Arm Morbidity and Disability After Breast Cancer: New Directions for Care

Thomas-MacLean, Roanne; Hack, Thomas F.; Kwan, Winkle; Towers, Anna; Miedema, Baukje; Tilley, Andrea

doi:10.1188/08.onf.65-71

Cited by 106 publications

(103 citation statements)

References 22 publications

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“…On the other hand, avoiding activity of the affected limb may lead to poor lymphatic clearance and, hence, stasis of the lymphatic fluid in the affected limb [32]. During the early 6 to 12 months after mastectomy, pain and decreased shoulder movements are more common than lymphedema [33]; these can also be prevented by upper-limb exercises [34]. Particularly, strength training will help not only in recovering arm strength but also in recovering bone mineral loss due to cancer treatment.…”

Section: Introductionmentioning

confidence: 99%

Effect of home-based exercise program on lymphedema and quality of life in female postmastectomy patients: Pre-post intervention study

Gautam¹,

Maiya²,

Vidyasagar³

2011

JRRD

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Abstract-Lymphedema is a debilitating complication following mastectomy, affecting the arm functions and quality of life (QOL) of breast cancer patients. Studies have shown the beneficial effects of upper-limb exercises on lymphedema in clinical settings. However, there is a dearth of evidence regarding the effect of home-based exercises on lymphedema; therefore, we examined the effect of a home-based exercise program on lymphedema and QOL in postmastectomy patients. Thirty-two female postmastectomy lymphedema patients participated in an individualized home-based exercise program for 8 weeks. Arm circumference, arm volume, and QOL (36-Item Short Form Health Survey) were measured before and after the program. Data were analyzed with the use of paired t-tests for circumferential and volumetric measures and Wilcoxon signed ranks tests for QOL. Significance level was set at p < 0.01 with Bonferroni correction (alpha/n = 0.05/5 = 0.01). Analysis showed a statistically significant improvement in the affected upper-limb circumference and volume (~122 mL reduction, p < 0.001) and in the QOL scores (p < 0.001) at the end of the home-based exercise program. The individualized home-based exercise program led to improvement in affected upper-limb volume and circumference and QOL of postmastectomy lymphedema patients.

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Section: Introductionmentioning

confidence: 99%

Effect of home-based exercise program on lymphedema and quality of life in female postmastectomy patients: Pre-post intervention study

Gautam¹,

Maiya²,

Vidyasagar³

2011

JRRD

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“…Esse achado é compatível com a literatura, que evidencia melhora da ADM após um período de três meses a um ano 10,16,17,23 . A dor na região da mama ou no membro superior foi a queixa mais frequente no período estudado e, segundo a literatura, sua frequência pode variar de 12 a 39% no primeiro ano após a cirurgia 11,24 .…”

Section: Discussionunclassified

Complicações e condutas fisioterapêuticas após cirurgia por câncer de mama: estudo retrospectivo

Nascimento

Oliveira

et al. 2012

Fisioter. Pesqui.

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RESUMO | Após cirurgia por câncer de mama, as mulheres estão sujeitas a desenvolver algumas complicações físicas. Os objetivos deste trabalho foram: investigar o desfecho dessas mulheres, que, durante o primeiro mês pós-operatório, foram submetidas a um programa de reabilitação e identificar ao longo de dois anos as complicações mais frequentes e as condutas fisioterapêuticas mais adotadas. Foi um estudo descritivo, retrospectivo, com dados de 707 prontuários de mulheres operadas por câncer de mama no Hospital da Mulher Professor Doutor José Aristodemo Pinotti da Universidade Estadual de Campinas, entre janeiro de 2006 e dezembro de 2007, atendidas pelo Setor de Fisioterapia. A análise foi feita por meio de médias, desvio padrão e frequências absolutas e relativas. Ao final do programa, 55% das mulheres receberam alta, 17% necessitaram de atendimento adicional e 26% não aderiram a ele. As complicações mais frequentes foram: aderência pericicatricial (26%), restrição da amplitude de movimento (24%) e deiscência cicatricial (17%). No primeiro ano após a cirurgia (n=460), foram relatados dor (28,5%), sensação de peso (21,5%) e restrição da amplitude de movimento do ombro (16, 7%); já no segundo (n=168), houve dor (48,2%), sensação de peso (42,8%) e linfedema (23,2%). Concluiu-se que, ao final do programa, a maioria das mulheres recebeu alta. Ao longo dos anos, houve redução da frequência de restrição da amplitude de movimento do ombro com aumento de linfedema. Cuidados com o braço, exercícios domiciliares e autodrenagem foram as condutas mais adotadas.Descritores | fisioterapia; terapia por exercício; reabilitação; complicações pós-operatórias; câncer de mama.ABSTRACT | After breast cancer surgery, women may develop some physical complications. Thus, the aims of this study were to investigate the outcome of these women, who participated in a rehabilitation program for one month, as well to identify along two years the most frequent complications and adopted physical therapy conducts. It was a descriptive and retrospective study with 707 medical records of women treated for breast cancer at the Women's Hospital Professor Doutor José Aristodemo Pinotti, Universidade Estadual de Campinas, between January 2006 and December 2007, admitted in the Division of Physical Therapy. Analysis was performed by means, standard deviation, absolute and relative frequencies. By the end of the program, 55% of women were discharged, 17% required additional treatment, and 26% did not join it. The most frequent complications were: pericicatricial adherence (26%), range of motion (ROM) restriction (24%), and scar dehiscence (17%). In the first year after surgery (n=460), the main complaints were: pain (28.5%), heaviness (21.5%), and restriction of shoulder range of motion (16.7%); in the second year (n=168), they were pain (48.2%), heaviness (42.8%), and lymphedema (23.2%). It was concluded that most women were discharged in the end of the program and, over the years, they presented reduction of shoulder range of motion frequency and lymp...

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“…Clinically, this is an irrelevant result, since the movement of extension is barely impaired in these patients. Conversely, Thomas-Maclean (12) in an study with 357 women that evaluated ROM, pain, lymphedema and this variables correlation with DASH, 6 and 12 months after surgery, observed a meaningful correlation of ROM limitation and pain with functional performance. Although no correlation between these variables in our sample size was found, the women in our study have a better performance and few limitations to execute daily life activities.…”

Section: Discussionmentioning

confidence: 99%

“…ROM limitation may also cause a negative impact on upper limber (UL) function affecting quality of life (QOL) (14,15). The impact on upper limb function is related to frequent complaints as difficulty to perform work, domestic and daily life activities (5,8,9,12,16).…”

Section: Introductionmentioning

confidence: 99%

Physiotherapeutic approach and functional performance after breast cancer surgery

et al. 2017

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Introduction: Surgery for breast cancer can impair range of motion (ROM) and functionality of upper limb (UL). Objective: To compare ROM and functional performance of homolateral UL after physiotherapeutic approach and to correlate these variables. Methods: A non-randomized clinical trial study enrolled 33 women who were submitted to mastectomy or quadrantectomy associated with axillary lymphadenectomy. ROM was assessed by homolateral UL and contralateral limb (control) goniometry. Functional performance was assessed by "Disability of arm, shoulder and hand" (DASH) questionnaire. The protocol consisted in 10 sessions (3 sessions per week during 60 minutes), involving passive mobilization of glenohumeral and scapulothoracic joint, soft tissue mobilization, neck muscles and upper limb muscles stretching, exercises in all planes of motion, applied alone or in combination. Weight bearing exercise with elastic bands and dumbbells from 0.5 to 1.0 kilograms were also applied. Results: There was a meaningful increase in ROM of all movements after physiotherapy; however, flexion, abduction and lateral rotation remained lower than

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Arm Morbidity and Disability After Breast Cancer: New Directions for Care

Abstract: Screening for pain and ROM restrictions should be part of breast cancer follow-up care. Left untreated, arm morbidity could have a long-term effect on quality of life. Additional research into the longevity of various arm morbidity symptoms and possible interrelationships also is required.

Cited by 106 publications

References 22 publications

Effect of home-based exercise program on lymphedema and quality of life in female postmastectomy patients: Pre-post intervention study

Effect of home-based exercise program on lymphedema and quality of life in female postmastectomy patients: Pre-post intervention study

Complicações e condutas fisioterapêuticas após cirurgia por câncer de mama: estudo retrospectivo

Physiotherapeutic approach and functional performance after breast cancer surgery

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