Effect of ERAS and Upper Limb Exercise on LoS After Modified Radical Mastectomy

The Effect of Enhanced Recovery After Surgery and Upper Limb Exercise on Length of Stay After Modified Radical Mastectomy

The goal of this clinical trial is to learn if Enhanced Recovery After Surgery (ERAS) protocol and upper limb exercise shorten the length of stay (LoS) in adults after modified radical mastectomy (MRM) surgery. The main questions it aims to answer are:

• Do ERAS protocol and upper limb exercise shorten the LoS after modified radical mastectomy (MRM)? Researchers will compare the ERAS protocol and upper limb exercise intervention to standard care to determine whether these interventions reduce LoS.

Four weeks before surgery, participants in intervention group will do:

• Aerobic exercise by walking for 30 minutes at moderate intensity (Borg scale 12-14) with frequency twice a week and by cycling for 30 minutes at moderate intensity (40-60% HRR / 64-76% HRmax/RPE 12-14) with frequency three times a week.
• Strengthening exercise of lower limbs three times a week, intensity 60-80% 1RM, 3 set, 10 repetition, rest 60 seconds between sets by machine pulley.
• Strengthening exercise of upper limbs at intensity 60-80% 1RM, frequency three times a week, 10 repetition, rest 60 seconds by bench press and cable front raise.
• Stretching exercise of upper limbs and range of motion exercise frequency three times a week, hold 10 seconds, by static stretching.

After surgery, both groups will do:

• Mobilization, ambulation, and shoulder range of motion exercise in first 24 hours after surgery.

Study Overview

• Status: Completed
• Conditions: Modified Radical Mastectomy
• Intervention / Treatment: Behavioral: Enhanced Recovery After Surgery; Behavioral: Upper Limb Exercise

• Study Type: Interventional
• Enrollment (Actual): 24
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Indonesia
  • North Sulawesi
    • Manado, North Sulawesi, Indonesia
      • Prof. Dr. R. D. Kandou General Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Women aged 30-65 years
2. Diagnosed with breast cancer by histopathological examination and will undergo the first MRM surgery
3. Planned to undergo neoadjuvant chemotherapy
4. Hemodynamically stable (assessed by vital signs)
5. Mini Mental State Examination (MMSE) score > 25
6. Comorbid diseases are controlled
7. Corrected nutritional status
8. No balance or coordination disorders
9. Normal or corrected vision function
10. Normal hearing function as tested by whisper test
11. Willing and agree to participate in the study until completion and sign informed consent

Exclusion Criteria:

1. Presence of distant metastasis
2. Presence of lymphedema
3. Limited joint range of motion
4. Other cardiovascular conditions that contraindicate physical exercise according to the American College of Sports Medicine (ACSM) guidelines

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Standard Care
Experimental: ERAS protocol and upper limb exercises	Behavioral: Enhanced Recovery After Surgery; Four weeks before surgery, participants in intervention group will do: Aerobic exercise by walking for 30 minutes at moderate intensity (Borg scale 12-14) with frequency twice a week and by cycling for 30 minutes at moderate intensity (40-60% HRR / 64-76% HRmax/RPE 12-14) with frequency three times a week.; Strengthening exercise of lower limbs three times a week, intensity 60-80% 1RM, 3 set, 10 repetition, rest 60 seconds between sets by machine pulley.; Behavioral: Upper Limb Exercise; Four weeks before surgery, participants in intervention group will do: Strengthening exercise of upper limbs at intensity 60-80% 1RM, frequency three times a week, 10 repetition, rest 60 seconds by bench press and cable front raise.; Stretching exercise of upper limbs and range of motion exercise frequency three times a week, hold 10 seconds, by static stretching.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Length of Stay	Length of stay after Modified Radical Mastectomy	From the date of surgery until hospital discharge, assessed up to 10 days

Collaborators and Investigators

• Sponsor: Prof. R. D. Kandou General Hospital

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2024
• Primary Completion (Actual): March 31, 2025
• Study Completion (Actual): March 31, 2025

Study Registration Dates

• First Submitted: April 28, 2026
• First Submitted That Met QC Criteria: May 4, 2026
• First Posted (Actual): May 7, 2026

Study Record Updates

• Last Update Posted (Actual): May 7, 2026
• Last Update Submitted That Met QC Criteria: May 4, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Exercises; Enhanced Recovery After Surgery; Prehabilitation
• Additional Relevant MeSH Terms: Behavior; Motor Activity; Surgical Procedures, Operative; Perioperative Care; Enhanced Recovery After Surgery
• Other Study ID Numbers: 200/EC/KEPK-KANDOU/X/2024

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No