Effectiveness of Rehabilitation Program on Shoulder Function of Breast Cancer Patients after Mastectomy: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 HU Yan , GU Pei , ZHANG Xiaoju

Fudan Center for Evidence-base Nursing: A Collaborative Center with Joanna Briggs, Fudan University, Shanghai 200433, China;

Corresponding author：

HU Yan, Email: huyan@fudan.edu.cn

Keywords：

Breast cancer; Mastectomy; Function; Rehabilitation; Quality of life

DOI：

10.7507/1672-2531.20090012

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To evaluate the effectiveness of exercise and rehabilitation program in improving shoulder function and quality of life for breast cancer patients after mastectomy.
Method 　We searched the Cochrane Database of Systematic Reviews, JBI Database of Systematic Reviews, MEDLINE (1966 to 2008), EMbase (1989 to 2007), CINAHL (Cumulative Index to Nursing and Allied Health literature), CBMdisc (1978 to 2008), and CNKI (1994 to 2008) to collect randomized controlled trials (RCTs). The quality of RCTs was critically appraised and data were extracted by 3 reviewers independently. Meta-analyses were conducted for the eligible RCTs.
Result 　Nineteen RCTs were included. Stepwise upper extremity exercise and body exercise were reported in the rehabilitation program. Nine studies indicated that the rehabilitation program significantly improved the shoulder function of breast cancer patients after mastectomy. Four studies demonstrated its effect on cardiopulmonary function and body endurance. Six RCTs proved the effect of rehabilitation program on health-related quality of life and fatigue alleviation.
Conclusion 　 Rehabilitation program consisting of stepwise upper extremity exercise and full-body exercise is effective in improving the shoulder function and enhancing the quality of life of breast cancer patients after mastectomy. It also has a positive effect in reducing fatigue for those undergoing chemotherapy or radiotherapy.

Citation： HU Yan,GU Pei,ZHANG Xiaoju. Effectiveness of Rehabilitation Program on Shoulder Function of Breast Cancer Patients after Mastectomy: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(1): 41-54. doi: 10.7507/1672-2531.20090012 Copy

1.	Parkin DM, Bray F, Perlay J, et al. Global cancer statistics, 2002. CA: A Cancer Journal for Clinicians, 2005, 55: 74-108.
2.	张总清, 李广灿, 叶召. 乳腺癌当前流行趋势分析. 中国肿瘤, 2000, 9(10): 454-455.
3.	吴亚群, 薛新波. 乳腺肿瘤. 武汉: 湖北科学技术出版社, 2002, 118-120.
4.	Hladiuk M, Huchcroft S, Temple W, et al. Arm function after axillary dissection for breast cancer. Journal of Surgical Oncology, 1992, 50: 47-52.
5.	Shapiro SL, Lopez AM, Schwartz GE, et al. Quality of life and breast cancer: Relationship to psychosocial variables. Journal of Clinical Psychology, 2001, 57(4): 501-519.
6.	Shimozuma K, Ganz PA, Petersen L, et al. Quality of life in the first year after breast cancer surgery: rehabilitation needs and patterns of recovery. Breast Cancer Research and Treatment, 1999, 56: 45-57.
7.	Bendz I, Olsen MF. Evaluation of immediate versus delayed shoulder exercises after breast cancer surgery including lymph node dissection - a randomsed controlled trial. The Breast, 2002, 11: 241-248.
8.	Matthews CE, Wilcox S, Hanby CL, et al. Evaluation of a 12-week home-based walking intervention for breast cancer survivors. Support Care Cancer, 2007, 15: 203-211.
9.	Courneya KS, Segal RJ, Mackey JR, et al. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. Journal of Clinical Oncology, 2007, 28(28): 4396-4404.
10.	Kirshbaum MN. A review of the benefits of whole body exercise during and after treatment for breast cancer. Journal of Clinical Nursing, 2006, 16: 104-121.
11.	Pinto BM, Floyd A. Methodologic issues in exercise intervention research in oncology (review). Seminars in Oncology Nursing, 2007, 23(4): 297-304.
12.	Knols R, Aaronson NK, Uebelhart D, et al. Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials. Journal of Clinical Oncology, 2005, 23(16): 3830-3842.
13.	Higgins JPT, Green S. Cochrance Handbook for Systematic Reviews of Interventions 4.2.6. 2006: The Cochrane Collaboration.
14.	Beurskens CHg, vanUden CJT, Strobbe LJA, et al. The efficacy of physiotherapy upon shoulder function following axillary dissection in breast cancer: a randomzed controlled study. BMC Cancer, 2007, 7: 166.
15.	Box RC, Reul-Hirche HM, Bullock-Saxton JE, et al. Shoulder movement after breast cancer surgery: results of a randomised controlled study of postoperative physiotherapy. Breast Cancer Research and Treatment, 2002, 75: 35-50.
16.	Box RC, Reul-Hirche HM, Bullock-Saxton JE, et al. Physiotherapy after breast cancer surgery: results of a randomised controlled study to minimise lymphoedema. Breast Cancer Research and Treatment, 2002b, 75: 51-64.
17.	Campbell A, Mutrie N, White F, et al. A pilot study of a supervised group exercise programme as a rehabiltation treatment for women with breast cancer receiving adjuvant treatment. European Journal of Oncology Nursing, 2005, 9: 56-63.
18.	Cho OH, Yoo YS, Kim NC. Efficacy of comprehensive group rehabilitation for women with early breast cancer in South Korea. Nursing and Health Science, 2006, 8: 140-146.
19.	Courneya KS, Mackey JR, Bell GJ, et al. Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: cardiopulmonary and quality of life outcomes. Journal of Clinical Oncology, 2003, 21(9): 1660-1668.
20.	Daley AJ, Crank H, Saxton JM, et al. Randomized trial of exercise therapy in women treated for breast cancer. Journal of Clinical Oncology, 2007, 25(13): 1713-1721.
21.	Lauridsen MC, PChristlansen, Hessov L. The effect of physiotheray on shoulder function in patients surgically treated for breast cancer: a randomized study. Acta Oncologica, 2005, 44: 449-457.
22.	Milne HM, Wallman KE, Gordon S, et al. Effect of a combined aerobic and resistance exercise program in breast cancer survivors; a randomized conrolled trial. Breast Cancer Research and Treatment, 2008, 108(2): 279-288.
23.	Mock V, Pickett M, Ropka ME, et al. Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer Practice, 2001, 9(3): 119-127.
24.	Mock V, Frangakis C, Davidson NE, et al. Exercise manages fatigue during breast cancer treatment: a randomized controlled trial. Psycho-Oncology, 2005, 14: 464-477.
25.	Mutrie N, Campbell AM, Whyte F, et al. Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial. BMJ, 2007, Doi:10.1136/bmj.39094.648553.AE: 1-7.
26.	Pinto BM, Frierson GM, Rabin C, et al. Home-based physical activity intervention for breast cancer patients. Journal of Clinical Oncology, 2005, 23(15): 3577-3587.
27.	Sandel SL, Judge J, Landry N, et al. Dance and movement program improves quality of life measures in breast cancer survivors. Cancer Nursing, 2005. 28(4): 301-309.
28.	Segal R, Evans W, Johnson D, et al. Structured exercise improves physical functioning in women with stages I and II breast cancer: results of a randomized controlled trial. Journal of Clinical Oncology, 2001, 19(3): 657-665.
29.	徐文红, 杨碎胜, 张晓华, 等. 以有氧运动为基础的术侧上肢针对性医疗体操对乳腺癌术后上肢功能康复的临床效果. 中国康复医学杂志, 2004, 19(7): 529-531.
30.	王炳高, 袁新颜, 王启堂, 等. 乳腺癌术后康复训练对患者上臂水及肩关节活动的影响. 中国临床康复, 2005, 9(30): 16-19.
31.	张晓菊, 胡雁, 黄嘉玲, 等. 渐进式康复护理对乳腺癌术后肩关节活动度及生命质量的影响. 复旦学报(医学版), 2008, 35(1): 128-132.
32.	Courneya KS, Friedenreich CM, Sela RA, et al, The group psychotherapy and home-based physical exercise (Group-Hope) trail in cancer survivors: physical fitness and quality of life outcomes. Psycho-Oncology, 2003b. 12: 357-374.
33.	McKenzie DC, Kalda AL. Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study. Journal of Clinical Oncology, 2003, 21(3): 463-466.

1. Parkin DM, Bray F, Perlay J, et al. Global cancer statistics, 2002. CA: A Cancer Journal for Clinicians, 2005, 55: 74-108.
2. 张总清, 李广灿, 叶召. 乳腺癌当前流行趋势分析. 中国肿瘤, 2000, 9(10): 454-455.
3. 吴亚群, 薛新波. 乳腺肿瘤. 武汉: 湖北科学技术出版社, 2002, 118-120.
4. Hladiuk M, Huchcroft S, Temple W, et al. Arm function after axillary dissection for breast cancer. Journal of Surgical Oncology, 1992, 50: 47-52.
5. Shapiro SL, Lopez AM, Schwartz GE, et al. Quality of life and breast cancer: Relationship to psychosocial variables. Journal of Clinical Psychology, 2001, 57(4): 501-519.
6. Shimozuma K, Ganz PA, Petersen L, et al. Quality of life in the first year after breast cancer surgery: rehabilitation needs and patterns of recovery. Breast Cancer Research and Treatment, 1999, 56: 45-57.
7. Bendz I, Olsen MF. Evaluation of immediate versus delayed shoulder exercises after breast cancer surgery including lymph node dissection - a randomsed controlled trial. The Breast, 2002, 11: 241-248.
8. Matthews CE, Wilcox S, Hanby CL, et al. Evaluation of a 12-week home-based walking intervention for breast cancer survivors. Support Care Cancer, 2007, 15: 203-211.
9. Courneya KS, Segal RJ, Mackey JR, et al. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. Journal of Clinical Oncology, 2007, 28(28): 4396-4404.
10. Kirshbaum MN. A review of the benefits of whole body exercise during and after treatment for breast cancer. Journal of Clinical Nursing, 2006, 16: 104-121.
11. Pinto BM, Floyd A. Methodologic issues in exercise intervention research in oncology (review). Seminars in Oncology Nursing, 2007, 23(4): 297-304.
12. Knols R, Aaronson NK, Uebelhart D, et al. Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials. Journal of Clinical Oncology, 2005, 23(16): 3830-3842.
13. Higgins JPT, Green S. Cochrance Handbook for Systematic Reviews of Interventions 4.2.6. 2006: The Cochrane Collaboration.
14. Beurskens CHg, vanUden CJT, Strobbe LJA, et al. The efficacy of physiotherapy upon shoulder function following axillary dissection in breast cancer: a randomzed controlled study. BMC Cancer, 2007, 7: 166.
15. Box RC, Reul-Hirche HM, Bullock-Saxton JE, et al. Shoulder movement after breast cancer surgery: results of a randomised controlled study of postoperative physiotherapy. Breast Cancer Research and Treatment, 2002, 75: 35-50.
16. Box RC, Reul-Hirche HM, Bullock-Saxton JE, et al. Physiotherapy after breast cancer surgery: results of a randomised controlled study to minimise lymphoedema. Breast Cancer Research and Treatment, 2002b, 75: 51-64.
17. Campbell A, Mutrie N, White F, et al. A pilot study of a supervised group exercise programme as a rehabiltation treatment for women with breast cancer receiving adjuvant treatment. European Journal of Oncology Nursing, 2005, 9: 56-63.
18. Cho OH, Yoo YS, Kim NC. Efficacy of comprehensive group rehabilitation for women with early breast cancer in South Korea. Nursing and Health Science, 2006, 8: 140-146.
19. Courneya KS, Mackey JR, Bell GJ, et al. Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: cardiopulmonary and quality of life outcomes. Journal of Clinical Oncology, 2003, 21(9): 1660-1668.
20. Daley AJ, Crank H, Saxton JM, et al. Randomized trial of exercise therapy in women treated for breast cancer. Journal of Clinical Oncology, 2007, 25(13): 1713-1721.
21. Lauridsen MC, PChristlansen, Hessov L. The effect of physiotheray on shoulder function in patients surgically treated for breast cancer: a randomized study. Acta Oncologica, 2005, 44: 449-457.
22. Milne HM, Wallman KE, Gordon S, et al. Effect of a combined aerobic and resistance exercise program in breast cancer survivors; a randomized conrolled trial. Breast Cancer Research and Treatment, 2008, 108(2): 279-288.
23. Mock V, Pickett M, Ropka ME, et al. Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer Practice, 2001, 9(3): 119-127.
24. Mock V, Frangakis C, Davidson NE, et al. Exercise manages fatigue during breast cancer treatment: a randomized controlled trial. Psycho-Oncology, 2005, 14: 464-477.
25. Mutrie N, Campbell AM, Whyte F, et al. Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial. BMJ, 2007, Doi:10.1136/bmj.39094.648553.AE: 1-7.
26. Pinto BM, Frierson GM, Rabin C, et al. Home-based physical activity intervention for breast cancer patients. Journal of Clinical Oncology, 2005, 23(15): 3577-3587.
27. Sandel SL, Judge J, Landry N, et al. Dance and movement program improves quality of life measures in breast cancer survivors. Cancer Nursing, 2005. 28(4): 301-309.
28. Segal R, Evans W, Johnson D, et al. Structured exercise improves physical functioning in women with stages I and II breast cancer: results of a randomized controlled trial. Journal of Clinical Oncology, 2001, 19(3): 657-665.
29. 徐文红, 杨碎胜, 张晓华, 等. 以有氧运动为基础的术侧上肢针对性医疗体操对乳腺癌术后上肢功能康复的临床效果. 中国康复医学杂志, 2004, 19(7): 529-531.
30. 王炳高, 袁新颜, 王启堂, 等. 乳腺癌术后康复训练对患者上臂水及肩关节活动的影响. 中国临床康复, 2005, 9(30): 16-19.
31. 张晓菊, 胡雁, 黄嘉玲, 等. 渐进式康复护理对乳腺癌术后肩关节活动度及生命质量的影响. 复旦学报(医学版), 2008, 35(1): 128-132.
32. Courneya KS, Friedenreich CM, Sela RA, et al, The group psychotherapy and home-based physical exercise (Group-Hope) trail in cancer survivors: physical fitness and quality of life outcomes. Psycho-Oncology, 2003b. 12: 357-374.
33. McKenzie DC, Kalda AL. Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study. Journal of Clinical Oncology, 2003, 21(3): 463-466.

Chinese Journal of Evidence-Based Medicine

Effectiveness of Rehabilitation Program on Shoulder Function of Breast Cancer Patients after Mastectomy: A Systematic Review

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content