Turkish Journal of Physical Medicine and Rehabilitation 2007 , Vol 53 , Num 4

Effectiveness of Comprehensive Rehabilitation Program and Home-Based Exercise in Middle and Long Term Mastectomy Related Disability

Ümit Dinçer 1 ,Erkan Kaya 2 ,Engin Çakar 3 ,Mehmet Zeki Kıralp 4 ,Hasan Dursun 5
1 Gata Haydarpaşa Eğitim Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul, Türkiye
2 Mareşal Çakmak Asker Hastanesi, Fiziksel Tıp ve Rehabilitasyon Servisi, Erzurum, Türkiye
3 GATA Haydarpaşa Training Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
4 Gülhane Askeri Tıp Akademisi Haydarpaşa Eğitim Hastanesi Fiziksel Tıp ve Rehabilitasyon Servisi, İstanbul, Türkiye
5 Gülhane Askeri Tıp Akademisi, Haydarpaşa Eğitim Hastanesi Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul

Objective: Aim was to compare the effectiveness of comprehensive physical therapy and rehabilitation (PM&R) program and home-based exercise program on disability in middle and long-term breast cancer survivors. 

Materials and Methods: Thirty-four breast cancer survivors with disability were randomly assigned to receive comprehensive rehabilitation program (n=16) or home-based exercise program (n=18). Constant-Murley Scale and Disability Arm, Shoulder and Hand Index were used for evaluating the disability related to the shoulder and hand problems. Pain was evaluated with visual analog scale, quality of life was evaluated with Short Form-36. The patients were evaluated at the beginning of the programs and after six weeks ending of the programs.

Results: There was a statistically significant difference between first and last Constant-Murley scores in PM&R group (p=0.001), but there was not significant difference in exercise group (p=0.593). Quality of life and pain scores revealed significant difference in PM&R group , but did not revealed in exercise group (p<0.05 and p>0.05, respectively). 

Conclusion: The disability of long term is a clinical entity generally ignored in breast cancer patients. In those patients, the quality of life status can be increased and disability can be decreased by the use of comprehensive physical therapy and rehabilitation programs. 
Home-based exercise program cannot effect these parameters alone. 

Keywords : Breast cancer, rehabilitation, exercise, TENS, whirlpool