Artículos de revistas
Random Clinical Comparative Trial Between Free And Directed Exercise In Post-operative Complications Of Breast Cancer [exercícios Livres Versus Direcionados Nas Complicações Pós-operatórias De Câncer De Mama]
Registro en:
Revista Da Associacao Medica Brasileira. , v. 52, n. 1, p. 37 - 42, 2006.
1044230
2-s2.0-33646763492
Autor
De Rezende L.F.
Beletti P.O.
Franco R.L.
Moraes S.S.
Costa Gurgel M.S.
Institución
Resumen
INTRODUCTION. The objective of this study was to evaluate the association among physiotherapy exercises performed - directed or free - in case of post-operative complications in women who underwent radical mastectomy or quadrantectomy with axillary dissection. METHODS. Sixty women were randomized. The directed group performed physiotherapy following a regimen of 19 exercises. The free group performed the exercises following the biomechanical physiological movements of the shoulder without a previously defined sequence or number of repetitions, exercises were done to the rhythm of music. RESULTS. In the average, the directed group remained 12.17 + 2.96 days with the drain, while the free group remained 11.96 + 2.32 days, with no significant difference between groups. The amount of secretion drained during the permanence of the drain also revealed resemblance between groups, with an average of 1308.71 + 562.6ml in the directed group and of 1391.62 + 644.65ml in the group of free exercises. Incidences of seroma and dehiscence of the surgical wound did not seem to be influenced by the type of exercise at any of the times evaluated. In the directed group, 7.4% and 3.4% of the women presented with seroma on the 28 th and 42 nd days, respectively, while at the same moments of evaluation the free group presented respectively. 3.6% and 3.6%. Incidence of dehiscence of the surgical wound also was similar in the two groups, in the directed group it was of 20% on the 14 th day, 31% on the 28 th day and 10.3% on the 42 nd day of postoperative. In the free group the incidence was of 23.3% on the 14 th day, of 33.3% on the 28 th day and of 22.2% on the 42 nd day of postoperative. The statistical difference observed in the averages of the hand and arm circumferences does not translate into clinical differences. CONCLUSION. The complications were not influenced f by the physiotherapy exercises performed. 52 1 37 42 (2002), http://www.inca.gov.br, Brasil. Ministério Da Saúde. INCA Instituto Nacional de Câncer [on line]Holmes, C.E., Muss, H.B., Diagnosis and treatment of breast cancer in the eldery (2003) CA Cancer J Clin, 53, pp. 227-244 Wingate, L., Efficacy of phisical therapy for patients who have undergone mastectomies (1985) Phys Ther, 65, pp. 896-900 Wingate, L., Croghan, I., Natarajan, N., Michalek, A.M., Jordan, C., Rehabilitation of the mastectomy patient: A randomized, blind, prospective study (1989) Arch Phys Med Rehabil, 70, pp. 21-24 Van Der Horst, Ch.M.A.M., Kenter, J.A.L., De Jong, M.T., Keeman, J.N., Shoulder function following early mobilization of the shoulder after mastectomy and axillary dissection (1985) Neth J Surg, 37, pp. 105-108 Schultz, I., Barholm, M., Grondal, S., Delayed shoulder exercises in reducing seroma frequency after modified radical mastectomy: A prospective randomized study (1997) Ann Surg Oncol, 4, pp. 293-297 Aitken, D.R., Minton, J.P., Complications associated with mastectomy (1983) Surg Clin North Am, 63 (6), pp. 1331-1489 Gaskin, T.A., Lobuglio, A., Kelly, P., Doss, M., Pizitz, N., Stretch: A rehabilitive program for patients with breast cancer (1989) South Med J, 82, pp. 467-469 Chen, S.H., Chen, M.F., Timing of shoulder exercise after modified radical mastectomy: A prospective study (1999) Chang Gung Med J, 22, pp. 37-43 Molinaro, J., Kleinfeld, M., Lebed, S., Physical therapy and dance in the surgical management of breast cancer (1986) Phys Ther, 66, pp. 967-969 Silva, M.P.P., Derchain, S.F.M., Rezende, L., Cabello, C., Martinez, E.Z., Movimento do ombro após cirurgia por carcinoma invasor da mama: Estudo randomizado prospectivo controlado de exercícios livres versus limitados a 90° no pós-operatório (2004) Rev Bras Ginecol Obstet, 26, pp. 125-130 Erickson, V.S., Pearson, M.L., Ganz, P.A., Adams, J., Kahn, K.L., Arm Edema in Breast Cancer Patients (2001) J Natl Cancer Inst, 97, pp. 96-111 Declaração de Helsinque III Sobre Os Princípios Éticos para Pesquisas Em Seres Humanos, , http://www.ibemol.com.br/declaracoes/helsinque3.asp Resolução CNS196/96 sobre pesquisa envolvendo seres humanos (1996) Inf Epidemiol SUS, p. 2. , Brasil. Ministério Da Saúde. Conselho Nacional da Saúde Flew, T.J., Wound drainage following radical mastectomy: The effect os restriction of shoulder movement (1979) Br J Surg, 66, pp. 302-305 Dawson, I., Stam, L., Heslinga, J.M., Kalsbeek, H.L., Effect of shoulder immobilization on wound seroma and shoulder dysfuntion following modified radical mastectomy: A randomized prospective clinical trial (1990) Br J Surg, 76, pp. 311-312 Jansen, R.F.M., Van Geel, A.N., De Groot, H.G.W., Rottier, A.B., Olthuis, G.A.A., Immediate versus delayed shoulder exercises after axillary lymph node dissection (1990) Am J Surg, 160, pp. 481-484 Knight Jr., C.D., Griffen, F.D., Knight, S.C.D., Prevention of seroma in mastectomy wounds. The effect of shoulder immobilization (1995) Arch Surg, 130, pp. 99-101 Bland, K., Copeland, E.M., (1994) A Mama, , São Paulo: Manole