Physical therapy after breast cancer surgery improves range of motion and pain over time

ABSTRACT

Treatment of breast cancer can impair range of motion (ROM) and cause homolateral upper limb pain (UL). This study aimed to compare the ROM, intensity and characterization of UL homolateral pain between the 1^st, 10^th and 20^th sessions of physiotherapy, besides correlating these variables. A clinical trial self-controlled study involving 49 women after mastectomy or quadrantectomy with pain complaint on UL was conducted. ROM was evaluated by goniometry and contralateral UL was adopted as control. The intensity of pain was evaluated by the visual analogue scale (VAS) and characterized by the McGill questionnaire, obtaining the number of words chosen (NWC) and the pain evaluation index (PRI). The ROM of the homolateral UL increased significantly over the 20 sessions. Comparing the homolateral UL with the control, only the abduction did not improve significantly after the 20^th session. Pain intensity, PRI and NWC reduced significantly between 1^st and 10^th and between 1^st and 20^th sessions. The sensory and evaluative categories also decreased significantly. We observed a significant correlation between VAS, PRI and NWC in the 10^th and 20^th sessions. Physiotherapy increased ROM, reduced pain in the homolateral UL, and fewer words were chosen to characterize the pain. Significant improvements were observed at the beginning of treatment, but with additional gains over time. Exercises for bilateral flexion, abduction, and external rotation should be emphasized.

Keywords:
Breast Neoplasms; Mastectomy; Pain; Physical therapy; Range of Motion, Articular