Physiotherapists’ experiences of managing upper limb movement impairments due to breast cancer treatment

ABSTRACT

Background: Physiotherapy is recommended for upper limb movement impairments (ULMI) following breast cancer treatment. There is limited research into the pathophysiology and management of ULMI. Care is provided in different health-care contexts by specialist and nonspecialist physiotherapists, with referrals set to increase. This study explores physiotherapists’ experiences of managing ULMI. Design: Qualitative study using a hermeneutic phenomenological approach. Method: We interviewed six physiotherapists from various UK treatment settings. The data were analyzed using interpretative phenomenological analysis. Findings: Four master themes were identified: (1) lack of confidence surrounds various aspects of practice, influenced by limited evidence to guide treatment of ULMI, fear of causing harm, and working in a less-established area of physiotherapy; (2) increasing confidence in practice develops with experience, reinforcing perceptions of the benefits of physiotherapy; (3) physiotherapy is understood to empower and enable patients to regain their sense of self and quality of life; and (4) provision of care is perceived to be subject to many barriers. Conclusion: Physiotherapy for ULMI has professional challenges but is seen as beneficial, encompassing psychosocial and physical effects. Experiences in this area of practice suggest a need for increased professional support, further research to guide treatment, and better patient and health professional awareness of ULMI and the role of physiotherapy.

KEYWORDS:

• Physiotherapy
• breast cancer
• upper limb
• qualitative research
• hermeneutic phenomenology

Acknowledgments

The authors would like to thank the physiotherapists who generously gave up their time for the interviews, the Association of Chartered Physiotherapists in Oncology and Palliative Care, and Chartered Society of Physiotherapy for advertising the study and East Sussex Healthcare NHS Trust for supporting the application to the NIHR trainee program.

Declaration of interest

The authors report no conflict of interest.

Additional information

Funding

This work was supported by the Research Trainees Coordinating Centre National Institute for Health Research, UK [CAT-MASTERS-2012-05].