Study Show Breast Cancer Survivors May Be at Increase Risk for Falls

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Survivors of breast cancer treatment may be at an increased risk for falls according to a new study.

Kerri Winters-Stone, PhD and colleagues from Oregon Health & Science University in Portland study findings were published online March 3, 2011 in the Archives of Physical Medicine and Rehabilitation.

Their findings showed 58% of breast cancer survivors (BCS) had experienced a fall in the previous year, with half reporting they fell more than once.

The study was designed to try to identify factors associated with falls in postmenopausal BCS including neuromuscular, balance, and vision factors. In particular, looking for any links between fall risk factors and cancer treatment.

The small study looked at 59 postmenopausal BCS who had finished chemotherapy within the past 2 years or were on an adjuvant endocrine therapy. The average age of the participants was 58 years old.

The study’s objective measures were postural control, vision, and neuromuscular function. These were assessed by a sensory organization test (SOT), a visual assessment battery, muscle mass by dual energy x-ray absorptiometry, and neuromuscular function with strength by repetition maximum, power by timed stair climb, and gait speed by 4m walk.

Participants self-reported falls for the past year (retrospective) and monthly for 6 months of the study (prospective).

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The researchers found 58% of the participants reported falls in the past year. Nearly half (47%) fell within the six months of the study. The annual fall rate reported for community-dwelling older adults over 65 is only 25- 30%.

The researchers noted the BCS with a history of falls had lower SOT scores with a vestibular deficit pattern in postural control (P<.01 and="" took="" longer="" to="" read="" letters="" on="" the="" contrast="" sensitivity="" chart="">

Vestibular score on the SOT mediated the relationship between treatment and falls among BCS who received chemotherapy only, but not adjuvant endocrine therapy.

The SOT test measures the ability to balance on a platform in conditions in which the only sensory system keeping their balance in check is the vestibular (inner ear) system.

The researchers conclude that the results of this project suggest that balance disturbances of vestibular origin and delays in detecting low contrast visual stimuli are associated with falls in BCS.

Women undergoing chemotherapy treatment for breast cancer should be aware that there might be changes that occur that could affect their balance. As they progress through treatment, they shouldn't ignore changes in balance they sense or merely attribute such changes to growing older.

Future studies that track falls and fall risk factors in BCS from diagnosis through treatment are warranted, as are studies that can identify treatment-related vestibular dysfunction and altered visual processing.

Source
Identifying Factors Associated With Falls in Postmenopausal Breast Cancer Survivors: A Multi-Disciplinary Approach; Winters-Stone KM, Torgrimson B, Horak F, Eisner A, Nail L, Leo MC, Chui S, Luoh S-W; Archives of Physical Medicine and Rehabilitation, published online 03 March 2011

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