Faculty of Health Sciences, University of Sydney, Lidcombe, Sydney, NSW 1825, Australia.
Breast Cancer Res Treat. 2012 Jun;133(2):667-76. doi: 10.1007/s10549-012-1964-1.
The aim of this study was to determine whether an exercise program, commencing 4-6 weeks post-operatively, reduces upper limb impairments in women treated for early breast cancer. Women (n = 160) were randomized to either an 8-week exercise program (n = 81) or to a control group (n = 79) following stratification for axillary surgery. The exercise program comprised a weekly session and home program of passive stretching and progressive resistance training for shoulder muscles. The control group attended fortnightly assessments but no exercises were provided. The primary outcome was self-reported arm symptoms derived from the EORTC breast cancer-specific questionnaire (BR23), scored out of 100 with a low score indicative of fewer symptoms. The secondary outcomes included physical measures of shoulder range of motion, strength, and swelling (i.e., lymphedema). Women were assessed immediately following the intervention and at 6 months post-intervention. The change in symptoms from baseline was not significantly different between groups immediately following the intervention or at 6 m post-intervention. The between group difference immediately following the intervention was 4 (95% CI -1 to 9) and 6 months post-intervention was 4 (-2 to 10). However, the change in range of motion for flexion and abduction was significantly greater in the exercise group immediately following the intervention, as was change in shoulder abductor strength. In conclusion, a supervised exercise program provided some, albeit small, additional benefit at 6 months post-intervention to women who had been provided with written information and reminders to use their arm. Both the groups reported few impairments including swelling immediately following the intervention and 6 months post-intervention. Notably, resistance training in the post-operative period did not precipitate lymphedema.
本研究旨在确定术后 4-6 周开始的运动方案是否能减轻早期乳腺癌治疗后女性的上肢损伤。将 160 名女性按腋窝手术分层分为运动组（n=81）和对照组（n=79）。运动方案包括每周一次的会议和家庭肩部肌肉被动拉伸和渐进性阻力训练方案。对照组每两周接受评估，但不提供运动。主要结果是来自 EORTC 乳腺癌特定问卷（BR23）的自我报告的手臂症状，满分为 100 分，得分越低表示症状越少。次要结果包括肩部运动范围、力量和肿胀（即淋巴水肿）的物理测量。女性在干预后立即和干预后 6 个月接受评估。干预后立即和 6 个月时，两组症状的变化无显著差异。干预后立即，组间差异为 4（95%CI-1 至 9），干预后 6 个月为 4（-2 至 10）。然而，运动组的前屈和外展活动范围的变化在干预后立即显著更大，肩部外展肌力量的变化也是如此。结论：对于接受过书面信息和提醒使用手臂的女性，监督运动方案在干预后 6 个月提供了一些，尽管很小，额外的益处。两组在干预后立即和 6 个月后报告的损伤都很少，包括肿胀。值得注意的是，术后期间的阻力训练不会引发淋巴水肿。
