Advantages of Stretching Before Surgery on the Functionality of the Shoulder after the Surgery in Patients Undergoing Mastectomy (original) (raw)
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The effect of physiotherapy in patients with modified radical mastectomy
National Journal of Physiology, Pharmacy and Pharmacology
Background: Through the years, breast cancer management evolved toward conservation surgery. It is obvious that the clinical management requires a multidisciplinary approach to restoration of activity if daily living and quality of life after modified radical mastectomy. Aims and Objectives: The objectives of the study were to measure pain after physiotherapy intervention, to measure chest expansion after physiotherapy intervention, and to measure and improve shoulder range of motion (ROM) after physiotherapy intervention. Materials and Methods: This was a cross-experimental study in which initial data were recorded from the medical records, and then, after assuming proper resting status of the patient, the patients were assessed first numeric pain rating scale (NRS) for pain, ROM of shoulder joint, and chest expansion before and after the physiotherapy treatment given till patient get discharged. Results: In the present study, a total of 7 participants were included who fulfilled inclusion criteria. All the participants underwent routine physiotherapy treatment started from the day 1 till discharged, and NRS for pain, ROM of shoulder joint, and chest expansion all parameters were statistically significant (P < 0.005). Conclusion: The present study concluded that physiotherapy is more effective in modified radical mastectomy.
Pakistan BioMedical Journal
Breast cancer is ranked the top in types of cancer that affects internationally. It affects up to 1 in 13 women during their lifetime. Physiotherapy is one of the major sources of recovery in patients of Mastectomy in terms of pain, ranges, and function. OBJECTIVE: To compare the effects of pre-operative shoulder rehabilitation program versus post-operative mastectomy patients. METHODS: This was a randomized clinical trial. The study setting was Oncology Department, Mayo Hospital Lahore, Shokat Khanum and Gulab Devi Hospital Lahore. The study was completed in 6 months. Total 50 subjects were allocated in two groups using lottery method of randomization. Patient with age less than 40 years, diagnosed with breast cancer were included, while those with associated signs of musculoskeletal problems, autoimmune systemic disease and advanced medical problem was excluded. Group A received set of exercises comprised of range of motion exercises and lymph edema education pre and post operativ...
Background: Modified radical mastectomy is a frequent surgery employed as a therapeutic procedure in patients with breast carcinoma with involvement of axillary lymph nodes. Many patients suffer from severe shoulder complaints after axillary lymph node dissection even with postoperative rehabilitation. Pre-operative exercise and education are recommended to reduce the incidence of breast cancer related upper limb dysfunction; it will shorten the recovery time. The objectives of the study are to determine the influence of pre-operative physiotherapy on shoulder ROM using goniometer in subjects with modified radical mastectomy and to determine the influence of pre-operative physiotherapy on functional activities using shoulder pain and disability index (SPADI) in subjects with modified radical mastectomy. Methods: 30 Subjects of adult women included in the study who met the inclusion criteria, divided into 2 groups. Experimental Group received preoperative physical therapy education and exercises 1-2 weeks before surgery and routine physical therapy protocol after surgery. Control Group received standard education brochure preoperatively and routine physical therapy post operatively. Measurements included shoulder ROM and functional evaluation using goniometer and SPADI. Measurements were taken at baseline i.e., pre operatively, post operatively at 4th day after removal of drains, and 1month after surgery. Results: All measures were significantly reduced after surgery, but most recovered after 1month of surgery and attained functional level in experimental Group. Conclusion: This study provides experimental evidence that preoperative education and exercise influence the postoperative shoulder ROM and functional activities after modified radical mastectomy.
Impact of Scapular Mobilization and Strengthening Exercises on Shoulder Function Post Mastectomy
The Egyptian Journal of Hospital Medicine, 2022
Background: Mastectomy after breast cancer is usually accompanied by shoulder dysfunction which interferes with the daily life activities of the patients and causes physical and psychological impairments. Objectives: This study aimed to assess the impact of scapular mobilization and strengthening exercises on shoulder function post mastectomy. Patients and methods: A single blinded randomized controlled trial included forty female patients, their ages ranged from 40 to 55 years suffering from post-mastectomy shoulder dysfunction. They were allocated randomly into two equal groups: the study group (group A), managed by scapular mobilization and strengthening exercises besides their conventional physical therapy program and the control group (group B), managed by the conventional physical therapy program only. Trial was applied for (three sessions/week) and lasted for four weeks. Shoulder pain and impairment, upward rotation of the scapula and shoulder range of motion were measured pre-and post-four-weeks of intervention. Results: after 4 weeks of treatment, percentage of change in shoulder pain and disability index (SPADI), upward rotation of scapula, shoulder flexion, abduction and external rotation was 34, 103.55, 45.71, 63.19 and 31.41% respectively in the study group and14.77, 58.42, 22.25, 30.30 and 23.40% in the control group, respectively. In all measures, there was a statistically significant difference in favour of the study group (p< 0.001). Conclusion: It could be concluded that adding scapular mobilization and strengthening exercises are more effective in improving shoulder function regarding pain and ROM post-mastectomy than using the conventional physical therapy program only.
Journal of Cancer Education, 2020
Breast cancer ranks highest in incidence and mortality among females and second among both genders. Lebanon has the second highest rate of breast cancer worldwide for those 35-39 years old and the highest for those 40-49. Mastectomy often results in deceased shoulder and arm mobility and decreased quality of life. The objective of this study was to assess the effect of an educational program of therapeutic exercises on the quality of life and functional ability in women after a mastectomy. Sixty women undergoing a mastectomy were randomly assigned to either an intervention or control group. The intervention group received extensive pre-surgery education as well as training on therapeutic exercises. Follow-up phone calls to the intervention group were made to ensure that the exercises were being done. Both groups were visited at home at two and four weeks to obtain the outcome variables. The Breast Cancer Patient Version was used to assess quality of life, and the "Goniometer" was used to assess the range of motion of the affected shoulder. At two and four weeks after surgery, women in the intervention group had significant improvements in their shoulder range of motion: flexion, extension, and abduction were significantly different between the control and intervention group at p = 0.04-0.00. For quality of life, physical, psychological, psychological, social, and spiritual well-being were significantly higher for the intervention group at both two and four weeks after surgery, p < 0.001. In a middle-income country, one-to-one education provided by a nurse, which included demonstrations, back demonstrations, and weekly phone calls had a positive impact on women's shoulder range of motion and quality of life. NCT04184102
Arm Function and Quality of Life Among Patients after Mastectomy
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2018
Introduction: For many women with breast cancer, mastectomy is a common form of treatment which has an indirect effect on female beauty, sexuality and feminity. Also, the patients suffer severe arm and shoulder morbidity post surgery which affects their quality of life. Aim: To determine the arm function and quality of life among patients after mastectomy and find correlation between these two aspects. Materials and Methods: A quantitative descriptive correlational design with non probability convenience sampling technique was used to collect data from 60 post mastectomy women. The setting used for the study was Gynecological Oncology OPD at Amrita Institute of Medical Sciences (AIMS), Kochi, Kerala, India. Data collection was done from November 2016 to December 2016. A standardized Quality of Life-Breast Cancer Patient Version (QOL-BCV) questionnaire and DASH (Disability of Arm Shoulder Hand) tool was used for the assessment along with a structured questionnaire to assess socio demographic and clinical data. Karl Pearson correlation test was used for data analysis. Results: The study result showed that majority of the patients 48 (80%) had good arm function with less disability. Quality of life of 21 (35%) patients was high and 39 (65%) patients had moderate quality of life. There was a significant correlation found between disability score and quality of life (r=-0.802) and with all the domains of quality of life {physical (r=-0.771), psychological (r=-0.695), social (r=-0.746) and spiritual (r=-0.500)}. Also a significant association was found between arm function and the clinical variables like edema (p=0.006) and radiation therapy (p=0.017). Conclusion: Arm disability influences quality of life of patients after mastectomy. The results of this study will help to improve actions to reduce arm disabilities such as lymphedema as early as possible, through proper assessment and post mastectomy exercises, including special care for patients undergoing radiation therapy. This will improve the quality of life of post mastectomy patients.
The Efficacy of Physiotherapy Recovery After a Modified Radical Mastectomy
Journal of Medical pharmaceutical and allied sciences, 2021
Breast cancer is the most common disease in females and the major cause of mortality and morbidity. In reality, 1.67 million new cases of breast cancer are diagnosed around the world, with 458,000 deaths per year. Approximately 89 percent of breast cancer survivors live for a minimum of five years after treatment, but adverse effects can last for months or years after surgery. The most common side effects of the upper limb are pain and joint dysfunction, which is described as having a prevalence range of 12 percent to 51 percent for pain and 1.5 percent to 50 percent for joint dysfunction.(1) The mainstay in primary breast cancer care is surgery.(2) To assess the impact of an early recovery program on shoulder mobility, functional ability, postoperative complications such as seroma, hematoma, and wound infection in patients who had undergone a modified radical mastectomy (MRM)and to assess the impact of variables in clinical practice (e.g., age, education, BMI, previous shoulder pro...
[Purpose] The aim of the study was to investigate the effect of kinesio tape on pain, range of motion, and disability of the shoulder. [Subjects and Methods] Seventy-four female patients who underwent modified radical mastectomy participated in this study. They were randomly divided into two groups, an experimental group that received kinesio tape for the shoulder joint in addition to a conventional physiotherapy program and a control group that received the physiotherapy program only. Outcome measures included the Visual Analogue Scale, shoulder range of motion, and Shoulder Pain and Disability Index. [Results] The experimental group showed significant differences in all outcome measures both within and between groups. The control group only showed a significant within group difference in shoulder flexion. [Conclusion] Clinicians should be able to recognize the benefits achieved through the use of adjunct treatment options such as kinesio tape in comparison with benefits that can be obtained through the use of individual modalities in physical therapy. Kinesio tape can be suggested and recommended for postmastectomy patients, especially for shoulder pain, range of motion, and disability.
Hellenic Journal of Surgery, 2015
Background: Seroma formation is a well-known complication after modified radical mastectomy (MRM) for breast cancer. Another well known complication is shoulder movement dysfunction following the same operation. Traditionally, patients were asked to perform exercises of the shoulders as early as possible after surgery in the belief that it reduces subsequent shoulder dysfunction. The aim of this study was to evaluate whether delayed shoulder exercises after MRM could reduce seroma formation without compromising the outcome of shoulder mobility. Methods: Fifty patients who underwent MRM were randomly divided into two groups, the early group and the delayed group, each consisting of 25 patients. Shoulder exercises were started in the patients allotted to the 'early group' from postop day 1, while those in the 'delayed group' began shoulder exercises from postop day 7. Seroma formation and other complications were closely noted. Their follow-up at one month and six months was assessed for shoulder movement dysfunction using the Constant scoring system. Results: There was significant increase in seroma formation in the 'early group' (79 %) compared to the 'delayed group' (p-value 0.027469) with an odds ratio of 5.76 [1.36, 24.36]. However, there was no significant difference in the shoulder dysfunction between both groups when measured after one month (p-value 0.889576) and six months (p-value 0.396509). Conclusion: The incidence of seroma after MRM is reduced by delaying shoulder exercises by one week rather than one day. The early initiation of shoulder exercises to avoid impairment of shoulder movements is not necessary.