POST-OPERATIVE PHYS!OTHERAPY FOR BREAST CANCER PATIENTS: WHAT TO CONSIDER
Keywords:
terms:breast neoplasms, rehabilitation, exercise movement techniques, physical therapy techniquesAbstract
Considering the increase in survival expectancy of women undergoing breast cancer surgery, the improvement of rehabilitation techniques has become fundamental, in arder to provide them with adequate mental and physical quality of life. There are no guidelines for the exercises used in physical rehabilitation programs after breast cancer surgery. Some studies discuss the association between the exercises and post-operative complications; however the literature contains succinct and personalized descriptions of the manner in which the exercises are performed. The objective of physiotherapy is to prevent complications, promote functional recovery and consequently provide a better quality of life for these women. However, both consensus and controversy can be found in the literature, regarding the best method to perform the exercises and their influence on post-operative complications. The objective of this study was to review the literature on the techniques of applying the exercises as well as to make a therapeutic proposition.
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References
Instituto Nacional de Câncer [Internet). Brasil: Ministério da Saúde; 2002. [acesso 2003 nov 15): Disponível em: http://www.inca.gov.br
Holmes CE, Muss HB. Diagnosis and treatment of breast cancer in the eldery. CA Cancer J Clin. 2003; 53(4):227-44.
Winick L, Robbins GF. The Post-Mastectomy Rehabilitation Group program. Structure, procedure, and population demography. Am J Surg. 1976; 132(5):599-602.
Sachs SH, Davis JM, Reynolds RN, Spagnola M, Hall P, Bloch A. Postmastectomy rehabilitation in a community hospital. J Fam Pract. 1980; 11(3): 395-401.
Sachs SH, Davis JM, Reynolds RN, Spagnola M, Hall P, Bloch A. Comparative results of postmastectomy rehabilitation in a specialized and a community hospital. Cancer. 1981; 48(5):1251-5.
Gaskin TA, Lobuglio A, Kelly P, Doss M, Pizitz N. Stretch: A rehabilitive program for patients with breast cancer. South Med J. 1989; 82(4):467-9.
van der Horst CM, Kenter JAL, de Jong MT, Keeman JN. Shoulder function following early mobilization of the shoulder after mastectomy and axillary dissection. Neth J Surg. 1985; 37(4):105-8.
Schultz 1, Barholm M, Grondal S. Delayed shoulder exercises in reducing seroma frequency after modified radical mastectomy: a prospective randomized study. Ann Surg Oncol. 1997; 4(4):293-7.
Aitken DR, Minton JP. Complications associatedwith mastectomy. Surg Clin North Am. 1983; 63(6): 1331-89.
Chen SH, Chen MF. Timing of shoulder exercise after modified radical mastectomy: a prospective study. Chang Gung Med J. 1999; 22(1):37-43
Wingate L. Efficacy of phisical therapy for patients who have undergone mastectomies. Phys Ther. 1985; 65(6):896-900.
Molinara J, Kleinfeld M, Lebed S. Phisical therapy and dance in the surgical management of breast cancer. Phys Ther. 1986; 66(6):967-9.
Gerber LH, Augustine EM. Rehabilitation management: restoring fitness and return to functional activity. ln: Harris JR, Lippman ME, Morrow M, Osborne CK. Disease of the breast. 2nd ed., Philadelphia: Linppicott Wilians & Wilkins; 2000. p.1001-7.
Camargo M, Marx A. Reabilitação física no câncer de mama. São Paulo: Manole, 2000.
Dawson 1, Stam L, Heslinga JM, Kalsbeek HL. Effect of shoulder immobilization on wound seroma and shoulder dysfuntion following modified radical mastectomy:a randomized prospective clinicai triai. Br J Surg. 1989; 76(3):311-2.
Flew TJ. Wound drainage following radical mastectomy: the effect os restriction of shoulder movement. Br J Surg. 1979; 66(5):302-5.
Jansen RFM, van Geei AN, de Groot HG, Rottier AB, Olthuis GA, van Putten WL. lmmediate versus delayed shoulder exercises after axillary lymph node dissection. Am J Surg. 1990; 160(5):481-4.
Bland K, Copeland EM. A mama. São Paulo. Manole; 1994.
Erickson VS, Pearson ML, Ganz PA, Adams J, Kahn KL. Arm edema in breast cancer patients. J Natl Cancer lnst. 2001; 93(2):96-111.
Sugden EM, Rezvani M, Harrison JM, Hughes LK. Shoulder movement after treatment of early stage breast cancer. Clin Oncol. 1998; 10(3): 173-81.
Wadsworth CT. Frozen shoulder. Phys Ther. 1986, 66(12):1878-83.
Knight CD Jr, Griffen FD, Knight CD Sr. Prevention of seroma in mastectomy wounds. The effect of shoulder immobilization. Arch Surg. 1995; 130(1):99-101.
Wingate L, Croghan 1, Natarajan N, Michalek AM, Jordan C. Rehabilitation of the mastectomy patient: a randomized, blind, prospective study. Arch Phys Med Rehabil. 1989; 70(1):21-4.
Silva MP, Derchain SFM, Rezende L, Cabello C, Martinez EZ. Movimento do ombro após cirurgia por carcinoma invasor da mama: estudo randomizado prospectivo controlado de exercícios livres versus limitados a 90º no pós-operatório. Rev Bras Ginecol Obstet. 2004; 26:125-30.
Amaral MTP. Orientação domiciliar: uma proposta de reabilitação física para mulheres tratadas por câncer de mama [dissertação]. Campinas: Universidade Estadual de Campinas; 2003.
Rezende LF. Ensaio clínico randomizado comparativo entre exercícios livres e direcionados na reabilitação pós-operatória de câncer de mama [dissertação]. Campinas: Universidade Estadual de Campinas; 2004.
Box RC, Reul-Hirche HM, Bullock-Saxton JE, Furnival CM. Shoulder movement after breast cancer surgery: results of a randomized controlled study of postoperative physiotherapy. Breast Cancer Res Treat. 2002; 75(1):35-50
Aitken RJ, Gaze MN, Rodger A, Chetty U, Forrest AP. Arm morbility within a triai of mastectomy and either nodal sample with selective radiotherapy or aillary clearance. Br J Surg. 1989; 76(6):568-71
Ernst MF, Voogd AC, Balder W, Klinkenbijl JHG, Roukema JA. Early and late morbity associated with axillary leveis 1-111 dissection in breast cancer. J Surg Oncol. 2002; 79(3):151-5.