title: Two exercise schemes in postoperative breast cancer: comparison of effects on shoulder movement and lymphatic disturbance.
abstract: OBJECTIVE
  We attempted to determine the best method of performing the exercises in rehabilitation after breast cancer surgery and their influence on postoperative complications. Currently, there are no guidelines for these exercises. The scope of this study was to evaluate the effect of two schemes of physiotherapy exercises (directed or free) on shoulder function and lymphatic disturbance in postoperative rehabilitation.
  
  
  METHODS
  Sixty women who underwent a modified radical mastectomy or quadrantectomy with axillary dissection were randomized into two groups.
  
  
  METHODS
  The physiotherapy technique used was kinesiotherapy. The directed group performed physiotherapy following a regimen of 19 exercises. The free group performed the exercises following the biomechanical physiological movements of the shoulder without a previously defined sequence or number of repetitions.
  
  
  RESULTS
  The averages of the flexion, abduction and external rotational movements of the shoulder showed better recovery with statistical significance in the directed group compared to the free group. There was no significant difference between the groups in lymphatic disturbance.
  
  
  CONCLUSIONS
  At the end of 42 days of follow-up, the movements of flexion, extension, abduction and external rotation of the shoulder were better rehabilitated in the directed group. The two schemes of exercises were not different with regard to lymphatic disturbance.
authors: Department of Obstetrics and Gynecology, State University of Campinas (UNICAMPS), Campinas, SP, Brazil.
authors: Laura Ferreira
authors: LF
authors: de Rezende
authors: Ricardo Laier
authors: RL
authors: Franco
authors: Mariana Ferreira
authors: MF
authors: de Rezende
authors: Patrícia Odila
authors: PO
authors: Beletti
authors: Sirlei Siani
authors: SS
authors: Morais
authors: Maria Salete Costa
authors: MS
authors: Gurgel