by Ifat Klein, Leonid Kalichman, Noy Chen, Sergio Susmallian
The Breast: Published, July 21, 2021
Background
Morbidity of the shoulders after breast cancer (BC) surgery
is a common side effect that includes; persistent pain, function limitation,
and decreased range of motion (ROM). This study examines the effect of early
physical therapy (PT) and patient's education on these morbidities.
Methods
A prospective, randomized clinical trial was conducted at a
single medical center from October 2018 until April 2019. Women scheduled for
breast cancer surgery were divided into intervention or control as standard
care. The intervention included a PT treatment that included exercise
instructions from the first postoperative day. Pain levels, upper limb
function, ROM, and complications were measured.
Results
The study includes 157 women (mean age, 52.2 ± 12.9). Early
PT reduced pain levels at the first month (NPRS 1.5 ± 1.2) and six months (NPRS
0.5 ± 0.8), compared with control (NPRS 2.1 ± 1.4, 1.0 ± 1.2), p = 0.019 and
p = 0.011, respectively. Subdivision of the sample into small and extensive
surgeries revealed additional positive effect for the intervention six months
postoperatively on functional disabilities, p = 0.004 and p = 0.032
respectively. No complications attributable to the intervention were recorded.
Conclusions
Early PT and patient education reduces pain levels, and may
improve function disabilities, without causing postoperative complications,
although a larger study is needed to achieve unequivocal results.
