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Exercicios para membros superiores durante radioterapia para cancer de mama e qualidade de vida (Upper limbs exercises during radiotherapy for breast cancer and quality of life) [Portuguese]
Oliveira MMF, Souza GA, Miranda MS, Okubo MAP, Amaral MT, Silva MPP, Gurgel MSC
Revista Brasileira de Ginecologia e Obstetricia 2010 Mar;32(3):133-138
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSE: To assess the influence of physiotherapy performed during radiotherapy (RT) on the quality of life (QL) of women under treatment for breast cancer. METHODS: This was a randomized clinical trial conducted on 55 women under RT treatment, 28 of whom were assigned to a group submitted to physiotherapy (PG) and 27 to the control group receiving no PG (CG). The physiotherapy technique used for PG was kinesiotherapy for the upper limbs using 19 exercises actively performed, with a series of ten rhythmic repetitions or stretching movements involving flexion, extension, abduction, adduction, internal and external shoulder rotation, separate or combined. QL was evaluated using the Functional Assessment of Cancer Therapy-Breast (FACT-B), at the beginning and at the end of RT and six months after the end of RT. The physiotherapy sessions were started concomitantly with RT, 90 days after surgery, on average. RESULTS: There was no difference between subgroups regarding the following subscales: physical well-being (p = 0.8), social/family well-being (p = 0.3), functional well-being (p = 0.2) and breast subscale (p = 0.2) at the three time points assessed. A comparison of the emotional subscale applied at the three evaluations demonstrated a better behavior of PG as compared to CG (p = 0.01), with both groups presenting improvement on the breast subscale between the beginning and the end of RT (PG p = 0.0004 and CG p = 0.003). There was improvement in FACT-B scores at the end of RT in both groups (PG p = 0.0006 and CG p = 0.003). However, at the sixth month after RT, this improvement was maintained only in PG (p = 0.005). QL assessed along time by the FACT B (p = 0.004) and the Trial Outcome Index (TOI) (sums of the physical and functional well-being subscales and of the breast subscale) was better for PG (p = 0.006). There was no evidence of negative effects associated with the exercises. CONCLUSIONS: The execution of exercises for the upper limbs was beneficial for QL during and six months after RT.

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