Physiotherapeutic approach and functional performance after breast cancer surgery

Abstract

Introduction: Surgery for breast cancer can impair range of motion (ROM) and functionality of upper limb (UL). Objective: To compare ROM and functional performance of homolateral UL after physiotherapeutic approach and to correlate these variables. Methods: A non-randomized clinical trial study enrolled 33 women who were submitted to mastectomy or quadrantectomy associated with axillary lymphadenectomy. ROM was assessed by homolateral UL and contralateral limb (control) goniometry. Functional performance was assessed by “Disability of arm, shoulder and hand” (DASH) questionnaire. The protocol consisted in 10 sessions (3 sessions per week during 60 minutes), involving passive mobilization of glenohumeral and scapulothoracic joint, soft tissue mobilization, neck muscles and upper limb muscles stretching, exercises in all planes of motion, applied alone or in combination. Weight bearing exercise with elastic bands and umbbells from 0.5 to 1.0 kilograms were also applied. Results: There was a meaningful increase in ROM of all movements after physiotherapy; however, flexion, abduction and lateral rotation remained lower than control limb. DASH score decreased significantly from 28.06 ± 16.1 to 15.71 ± 10.7 (p = 0.001) meaning an improvement in functional performance of UL. No correlation was observed between ROM and DASH. Conclusion: Functional performance and ROM, after 10 physiotherapy sessions, improved significantly, however, a long-term follow-up can contribute to further improvement.