Effectiveness of a self-administered, home-based exercise rehabilitation program for women following a modified radical mastectomy and axillary node dissection: a preliminary study.
OBJECTIVE
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.


METHODS
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.


RESULTS
As a result of the exercise programme intervention, there was a time x 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.


CONCLUSIONS
This HBE rehabilitation programme is an effective way to improve shoulder mobility and ROM during the immediate 2-week recovery period following surgery.
Kilgour
Robert D
RD
Department of Exercise Science, The Richard J. Renaud Science Complex, Concordia University, Montreal, QC, Canada. kilgour@alcor.concordia.ca
Jones
David H
DH
Keyserlingk
John R
JR
D001365:Axilla; D001943:Breast Neoplasms / Q000534:rehabilitation* / Q000601:surgery*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects; D008209:Lymphedema / Q000209:etiology; D015411:Mastectomy, Modified Radical / Q000009:adverse effects; D008875:Middle Aged; D010349:Patient Compliance; D010865:Pilot Projects; D016059:Range of Motion, Articular / Q000502:physiology*; D012782:Shoulder / Q000502:physiology; D014741:Video Recording