Graduation Year


Document Type


Degree Type

Open Access Capstone

Degree Name

Doctor of Occupational Therapy (OTD)


Occupational Therapy


Executive Summary

Background: Currently there is sufficient evidence indicating safety with upper extremity resistive exercise among those at risk for developing breast cancer related lymphedema. However, there is insufficient evidence of the benefits of pre-operative lymphedema prevention education, upper body strengthening exercises, and strategies to continue or resume physically demanding activities that breast cancer survivors need to do, want to do, or are expected to do.

Purpose: This project described the impact pre-operative education has on activity participation, and perceived upper extremity function among individuals diagnosed with breast cancer compared to those who do not receive pre-operative education. The capstone project aimed to (a) describe and compare activity participation rates among individuals diagnosed with breast cancer who attended pre-operative education and those who did not attend pre-operative education and (b) describe and compare perceived arm function among individuals diagnosed with breast cancer who attended pre-operative education and those who did not attend pre-operative education.

Theoretical Framework: Data gathered within this observational study was organized by the Person, Environment, Occupation, and performance model to illustrate the factors impacting the individual with breast cancer’s ability to perform occupations that were important to them.

Methods: A static group comparison research design was used to compare breast cancer survivors’ perceived arm function and activity level among those seen pre-operatively and postoperatively and post-operatively only. Disability, Arm, Shoulder, Hand (DASH) assessment and Activity Card Sort-modified (ACSm) scores were graphically compared and described.

Results: Among those survivors seen pre-operatively and post-operatively, DASH scores indicated higher perceived arm function when compared to those seen post-operatively only. Additionally, ASCm overall activity participation scores were higher among those survivors who were seen pre-operatively and post-operatively versus those seen post-operatively only.

Conclusions: This pilot study illustrated that it was feasible for occupational therapy to provide lymphedema prevention education, upper body exercises and strategies to safely complete physically demanding activities pre-operatively. The findings from this small sample are promising. There is a need for further research with a larger population to determine if preoperative occupational therapy is associated with higher rates of participation in physically demanding activities and greater perceived arm function.

Faculty Mentor

Anne Fleischer PhD, MPH, OT/L, CLT-LANA

Department Affiliation

Occupational Therapy

Committee Member

Cheryl Carrico, MS, OT/L

Department Affiliation

Occupational Therapy

Department Affiliation

Occupational Therapy



Dr. Anne Fleischer Thank you for your continued patience and support throughout the development and implementation of this capstone project. Your constant feedback and encouragement made this result possible. I could not have done without your support.

Professor Cheryl Carrico Thank you for your feedback and contributions to the ultimate success of my capstone project and presentation.

Liessell Hamilton Thank you for being my original OT mentor and cheerleader since beginning my journey at Owensboro Health. Without your contributions to the breast program at Owensboro Health this capstone project would not have been possible.

Jerod and the boys, as well as my parents and family Thank you for all your constant support and motivation along this journey. Thank you for always lending a listening ear and cheering me on. Although this journey is ending there are many more ahead and I know with your support I will not fail.

IRB Approval Number (if applicable)