Validation of the Upper Limb Functional Index on Breast Cancer Survivor

Int J Environ Res Public Health. 2023 Mar 12;20(6):4997. doi: 10.3390/ijerph20064997.

Abstract

Breast cancer survivors (BCS) may face functional alterations after surgical intervention. Upper Limb Disorders (ULDs) are highly prevalent even years after a diagnosis. Clinicians may assess the upper limbs after breast cancer. The Upper Limb Functional Index (ULFI) has been validated across different populations and languages. This study aimed to assess the psychometric properties of the Upper Limb Functional Index Spanish version (ULFI-Sp) in the BCS.

Methods: A psychometric validation study of the ULFI-Sp was conducted on 216 voluntary breast cancer survivors. The psychometric properties were as follows: analysis of the factor structure by maximum likelihood extraction (MLE), internal consistency, and construct validity by confirmatory factor analysis (CFA).

Results: The factor structure was one-dimensional. ULFI-Sp showed a high internal consistency for the total score (α = 0.916) and the regression score obtained from MLE (α = 0.996). CFA revealed a poor fit, and a new 14-item model (short version) was further tested. The developed short version of the ULFI-SP is preferable to assess upper limb function in Spanish BCS.

Conclusions: Given the high prevalence of ULD in this population and the broader versions of ULFI across different languages, this study's results may be transferred to clinical practice and integrated as part of upper limb assessment after breast cancer.

Keywords: breast cancer; functional assessment; patient-reported outcome; psychometrics; upper extremity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Neoplasms*
  • Cancer Survivors*
  • Disability Evaluation
  • Female
  • Humans
  • Musculoskeletal Diseases* / diagnosis
  • Psychometrics
  • Reproducibility of Results
  • Surveys and Questionnaires
  • Upper Extremity

Grants and funding

Contract N° PS16060 partially funded this research project in IBIMA between Novartis–IBIMA (translation research in cancer B-01 and Clinimetric F-14). This consisted of a payment for the author, CRJ, as a physical therapist in the assessment. There is no other relationship with Novartis as a partial funder apart from defraying employment expenses, and there are no patents, products in development, or marketed products relationships to declare according to the definition of financial competing interests.