Clinical Research Division, Brazilian National Cancer Institute, Rio de Janeiro, Brazil.
Physiotherapy Department, Brazilian National Cancer Institute, Rio de Janeiro, Brazil.
Breast Cancer Res Treat. 2020 Nov;184(1):97-105. doi: 10.1007/s10549-020-05826-9. Epub 2020 Aug 17.
The goal of this study is to evaluate the influence of shoulder exercises with restricted amplitude movement (RAM) or free amplitude movement (FAM) performed from the first postoperative day (1st POD) on the incidence of surgical wound complications (SWC) in breast cancer.
This study comprises a randomized clinical trial with an intention-to-treat analysis including 465 women aged 18 to 79, who underwent curative surgery for breast cancer. Participants were submitted to perform free amplitude movement (FAM) or restricted amplitude movement (RAM) shoulder exercises, until the 30th postoperative day. The outcome measures were the SWC: seroma, dehiscence, necrosis, infection, hematoma and bruise.
461 participants completed the follow-up. Thirty days after surgery, 63.8% of the women presented some surgical wound complication, with necrosis (39.3%) and seroma (30.8%) as the most frequent. No statistically significant differences in SWC according to postoperative amplitude shoulder exercise (FAM vs RAM), even after a stratified analysis by type of surgery (segmentectomy vs mastectomy) or axillary approach (axillary lymphadenectomy versus sentinel lymph node biopsy) were observed.
FAM exercises do not increase the incidence of postoperative wound complications compared to RAM exercises.
NCT03796845.
本研究旨在评估乳腺癌患者术后第 1 天（1st POD）开始进行受限幅度运动（RAM）或自由幅度运动（FAM）的肩部运动对手术切口并发症（SWC）发生率的影响。
本研究为一项随机临床试验，意向治疗分析纳入了 465 名年龄在 18 至 79 岁之间的接受乳腺癌根治术的女性。参与者被要求进行自由幅度运动（FAM）或受限幅度运动（RAM）的肩部运动，直至术后第 30 天。主要结局指标为手术切口并发症（SWC）：血清肿、裂开、坏死、感染、血肿和瘀斑。
461 名参与者完成了随访。术后 30 天，63.8%的女性出现了一些手术切口并发症，其中坏死（39.3%）和血清肿（30.8%）最为常见。术后肩部运动幅度（FAM 与 RAM）对 SWC 无显著影响，即使在手术类型（节段切除术与乳房切除术）或腋窝入路（腋窝淋巴结清扫术与前哨淋巴结活检术）的分层分析后也未观察到差异。
与 RAM 运动相比，FAM 运动不会增加术后伤口并发症的发生率。
NCT03796845。
