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Clinical breast cancer · Feb 2018
Randomized Controlled TrialA Pilot Randomized Controlled Trial on the Effects of a Progressive Exercise Program on the Range of Motion and Upper Extremity Grip Strength in Young Adults With Breast Cancer.
- Marize Ibrahim, Thierry Muanza, Nadia Smirnow, Warren Sateren, Beatrice Fournier, Petr Kavan, Michael Palumbo, Richard Dalfen, and Mary-Ann Dalzell.
- Jewish General Hospital, Rehabilitation and Exercise Oncology Program, Hope & Cope, Montreal, QC, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, QC, Canada; Department of Oncology, McGill University, Montreal, QC, Canada.
- Clin. Breast Cancer. 2018 Feb 1; 18 (1): e55-e64.
BackgroundThe diagnosis of breast cancer in young women (aged 18-45 years) has been increasing. Women are commonly left coping with treatment-related disabilities of the upper limb that can persist for > 2 years postoperatively.Patients And MethodsA total of 59 young breast cancer patients (29 in the intervention group and 30 in the control group) participated in a pilot prospective randomized controlled trial to determine whether a 12-week postradiation exercise program would improve long-term arm mobility, pain, and handgrip strength. During an 18-month period, range of motion, handgrip strength, and pain with shoulder movements were evaluated at 6 points.ResultsAlthough the differences were not statistically significant, external rotation and horizontal abduction of the shoulder improved in the intervention group immediately after the exercise intervention (3 months) and showed a trend toward less pain on movement. However, at 18 months after radiation the control and intervention groups both retained a residual loss of range and persistent pain with movement. Radiation to the axilla and/or chest wall yielded long-term (18 months) limitations in flexion and horizontal abduction compared with hypofractionation, which resulted in greater flexion and external rotation at 18 months. The median grip strength of the study participants corresponded to the 10th percentile of healthy aged-matched white women.ConclusionThe exercise intervention timed shortly after radiation improved short-term shoulder mobility and pain; however, these gains were not sustained at 18 months after radiation.Copyright © 2017 Elsevier Inc. All rights reserved.
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