Effects of an Exercise Program Incorporating Shoulder Exercise Innovation on Shoulder Range of Motion and Upper Limb Function in Breast Cancer Patients After Surgery
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Abstract
This quasi-experimental study with a two-group pre–posttest design aimed to examine the effects of an exercise program combined with a shoulder exercise innovation on shoulder range of motion and upper limb function among postoperative breast cancer patients. The sample consisted of 66 breast cancer patients who underwent surgery at Buddhachinaraj Hospital, Phitsanulok. Participants were purposively selected and assigned to either the control group (n = 33) or the experimental group (n = 33). Research instruments included: 1) the exercise program with the shoulder exercise innovation, a handbook, and video clips demonstrating arm and shoulder exercises, 2) a goniometer, 3) a record form for shoulder range of motion, and 4) an arm function assessment tool. The content validities were approved by three experts with a CVI = 1.00, and the reliability of the second to fourth tools, assessed by Cohen's kappa coefficient, was .70. Data were analyzed using frequency, percentage, Chi-square test, Fisher’s exact test, median, Wilcoxon signed-rank test, and Mann–Whitney U test.
The results showed that after the intervention, the experimental group demonstrated no significant differences in shoulder range of motion compared with the pretest (all range of motion values remained within normal ranges). In contrast, the control group showed a statistically significant decrease in range of motion in certain movements abduction, forward flexion, and internal rotation at 90° elbow flexion (p<.001). Additionally, arm function scores
in the experimental group showed a statistically significant improvement after the intervention (p<.001), whereas no significant change was observed in the control group. When comparing the experimental group with the control group, the experimental group had a statistically significantly better range of motion in abduction, forward flexion, and internal rotation at 90° elbow flexion (p<.001), as well as better arm function scores (p<.001), after the intervention.
Therefore, it is recommended that nurses apply this program in the care of other breast cancer patients undergoing surgery.
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