Department of Gynecology, Federal University of São Paulo (UNIFESP), São Paulo.
Lusíada University Center (UNILUS), Santos, SP, Brazil.
Am J Clin Oncol. 2021 Jun 1;44(6):283-290. doi: 10.1097/COC.0000000000000811.
The objective is to evaluate the effect of limiting shoulder range of motion (ROM) for 15 or 30 days on surgical complications and on shoulder ROM, pain, and upper limb function of breast cancer patients following conservative oncoplastic surgery.
A randomized clinical trial was conducted with 60 women with breast cancer who underwent conservative oncoplastic surgery. The day after surgery, all patients started an exercise protocol with shoulder exercises limited to 90 degrees. Two weeks after surgery they were randomized into Free ROM Group (n=30) or Limited ROM Group (n=30). The Free ROM Group was allowed to perform shoulder exercises with unlimited ROM; the Limited ROM Group continued with shoulder movement restricted at 90 degrees until 30 days after surgery, at which time they were also allowed free ROM. The primary outcome was the incidence of postoperative complications (dehiscence, seroma, infection, and necrosis) and secondary outcomes were shoulder ROM, pain, and upper limb function.
No difference in the incidence of postoperative scar complications between groups was noted. There was no difference between the groups in shoulder joint amplitude, pain, or upper limb function.
The free ROM exercise protocol 15 days post surgery was safe concerning cicatricial complications.
评估限制肩部活动范围（ROM）15 天或 30 天对接受保乳肿瘤整形术后乳腺癌患者手术并发症以及肩部 ROM、疼痛和上肢功能的影响。
对 60 名接受保乳肿瘤整形术的乳腺癌女性患者进行了一项随机临床试验。术后第一天，所有患者开始进行一项肩部运动方案，肩部运动限制在 90 度以内。术后 2 周，他们被随机分为自由 ROM 组（n=30）或限制 ROM 组（n=30）。自由 ROM 组可进行无限制 ROM 的肩部运动；限制 ROM 组继续限制肩部运动在 90 度以内，直到术后 30 天，此时也允许进行自由 ROM。主要结局是术后并发症（裂开、血清肿、感染和坏死）的发生率，次要结局是肩部 ROM、疼痛和上肢功能。
两组间术后瘢痕并发症的发生率无差异。两组间肩关节幅度、疼痛或上肢功能无差异。
术后 15 天进行自由 ROM 运动方案不会增加瘢痕并发症的风险。
