Exercise Improves Arm Function After Breast Cancer Surgery
Posted Jun 21 2010 7:52am
Breast cancer surgery, particularly mastectomy, can dramatically effect the associated shoulder and arm by reducing range of motion and strength, while causing pain and swelling under the arm. Previous studies have suggested that strengthening and stretching exercises after breast cancer surgery can help improve recovery of arm function. However, questions about appropriate forms of exercise and when to begin exercising after surgery remain.
A new detailed review of the science examined the results of 24 clinical trials that involved over 2,000 patients in an attempt to clear up some of the questions regarding the utility of arm exercises after breast cancer surgery.
Early versus Delayed Exercise:
Starting arm exercises 1-3 days after breast cancer surgery appeared to have greater benefits for range of motion in the short term compared to delaying exercise for about 1 week.
Negative effects of exercising early included an increase in wound drainage that required drains to remain in place about 1 day longer on average.
Structured Exercise versus Usual Care (exercise pamphlet or no exercise)
Structured exercises done during the first few weeks after breast cancer surgery substantially improved shoulder range of motion.
Physical therapy improved shoulder function both immediately after the therapy program and at least 6 months after program completion.
No increased risk of arm swelling was observed whether the structured exercise program was started immediately after breast cancer surgery, during post-surgical breast cancer therapy, or following breast cancer treatment.
Overall, this review of the scientific evidence confirms the importance of upper arm exercises for re-establishing range of motion and arm strength after breast cancer surgery. More importantly, this review makes it clear that structured exercise programs like physical therapy are likely to provide the greatest benefits. While starting upper arm exercises within the first few days following surgery provides some additional benefit in short-term recovery, it comes with the risk of additional wound draining. Beginning a structured exercise program within the first few weeks following breast cancer surgery has the potential to improve arm function and reduce the risk of long-term complications that reduce arm function and strength.