Abstract
Öncü H. Evaluation of the Reliability and Validity of the '6 Minute Pegboard and Ring Test' Unsupported Arm Function Exercise Test in Patients with Breast Cancer, Hacettepe University, Graduate School of Health Sciences, Cardiopulmonary Rehabilitation Program, Master Thesis, Ankara, 2022. Breast cancer is the most common type of cancer among women. Despite the increase in survival rates after breast cancer with the development of treatment opportunities in recent years, there are many side effects that reduce the quality of life and limit activities of daily living. Upper extremity functional limitations are one of the most common activity limitations in patients with breast cancer. The 6 minute pegboard and ring test (6PBRT) is a test that evaluates upper extremity functional capacity. The aim of this study was to investigate the validity and reliability of the 6PBRT in patients with breast cancer. Forty-eight patients with breast cancer (mean age=55.40 ±10.40 years) were included in the study. The demographic and physical characteristics and medical history of the individuals were recorded. Anthropometric evaluation of the upper extremity was done by length measurement. Evaluation of lymphedema was done by circumference measurement. Functional Impairment Test-Hand, and Neck/Shoulder/Arm (FIT-HaNSA) test was performed for upper extremity endurance assessment. Grip strength was measured with a hand dynamometer. Pain threshold was evaluated with an algometer. Upper extremity functional arm exercise capacity was evaluated with 6PBRT. Maximal arm exercise capacity was evaluated with the arm ergometer test. Upper extremity functionality of the patients was evaluated with the Quick Disabilities of the Arm, Shoulder and Hand Questionnare (Q-DASH-T). For the reliability of 6PBRT, the test was repeated at 30 min intervals under the same conditions. Peak workload (W) and oxygen consumption level (VO2) reached during arm ergometer test and Q-DASH-T score were determined as criteria method for the validity of the 6PBRT. To determine test-retest reliability, Bland-Altman analysis, ICC and 95% confidence Intervals (CI) were analyzed. There was a statistically significant, very strong positive correlation between the first and the second 6PBRT scores (r=0,866, p<0,001) as a result of the study. The ICC value for 6PBRT was 0,782 (95% CI=0,334-0,910). The standard error of measurement (SEM) was 17,39 and the minimal detectable change (MDC) was 48,06. According to the Bland-Altman analysis, the repeatable lower and upper limits of 6PBRT were -55,51 and -21,89 rings, respectively. There was a strong, statistically significant relationship in the positive direction peak VO2 (r=0,649, p=<0,001) and peak workload (W) (r=0,601, p=<0,001) on the arm ergometer with the 6PBRT score. There was a moderately strong, statistically significant negative correlation between the 6PBRT score and the Quick-DASH-T score (r=-0,466, p=0,003). This study showed that the 6PBRT has good test-retest reliability and is a valid test in patients with breast cancer. These results support that 6PBRT is a practical, useful, valid and reliable assessment tool in the evaluation of arm exercise capacity in patients with breast cancer.
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