Evaluation of a physiotherapeutic protocol applied to mastectomized patients

Abstract

Objective: The objective of this study was to assess a physiotherapeutic protocol applied to mastectomized patients (Madden's technique). Methods: 119 patients aged 29-79 years were assessed and submitted to Modified Radical Mastectomy by Madden's technique, at the Instituto de Mastologia e Ginecologia do Hospital Beneficência Portuguesa, São Paulo, from May 2001 to December 2002. Out of these 119 patients, only 44 were selected according to inclusion and exclusion criteria. Two groups were composed, one with 33 patients submitted to a physiotherapeutic protocol up to discharge, and another group with 11 patients who discontinued treatment. ROM and likely progression to lymphedema were assessed in both groups. Results: By the end of treatment, all patients submitted to the physiotherapeutic protocol presented no limitation and/or small limitation in ROM, varying from 150º to 180º, and only three of them developed lymphedema. When the group who discontinued treatment was reassessed, ROM limitation varied from 40º to 170º, and four patients developed lymphedema. Conclusion: This study showed the efficiency of the proposed protocol for post mastectomized patients. Early physiotherapeutic intervention applied at hospital, not only helps preventing post-surgical complications, but it also rehabilitates patients earlier for their activities of daily living (ADLs). Moreover, it benefits them by receiving collaboration and encouragement for treatment provided by a multidisciplinary team.