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The Impact of Therapeutic Exercises on the Quality of Life and Shoulder Range of Motion in Women After a Mastectomy, an RCT

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Abstract

Breast cancer ranks highest in incidence and mortality among females and second among both genders. Lebanon has the second highest rate of breast cancer worldwide for those 35–39 years old and the highest for those 40–49. Mastectomy often results in deceased shoulder and arm mobility and decreased quality of life. The objective of this study was to assess the effect of an educational program of therapeutic exercises on the quality of life and functional ability in women after a mastectomy. Sixty women undergoing a mastectomy were randomly assigned to either an intervention or control group. The intervention group received extensive pre-surgery education as well as training on therapeutic exercises. Follow-up phone calls to the intervention group were made to ensure that the exercises were being done. Both groups were visited at home at two and four weeks to obtain the outcome variables. The Breast Cancer Patient Version was used to assess quality of life, and the “Goniometer” was used to assess the range of motion of the affected shoulder. At two and four weeks after surgery, women in the intervention group had significant improvements in their shoulder range of motion: flexion, extension, and abduction were significantly different between the control and intervention group at p = 0.04–0.00. For quality of life, physical, psychological, psychological, social, and spiritual well-being were significantly higher for the intervention group at both two and four weeks after surgery, p < 0.001. In a middle-income country, one-to-one education provided by a nurse, which included demonstrations, back demonstrations, and weekly phone calls had a positive impact on women’s shoulder range of motion and quality of life. NCT04184102

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Author information

Authors and Affiliations

  1. Medical Surgical Unit, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon

    Mohamad Majed

  2. California State University Channel Islands, Camarillo, CA, USA

    Charlene A. Neimi

  3. Medical-Surgical Nursing Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon

    Sawsan Moustafa Youssef

  4. Beirut Arab University, Beirut, Lebanon

    Khaled Ahmed Takey

  5. School of Nursing, Azusa Pacific University, Azusa, CA, 91702, USA

    Lina Kurdahi Badr

Authors
  1. Mohamad Majed
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  2. Charlene A. Neimi
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  3. Sawsan Moustafa Youssef
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  4. Khaled Ahmed Takey
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  5. Lina Kurdahi Badr
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Correspondence to Lina Kurdahi Badr.

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Quick points

• Nurses can play an important role in teaching women who are undergoing a mastectomy, exercises that may improve their physical and psychological outcomes.

• This study in a middle-income country found that women who underwent a mastectomy and received education, and exercise training had better range of motion in their affected shoulder and better quality of life.

• This randomized control trial study adds to body of evidence regarding the effect of exercise and education on the outcome of women undergoing mastectomies, which has not been conclusively established.

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Majed, M., Neimi, C.A., Youssef, S.M. et al. The Impact of Therapeutic Exercises on the Quality of Life and Shoulder Range of Motion in Women After a Mastectomy, an RCT. J Canc Educ 37, 843–851 (2022). https://doi.org/10.1007/s13187-020-01894-z

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