THE ROLE OF PHYSICAL THERAPY FOLLOWING ONCOLOGIC BREAST SURGERY

Abstract

The relevance of physical therapy following oncological surgeries on the breast, as an integral part of the recovery of function of the upper extremity and the prevention of secondary lymphedema, is assessed. Cancer therapy, including radical or breast-conserving surgery, is associated with a constellation of impairments such as pain, post-operative edema, a reduction in the active and passive mobility of the shoulder joint, muscle weakness, sensory changes, the formation of scars, and changes in posture. These result in decreased capacity to perform everyday activities, and lead to a loss of functional independence and a diminished quality of life.

Rehabilitation programs are based on fundamental principles, including timely commencement, individualization, gradual increase of exercise load, regularity of activities, and active patient participation. Physical therapy treatment interventions include exercise for the recovery of ROM, AROM, and IR/ER, isometric and isotonic exercises, breathing exercises, exercises assisting lymphatic drainage, posture correction, and functional exercises in performing activities of daily living. Early exercises involving movements have been found to be safe, effective in decreasing pain, prevent contractures, regain mobility of the shoulder joint, and decrease the incidence of lymphedema.

The physical therapist performs functional assessment, develops the rehabilitation program, sets SMART goals, and monitors recovery. The need for an multidiisciplinary team approach to include collaboration physical therapist with the surgeon, oncologist and other professionals is emphasized to ensure continuity in the treatment and rehabilitation process. This review shows that physical therapy is essential in postoperative care, supporting upper limb recovery, preventing complications, and improving quality of life.