Critical Reviews™ in Physical and Rehabilitation Medicine

Efficacy of Physical Therapy Methods and Exercise After a Breast Cancer Operation: A Systematic Review

ABSTRACT

In physical therapy various methods are used after a breast cancer operation. This systematic review aims to evaluate the effects of lymphedema therapy methods, postoperative shoulder exercise, exercise therapy, and aerobic exercise. The evolving data and calculations regarding the effect size support the delayed onset of postoperative shoulder exercise. Numerous studies concerning lymphedema therapy suffered methodological deficits. Elastic sleeve therapy is the only method shown to be effective when used alone. Treatment combinations were examined in many studies and treatment bias therefore restricted conclusions regarding the effectiveness of one method alone. Studies concerning exercise therapy and exercise were few and only two were true-experimental clinical trials. Three studies of exercise therapy showed in some measured variables that the experimental group had better results when following the effects of an exercise program for 1–3 months, although further conclusions were prevented because of the treatment bias. Exercise such as walking and cycling was studied during chemotherapy and radiation therapy. Results concerning functional capacity of the experimental groups showed convergent improvement; psychological measurements such as anxiety, fatigue, and satisfaction with the body showed positive changes. Based on these studies, no conclusion can be made about the best training intensity and duration during chemotherapy and radiation therapy.