ULLT. Descriptive statistics of all variables including repetitions and PE were calculated for group by time using SPSS ver21. A repeated measures analysis of variance was used to compare HC to BC over time. The ULLT and shoulder flexion, abduction, internal and external rotation motion were measured by a clinician. Subjects completed the following questionnaires: Disabilities of the Arm, Shoulder, and Hand-Quick (Quick DASH), SF-36 and Symptom Distress questionnaire. Women with BC completed the questionnaires at baseline, 1-3 months

WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS833–eS1237

and 12 months post-operatively, and were compared to HC at one time point. Results: At baseline the mean (SD) repetitions lifted were 17 ± 5 and for RULLT and LULLT for BC and 15 ± 6 for RULLT and LULLT for HC respectively. Differences between number of repetitions completed for both RULLT, LULLT were significant between HC and BC groups (p = 0.003) at baseline. There were no significant difference at 1-3 months and 12+ months between RULLT and LULLT with the mean (SD) for BC was 16 ± 7 and 16 ± 6 for the RULLT respectively, and 15 ± 7 and 16 ± 6 for the LULLT respectively. RPE averaged 12.4 ± 2.9 for all BC. No significant differences in RPE were found between groups at 1–3 months, however, RPE at 12+ months was significantly lower at 12+ months in the BC (p = 0.034). Conclusion(s): The ULLT repetitions were significantly lower in HC compared to BC at baseline for both UL. This suggests that women with BC hadequate lifting capacity at time of cancer diagnosis. There was no significant difference at 1–3 months or 12+ months post-operatively indicating the prospective surveillance and early intervention was effective in improving upper limb lifting capacity. Implications: The ULLT provides an objective measure of UL function (motion, strength, and muscular endurance) which can be used throughout BC treatment to identify if impairments exist and guide rehabilitation strategies. Keywords: Breast cancer; Muscle endurance; Muscle strength Funding acknowledgements: Funding was provided by the National Institutes of Health (NIH) and Walter Reed Military Medical Center (WRMMC). Ethics approval: This study was an NIH and WRMMC IRB approved trial, and informed consent was obtained from all participants. http://dx.doi.org/10.1016/j.physio.2015.03.2130

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Research Report Poster Presentation Number: RR-PO-08-07-Mon Monday 4 May 2015 12:15 Exhibit halls 401–403 PILOT TESTING OF THE GUIDELINE FOR REPORTING OF EVIDENCE-BASED PRACTICE EDUCATIONAL INTERVENTIONS AND TEACHING (GREET) A. Phillips 1 , L.K. Lewis 2 , M.P. McEvoy 3 , J. Galipeau 4 , P. Glasziou 5 , D. Moher 6,7 , J.K. Tilson 8 , M.T. Williams 9,10 1 University

of South Australia, Health Science, Adelaide, Australia; 2 University of South Australia, Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, School of Health Sciences, Adelaide, Australia; 3 University of South Australia, International Centre for Allied Health Evidence (iCAHE), Adelaide, Australia; 4 The Ottawa Hospital Research Institute, Centre for Practice-Changing Research (CPRC), Ontario, Canada; 5 Bond University, Centre for Research in Evidence-Based Practice (CREBP), Robina, Australia; 6 The Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ontario, Canada; 7 Centre for Practice-Changing Research (CPCR), Ontario, Canada; 8 University of Southern California, Division of Biokinesiology and Physical Therapy, Los Angeles, USA; 9 University of South Australia, School of Population Health, Adelaide, Australia; 10 Nutritional Physiology Research Centre (NPRC), Adelaide, Australia Background: The importance of evidence-based practice (EBP) is well recognised in the education of health professionals. Despite a growing number of published educational interventions for EBP, several systematic reviews have been unable to determine best practice for EBP education. Contributing to the difficulty is the inconsistent reporting of interventions. While there are reporting guidelines for study designs, there are few to describe interventions and none for the reporting of educational interventions for EBP. To address this issue, the Guideline for Reporting Evidence-based practice Educational interventions and Teaching (GREET) was developed. Purpose: To determine the usability (wording, layout and ease of use) of the GREET checklist and the accompanying explanation and elaboration (E&E) paper. Methods: This pilot study used a cross-sectional, descriptive design. The GREET checklist is comprised of 17 items arising from a systematic review and Delphi consensus survey. The E&E paper was developed to enhance the use and understanding of the GREET checklist. Tertiary health professional students with and without prior exposure to EBP education or reporting guidelines were invited to use the GREET checklist and E&E paper to review a research study