Effectiveness of Exercise Protocol on Upper Arm Dysfunction and Quality of Life among Women with Breast Cancer: Randomized Controlled Trial

Abstract

Introduction: Upper arm dysfunction occurs after breast cancer surgery and include one or more of following arm impairments like decreased shoulder range of motion, strength, pain, numbness, swelling, weakness, and lymphedema. The objective of study was to assess the effectiveness of exercise protocol on upper arm dysfunction and quality of life (QOL) among women with breast cancer who have undergone mastectomy with axillary lymph node dissection. Methods: A randomized controlled trial (Time series design) included 44 women with breast cancer in All India Institute of Medical Sciences (AIIMS), New Delhi and who were scheduled for mastectomy with axillary lymph node dissection. Purposive sampling was done. Subjects were randomly allocated to experimental (n=22) and control group (n=22). However, 40 patients completed the study till 8 weeks. Subjects in experimental group received exercise protocol from post-surgery day 1 to 8 weeks while control group received standard routine care. Data regarding socio demographic and clinical characteristics were collected at baseline. Upper arm dysfunction and quality of life were assessed by structured questionnaires at baseline (post-surgery day 1) at 2 weeks and at 8 weeks. Results: The two groups were homogenous with regard to socio-demographic variables and clinical characteristics at baseline. The experimental group had significant reduction in upper arm dysfunction, seen by reduction in mean subjective symptom score (p<0.0001) and DASH scores (p<0.0001) as compared to control group. There was significant improvement in Quality of life scores in experimental group as compared to control group with p value <0.0001 indicating improvement in quality of life after 8 weeks of intervention. Conclusion: Exercise protocol administration from day 1 after surgery to 8 weeks was effective in reducing upper arm dysfunction and improving the quality of life among breast cancer patients who have undergone mastectomy with axillary lymph node dissection.