Reliability and validity of the Upper Limb Functional Test (ULIFT) for women after breast cancer surgery

Abstract

Purpose

To evaluate the reliability and convergent validity of the Upper Limb Functional Test (ULIFT) in women after breast cancer surgery.

Materials and methods

A cross-sectional study with 25 women (mean age 50 ± 7.3 years) with breast cancer submitted to a surgery intervention within a minimum period of three years. Intraclass correlation coefficients (ICCs) were calculated to assess the test–retest reliability. A Bland–Altman plot examined the agreement between the times to complete two tests. Validity was established by correlating the ULIFT and DASH total score. The receiver operating characteristic (ROC) curve was used to determine the cut-off point for ULIFT in order to discriminate patients with some level of upper limb dysfunction.

Results

The ULIFT showed high reproducibility (ICC = 0.89; p < 0.001), learning effect of 7.21%, and a moderate correlation with the DASH total score (r = 0.536; R² = 0.28; p = 0.006). The standard error of measurement was 6.9 s and the smallest real difference was 19.1 s. The ROC curve indicated a cut-off point of 109.2 s (sensitivity = 68.7%; specificity = 77.8%; area under ROC curve = 0.77).

Conclusions

The ULIFT could be a valid and reliable test to assess upper limb functionality in patients submitted to breast cancer surgery.

Implications for rehabilitation

• The ULIFT is a reliable and valid test to assess upper limb function in women after breast cancer surgery, considering specifically the lifting and range of motion construct of unilateral upper limb function.

• The ULIFT could help identify those most at risk of developing upper limb dysfunction after breast cancer surgery and could benefit the follow-up of a postoperative rehabilitation program.

• Two ULIFTs should be performed in order to achieve patient’s best performance.

Keywords:

• Physical functional performance
• mastectomy
• rehabilitation
• reproducibility of results
• upper extremity

Acknowledgements

The authors would like to acknowledge Dr. Guilherme Silva Nunes and Dr. Manuela Karloh for their support during the statistical analysis and review of the final version.

Ethical approval

The Human Research Ethics Committee of Santa Catarina State University and of Carmela Dutra Maternity Hospital approved this study (approval number CAAE 39722314.70000.0118). All participants gave written informed consent before data collection began. URL to check ethical registration: http://plataformabrasil.saude.gov.br/login.jsf “Confirmar aprovação pelo CAAE”.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Educational Program for Health Work/Health Vigilance (PET-VS) − 2013/2015, from Ministry of Education of Brazil, destined to promote education, services and research.