Effectiveness of early rehabilitation on range of motion, muscle strength and arm function after breast cancer surgery: a systematic review of randomized controlled trials

Autor(es)

Ribeiro, Ivana Leao ^{[1, 2]} ; Carreira Moreira, Roberta Fatima ^[1] ; Ferrari, Angelica Viana ^[1] ; Alburquerque-Sendin, Francisco ^{[3, 4]} ; Camargo, Paula Rezende ^[1] ; Salvini, Tania Fatima ^[1]

Afiliação do(s) autor(es)

^[1] Univ Fed Sao Carlos, Dept Phys Therapy, Sao Carlos, SP - Brazil

^[2] Univ Catolica Maule, Fac Hlth Sci, Dept Kinesiol, Talca - Chile

^[3] Univ Cordoba, Dept Sociosanitary Sci Radiol & Phys Med, Cordoba - Spain

^[4] Inst Maimonides Invest Biomed Cordoba IMIBIC, Cordoba - Spain

• Tipo de documento: Artigo de Revisão
• Fonte: CLINICAL REHABILITATION; v. 33, n. 12, p. 1876-1886, DEC 2019.
• Citações Web of Science: 0

Resumo

Objective: The objective was to evaluate the effectiveness of early rehabilitation on arm range of motion (ROM), strength and function after breast cancer surgery (BCS). Data sources: PubMed, MEDLINE, Bireme, Embase, LILACS and CINAHL databases were searched. Methods: Two independent reviewers selected randomized controlled trials evaluating women who underwent early rehabilitation to restore arm ROM, strength or function after BCS. Cochrane Collaboration recommendations and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Methodological quality was assessed by the PEDro scale. The International Classification of Functioning, Disability and Health was considered to analyze results. Effect size (ES) was calculated for clinical relevance interpretation of the outcomes of interest, and the evidence was summarized through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Results: Up to June 2019, a total of 1658 references were identified and 15 studies were included. Twelve of them presented adequate methodological quality. A total of 1710 patients were evaluated. Few studies performed the simultaneous assessment of variables related to body structure and function and patient-reported outcomes. A moderate level of evidence was synthesized regarding the effectiveness of ROM exercises for improving arm flexion, abduction and external rotation (ES: 0.45-2.5). A low level of evidence was synthesized regarding the effectiveness of isolated strengthening exercises for patient-reported arm function. ROM exercises associated with muscle strengthening exhibited a moderate level of evidence for improving shoulder flexion (ES: 1.4-2.4). Conclusion: Both ROM and strengthening exercises associated with ROM exercises improved shoulder flexion, abduction and external rotation ROM after BCS. Shoulder abduction and external rotation showed less recovery, irrespective of the intervention applied. (AU)

• Processo FAPESP: 11/22122-5 - Estudo das adaptações biomecânicas, sensoriais, cardiorespiratórias e da qualidade de vida associadas à intervenção fisioterapêutica na síndrome fibromiálgica
• Beneficiário: Tania de Fatima Salvini
• Linha de fomento: Auxílio à Pesquisa - Temático
• Processo FAPESP: 15/50303-5 - Study of the sensorial, perceived pain, quality of life and biomechanical adaptations associated to physical therapy intervention in the fibromyalgic syndrome
• Beneficiário: Tania de Fatima Salvini
• Linha de fomento: Auxílio à Pesquisa - Regular