Exercise helps patients regain arm mobility more quickly after breast cancer surgery
A new study indicates that physical therapy can help women receiving a lymph node dissection for breast cancer regain full use of their affected arm more rapidly than current standard follow-up care.
Many women who are treated for breast cancer receive a lymph node dissection, which is a surgery to remove lymphatic tissue between the breast and underarm. When lymph nodes are removed or damaged, fluid can build up in tissues and cause swelling, called lymphedema, which can make it difficult to move the arm. Loss of range of motion can occur soon after surgery, is disabling, and may last for many months or longer.
This study followed 568 women who had a lymph node dissection and were at risk for lymphedema. They were randomly assigned to 1 of 2 groups. Both groups received standard written educational materials about signs and symptoms of lymphedema and strategies to reduce risk. In addition, one of the groups received an exercise session with a physical therapist to learn how to do arm stretching and breathing exercises.
The women received surveys to fill out before their surgery, after surgery, at 1 year after their surgery, and at 18 months after their surgery to assess their arm range of motion from very little to full range.
Before surgery, fewer women in the exercise group than in the education-only group reported full range of motion (left arm, 58% vs. 75%; right arm, 57% vs. 76%). Over time, range of motion generally got better in both groups, but women in the exercise group reported faster improvement. Specifically, for full range of motion in both arms:
At 1 year after surgery, more women in the exercise group had full range of arm motion (91% left arm, 90% right arm) than in the education-only group (84% left arm, 83% right arm).
At 18 months after surgery, 93% of women in both groups reported having regained full range of motion in both arms.
Further analysis looked at how much the range of motion improved in the affected arm where the surgery was performed.
At 1 year after surgery, there was a 32% improvement in range of motion in the exercise group, compared to a 6% improvement in the education-only group.
At 18 months after surgery, there was a 37% improvement in the exercise group, compared to a 13% improvement in the education-only group.
What does this mean? Education helps women regain range of motion in their arms after dissection surgery, but guided exercise training in addition to that education helps women recover faster.