Impact of Applying Shoulder Exercises on Preventing shoulder Dysfunction among Post Operative Breast Cancer Women

Background: Breast cancer is one of the alarming type of cancer which affect patients physically, socially and psychologically. Mastectomy is one of the surgical procedure for managing it.Mastectomy results in shoulder stiffness and pain, thus leading to decrease musculature strength and limitation of ROM. These changes prevent post mastectomy patients from performing normal activities of daily living. Aim: Was to study the impact of applying shoulder exercises on preventing shoulder   dysfunction among post operative breast cancer women. Design: a quasi-experimental study designwas used . Setting: The study was carried out in the surgical oncology department and surgical outpatient clinic at national  Cancer Institute   Cairo, Egypt. Subjects: A purposive  sample of(60) adult female patients with breast cancer scheduled for modified radical mastectomy and were randomly and alternatively divided equally into study and control groups; (30) for each. Tools: Two tools were used to collect data included I: patients' Structured Interview questionnairewhich include part I  patients' personal data , Part II patients' General health condition and tool II Disability of the Arm ,Shoulder and Hand (DASH questionnaire ) Pre & post exercises. Results: 50% of the study sample had no  difficulty to write and to put on pullover sweater and 63.3% of them had moderate difficulty to push open a heavy door  and to do recreational activities. 53.3% of the study sample had no  limited  activities  interference with their social activities after 4 weeks follow up   and no limited stiffness in arm ,shoulder or hand post exercises  and no tingling in arm, shoulder and hand . Total scores of the  study group  pre  shoulder exercises had a highly significant correlation with total scores of the  study group post and  follow up shoulder  exercises (P= 0.00,.002).Conclusion: Shoulder exercise in post mastectomy women  improves upper extremity range of motion and reduces pain. Shoulder exercises   were also found to improve shoulder function and upper extremity activities of daily living (ADL).Recommendations: Continuous education of  women to do shoulder exercises  which can  play an important role in improving shoulder dysfunction after mastectomy. A simple illustrated booklet and posters of shoulder exercises should be developed for breast cancer patients to prevent shoulder dysfunction after mastectomy.