Effectiveness of a self-administered, home-based exercise rehabilitation program for women following a modified radical mastectomy and axillary node dissection: a preliminary study
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This pilot study examined the effects of a self-administered, home-based exercise (HBE) rehabilitation programme designed to help women regain shoulder mobility immediately following surgery for a modified radical mastectomy and axillary node dissection.
Twenty-seven women who were scheduled for surgery were randomly assigned to either a post-surgical experimental HBE rehabilitation group (n = 16) or a usual care group (UC; n = 11). Women assigned to the HBE group followed an 11 day (days 3–14 post-surgery), home-based rehabilitation programme consisting of shoulder flexibility and stretching exercises that were described on videotape. The videotape programme was modelled after the exercises and guidelines described in a brochure produced by the Canadian Cancer Society.
As a result of the exercise programme intervention, there was a time × group interaction indicating that the HBE group demonstrated a significantly greater increase in shoulder flexion range of motion (ROM) (p = 0.003) and abduction ROM (p = 0.036) when compared to the UC. There were no statistical differences in shoulder strength between groups over time. External rotation (p = 0.036) and grip strength (p = 0.001) significantly increased in both groups during the intervention period but there were no interaction effects. With respect to the forearm circumferences, there was a significant decrease over time (p < 0.001) but no interaction between groups.
This HBE rehabilitation programme is an effective way to improve shoulder mobility and ROM during the immediate 2-week recovery period following surgery.
KeywordsAxillary node dissection Home-based exercise programme Mastectomy Shoulder range of motion
This study was supported by grants from the Ville Marie Oncology Foundation and the General Research Fund of Concordia University. We are indebted to all the women who contributed their time and effort; the staff at the Ville Marie Medical and Women’s Health Centre for their assistance in the organization and administration of the study. We also wish to thank Dr. Simon Bacon and Dr. Lucie Bonneville for their statistical analyses and advice. A special word of thanks goes to Gaby Miller, Kalan Gardiner and Tracy Griffiths who participated in the development and production of the exercise video.
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