Physical therapy after breast cancer surgery improves range of motion and pain over time
Mariana Tirolli Rett, Danielly Pereira Moura, Fernanda Bispo de Oliveira, Helena Yannael Bezerra Domingos, Mariana Maia Freire de Oliveira, Rubneide Barreto Silva Gallo, Walderi Monteiro da Silva Júnior
Abstract
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 1st, 10th and 20th 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 20th session. Pain intensity, PRI and NWC reduced significantly between 1st and 10th and between 1st and 20th sessions. The sensory and evaluative categories also decreased significantly. We observed a significant correlation between VAS, PRI and NWC in the 10th and 20th 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.