REPLY TO THE LETTER TO THE EDITOR
Reply to the Letter to the Editor by Adrián J.Barrios-Condori
Réplica à Carta ao Editor de Adrián J.Barrios-Condori
Respuesta a la Carta al Editor por Autoria de Adrián J.Barrios-Condori
https://doi.org/10.32635/2176-9745.RBC.2025v71n4.5271AEN
This document is related to the doi: https://doi.org/10.32635/2176-9745.RBC.2026v72n2.5693
Myara Cristiny Monteiro Cardoso1
1Universidade Federal do Pará (UFPA), Hospital Universitário João de Barros Barreto (HUJBB), Laboratório de Avaliação e Reabilitação das Disfunções Cardiovascular, Oncológica e Respiratória (LACOR), Programa de Residência de Fisioterapia em Oncologia. Belém (PA), Brasil. E-mail: myaracardoso@gmail.com. Orcid iD: https://orcid.org/0000-0002-2456-8034
Corresponding author: Myara Cristiny Monteiro Cardoso. Travessa Barão do Triunfo, 1108 – Pedreira. Belém (PA), Brasil. CEP 66080-680. E-mail: myaracardoso@gmail.com
Dear Editor,
I thank the author Adrián J.Barrios Condori for the thorough analysis of the article “Evaluation of Postoperative Upper Limbs Functionality, Quality of Life and Fatigue in Women with Breast Cancer at a Reference Hospital in the Amazon Region” written by me and my associates Rayssa da Silva Araújo, Jaqueline Pinheiro da Silva, Rayane de Nazaré Monteiro Brandão and Saul Rassy Carneiro, published in volume 69, number 3 of Revista Brasileira de Cancerologia, and for the pertinent considerations that help to expand the scientific discussion and the methodological improvement of future studies in oncologic rehabilitation.
In what concerns lymphedema, all the participants have been followed-up at a reference hospital when they were evaluated by the hospital staff since the first postoperative day. If lymphedema was detected, the patients left the study and were referred to a specific and specialized follow-up group. Therefore, the sample consisted only of women without lymphedema, which justifies the non-utilization of specific instruments. In addition, this information was not clearly explained in the original manuscript and was registered as errata for methodological clarification and scientific transparency.
SPADI, a very good questionnaire, has been utilized earlier in another study by the same group of authors but still under elaboration. However, it was not utilized because the main goal was not to evaluate pain alone but the global functionality of the upper limbs and its relation with quality of life and fatigue.
Additionally, the questionnaires of quality of life utilized were not targeted to exclusive evaluation of the quality of the function of the upper limb, but to understand comprehensively the impact of functional deficit on the quality of life of these women, considering the repercussions on the activities of daily life, physical, emotional and functional well-being.
According to the literature on muscle strength1-2, strength is recognized as an important marker of the body function and functional integrity of the musculoskeletal system in breast cancer survivors, directly reflecting the functional capacity and limitations resulting from the oncologic treatment.
I concur with the author in regard to the importance of combined utilization of objective measures and self-reported instruments because of the more comprehensive evaluation of the functionality and clinical impacts. In that sense, the group is concluding a study whose objective was to analyze the intra and inter-rater reliability of the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST)3-4 in women with breast cancer. It is an easy-to-apply test of functional performance of upper limbs in closed kinetic chain that does not require complex technological resources and provides quantitative data on the functionality of the upper limb. The utilization of instruments as CKCUEST can contribute significantly for the functional evaluation of this population in resources-constrained clinical contexts, in addition to complement data obtained through self-reported questionnaires.
I appreciate the suggestions of other evaluation instruments, a few of them unknown by this group. These contributions expand the methodological perspectives and will be considered in future investigations.
CONTRIBUTION
The author is the sole responsible for the reply to the Letter to the Editor and approved the final version to be published.
DECLARATION OF CONFLICT OF INTERESTS
There is no conflict of interests to declare.
DATA AVAILABILY STATEMENT
All the content underlying the text is contained in the manuscript.
FUNDING SOURCES
None.
REFERENCES
1. Siqueira TC, Frágoas SP, Pelegrini A, et al. Factors associated with upper limb dysfunction in breast cancer survivors. Support Care Cancer. 2021;29(4):1933-40. doi: https://doi.org/10.1007/s00520-020-05668-7
2. Leonardis JM, Lulic-Kuryllo T, Lipps DB. The impact of local therapies for breast cancer on shoulder muscle health and function. Crit Rev Oncol Hematol. 2022;177:103759. doi: https://doi.org/10.1016/j.critrevonc.2022.103759
3. Goldbeck TG, Davies GJ. Test-retest reliability of the closed kinetic chain upper extremity stability test: a clinical field test. J Sport Rehabil. 2000;9(1):35-45. doi: https://doi.org/10.1123/jsr.9.1.35
4. Tucci HT, Martins J, Sposito GC, et al. Closed kinetic chain upper extremity stability test (CKCUES test): a reliability study in persons with and without shoulder impingement syndrome. BMC Musculoskelet Disord. 2014;15(1):1-9. doi: https://doi.org/10.1186/1471-2474-15-1
Recebido em 27/2/2026
Aprovado em 3/3/2026
Scientific-editor: Anke Bergmann. Orcid iD: https://orcid.org/0000-0002-1972-8777
Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições, desde que o trabalho original seja corretamente citado.