Upper Limb Function After Breast Cancer Surgery: the Role of Post-operative Physical Therapy Intervention
Condition: Breast Neoplasms
MeSH terms: Breast Neoplasms
Study type: Interventional

Summary: 
      Surgical treatments can cause late effects influencing activity of daily living, physical
      activity, and overall health. Late effects include persistent pain reported by 30 - 50% of
      women that underwent breast operations, restrictions of arm and shoulder movement were
      reported in 35% of patients, lymphedema in 15 - 25% of women who undergo axillary lymph node
      dissection and in about 6% of women who undergo sentinel lymph node biopsy. Lymphedema
      results in physical impairments including compromised function, diminished strength, fatigue,
      and pain in the affected arm . The axillary web syndrome is a self-limiting and frequently
      overlooked cause of significant morbidity in the early postoperative period after breast
      cancer, which is characterized by axillary pain that runs down the medial arm, limited
      shoulder range of motion (ROM) .

      Physiotherapy and exercise in the postoperative period can result in a significant
      improvement in shoulder ROM in women treated for breast cancer, Additionally, exercises are
      an effective intervention to improve quality of life, cardiorespiratory fitness, physical
      functioning and fatigue in breast cancer patients. However, in the postoperative period
      consideration should be given to the early implementation of exercises because of the
      potential for seroma and increases in wound drainage volume and duration.

      There is limited evidence on the influence of postoperative physiotherapy intervention, and
      instruction program on upper limb range of motion and return to physical activity divided by
      the type of surgery and regarding complications.
    

Detailed description: 
      Aim The aim of this study is to evaluate the influence of early postoperative physical
      therapy program on upper-limb function and returning to physical activity in the first 6
      months following surgery.

      Hypotheses

        -  Early physical activity performed post-operative will improve ROM and therefore, will
           help women after breast surgeries to return faster to their routine physical activity
           and by that promote physical health.

        -  Early postoperative physical therapy is safe when the program for is tailored to the
           type of surgery.

      Methods

      Study design Parallel group prospective randomized controlled clinical trial. Two surgical
      department's including general surgery department and genecology department in Assuta
      hospital, Tel Aviv, Israel

      Sample All women undergoing breast cancer surgeries in Assuta hospital between 02.01.2018 and
      till 07.01.2019 will be randomized into two groups: Group A (intervention group) will be
      instructed first day post-operative to exercise program; Group B (control group) without
      intervention.
    

Intervention name(s): PHYSICAL THERAPY
Intervention type(s): Other
Intervention description(s): EXERCISES AND EDUCATION TO FOLLOWING AFTER DISCHARGE PHYSICAL TREATMENT
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: RCT intervention and not intervention
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: Breast surgery; Physiotherapy; Breast Cancer; Shoulder pain; Shoulder motion