Below is further information about the exercises used in the recent investigation entitled:
"The incidence of lymphoedema following 'early' versus 'delayed' shoulder mobilisation after axillary node dissection for invasive breast cancer: A randomised controlled trial".
This study investigated the incidence of lymphoedema and other shoulder complications in women treated with surgery including axillary node dissection.
The main result of this study was that there were a significantly greater number of women who developed lymphoedema after a programme of early full shoulder mobilisation. The relative risk of developing lymphoedema after early shoulder mobilisation was 2.7 (95% CI 1.1 to 6.3; p=0.031). Women using the delayed exercise programme did not develop any greater problems with their arm when compared to women in the early exercise group.
The conclusion of this study was that a programme of exercise that delays full shoulder mobilisation for one week is recommended after axillary node dissection for invasive breast cancer. The images provided illustrate the two sets of exercises that formed the exercise protocol for participants in the delayed mobilisation group. The first set of exercises was used for the first week after surgery and the second set was started on Day 7. The exercises should be undertaken four times a day, starting with three of each exercise and building up to five times for each exercise. They will have the best effect if each exercise is carried out slowly, as a slow stretch. When you have stretched the arm as far as is comfortable, hold the position for the count of five and then try to stretch a little bit further, before returning your arm to the resting position.The exercises should take about ten minutes to complete.
Repeat the exercises four times a day until you can perform full shoulder movements and exercise with comfort. After this is possible, you are still advised to repeat the exercises once a day for a full year after your surgery. The reason for continuing the arm exercises is that the shoulder can become stiff at any point in this first year, especially if you have been treated with radiotherapy.A leaflet providing a pictorial guide to the exercises can be viewed by clicking on the link "Arm Exercises following Breast Surgery".
We hope that you find this guidance helpful.
With best wishes
Dr Jacquelyne Todd PhD MCSP Graddipphys