Physical therapy effects on upper functional performance after breast cancer surgery

Abstract

Objective: To verify the effects of physical therapy on the range of movement (ROM) and the functional performance of the homolateral upper limb after breast cancer surgery and to correlate these variables. Materials and Methods: Case series study including women undergoing physiotherapy after unilateral breast cancer surgery and axillary dissection. ROM of both upper limbs was measured by goniometry and the contralateral limb was used as control. Functional performance was evaluated using the "deficiency of the shoulder, arm and hand" (DASH) questionnaire. The physiotherapy program consisted of a 10 session of stretching and active exercises protocol. The goniometry and DASH scores were compared by Wilcoxon signed rank test and the Spearman correlation test was used to correlate these variables, with the significance established in 5%. Results: Ten women were included with a median age of 52.5 (41.7-59.5) years old. Seven were submitted to mastectomy and three to quadrantectomy. The results showed a significant increase in the ROM, especially in the movements of flexion, abduction and external rotation (p=0.005). After the physiotherapy, the ROM was similar between both upper limbs. The total DASH score decreased significantly from 38.9 (36-46.4) to 21.2 (9.5-23.8), (p=0.005). Conclusion: It was found that after 10 sessions of physical therapy the ROM and functional performance of the homolateral upper limb improved significantly, but there was no correlation between ROM and DASH.