Development and Validation of an Exercise Program for Women Submitted to Breast Cancer Surgery

Abstract

Background: The benefits of early functional rehabilitation in women submitted to breast cancer surgery are widely known, but there is no consensus on the best exercises or their periodicity and duration. Objective: The objectives were to identify and select a set of exercises for a postoperative rehabilitation program aimed at functional recovery of the ipsilateral limb and to validate this program with experts. Methods: Review of scientific articles on the effectiveness of functional rehabilitation programs for shoulder range of movement following breast cancer surgery, published from 1997 to 2006 in the MEDLINE, LILACS, and PUBMED databases. Selection of a set of exercises for the recovery of shoulder range of movement and its evaluation by rehabilitation experts. Results: Of the 21 articles found, 12 reported on testing or standardization of procedures for post-mastectomy physical rehabilitation, which constituted the basis for selecting the 20 exercises submitted to expert evaluation. The experts considered nine of these exercises indispensable, with a concordance rate greater than or equal to 75%. The exercises that achieved the highest concordance rates were cervical stretching, shoulder flexion, extension, and abduction. Conclusion: The study findings contributed greatly to the reorganization of the existing manual at the Breast Cancer Service of the Federal University in São Paulo (UNIFESP).