The Effects of a Specific Exercise Program on Shoulder Function for Breast Cancer Survivors, 6-9 Months Post-Surgery

Background: The most common complication following breast cancer intervention surgery is a lack of shoulder function of the affected side, which has been linked to a decrease in quality of life. Presently, few reports are available that examine the benefits of a limited active, rehabilitative shoulder program to assist this population during their recovery period (6-9 months).

Hypothesis: Implementing a specific active exercise program (9 weeks) for breast cancer survivors, 6-9 months post-surgery will improve this populations perceived quality of life, perceived shoulder function, improve their observational posture, decrease lymphedema and improve their active shoulder range of motion.

Study Design and Methods: This study was approved by York Universitys Human Participants Review Sub-Committee and Mount Sinais Toronto Academic Health Sciences Network. The exercise program targeted muscle range of motion, strength, endurance and included the following exercises: static pectoralis stretch, active shoulder lateral raises with internal rotation, bent over row and standing push-ups. The exercise program was progressive (an increase of 5 repetitions per week) and was the same four exercises for each participant within the study. All participants (n=6) were assessed at baseline, four weeks post-baseline and eight weeks post-baseline. Only baseline measurements and final assessment were analyzed for the overall true effect of the exercise intervention. Outcome measures included: Quality of Life questionnaires (EORTC QLQ-C30, QLQ-BR23 and DASH), clinical postural evaluation, measurement of lymphedema (by a cloth measuring tape) and range of motion using a standard manual goniometer.

Results: Upon the completion of the study, participants found a perceived improvement in the social functioning scale, with a mean change from baseline to final assessment: 58.0-77.7 (t=-2.91, p=0.03, SD 11.79), and pain scale, with a mean from baseline to final assessment: 41-22 (t=3.80, p=0.01, SD11.79). Furthermore, participants perceived an improvement in their shoulder function in approximately 20% of the DASH questionnaire items and clinically, the participants shoulder range of motion made a relevant improvement from baseline to final assessment.

Conclusion: The implementation of an active and daily exercise program was statistically significant and clinically relevant in the perceived improvement of quality of life, both a perceived and an observational improvement in shoulder function for breast cancer survivors 6-9 months post-surgery.