A pilot study evaluating the effect of early physical therapy on pain and disabilities after breast cancer surgery: Prospective randomized control trail

Ifat Klein, Leonid Kalichman, Noy Chen, Sergio Susmallian, Ifat Klein, Leonid Kalichman, Noy Chen, Sergio Susmallian

Abstract

Background: Morbidity of the shoulders after breast cancer (BC) surgery is a common side effect that includes; persistent pain, function limitation, and decreased range of motion (ROM). This study examines the effect of early physical therapy (PT) and patient's education on these morbidities.

Methods: A prospective, randomized clinical trial was conducted at a single medical center from October 2018 until April 2019. Women scheduled for breast cancer surgery were divided into intervention or control as standard care. The intervention included a PT treatment that included exercise instructions from the first postoperative day. Pain levels, upper limb function, ROM, and complications were measured.

Results: The study includes 157 women (mean age, 52.2 ± 12.9). Early PT reduced pain levels at the first month (NPRS 1.5 ± 1.2) and six months (NPRS 0.5 ± 0.8), compared with control (NPRS 2.1 ± 1.4, 1.0 ± 1.2), p = 0.019 and p = 0.011, respectively. Subdivision of the sample into small and extensive surgeries revealed additional positive effect for the intervention six months postoperatively on functional disabilities, p = 0.004 and p = 0.032 respectively. No complications attributable to the intervention were recorded.

Conclusions: Early PT and patient education reduces pain levels, and may improve function disabilities, without causing postoperative complications, although a larger study is needed to achieve unequivocal results.

Keywords: Breast neoplasm; Pain; Physical activity; Physical therapy modalities; Rehabilitation.

Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

Figures

Fig. 1
Fig. 1
Flow chart of the study. A: Small surgery with intervention, B: Small surgery control, C: Extensive surgery with intervention, D: Extensive surgery control.
Fig. 2
Fig. 2
Mean function scores over time in four study groups. Abbreviations: PRE-OP: Preoperative, MNTH: Month.
Fig. 3
Fig. 3
Mean pain scores over time in the four study groups. Abbreviations: PRE-OP: Preoperative, PERI-OP: Perioperative (during hospitalization), MNTH: Month.

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Source: PubMed

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