ImportanceRecovery of shoulder function following breast cancer surgery is crucial for physical functioning and quality of life. While early implementation of shoulder rehabilitation exercises may enhance recovery, the optimal timing and exercise program remain unclear.ObjectiveTo investigate whether an early exercise intervention, initiated 1 day postsurgery and continued for 1 month through subsequent visits, could improve shoulder range of motion (ROM) and strength in patients with breast cancer.Design, Setting, and ParticipantsA parallel-group, 2-arm randomized clinical trial was conducted between June 2020 and October 2021 at the Breast Cancer Center in Seoul, South Korea. Fifty-six patients (of 119 screened) with early-stage breast cancer who were scheduled for partial or total mastectomy were randomized into a tailored resistance exercise group (n = 28) or a usual care group (n = 28). Data were analyzed from November 2021 to June 2022.InterventionsThe exercise intervention commenced 1 day postsurgery and consisted of 4 supervised exercise education sessions corresponding with surgeon visits and daily home-based exercises for the first postoperative month. Tailored programs, including stretching and strength exercises, were adjusted based on individual shoulder function recovery status.Main Outcomes and MeasuresPrimary end points were shoulder ROM and strength at 1 and 6 months postsurgery. Physical activity, body composition, and quality of life were assessed at 6 months.ResultsOf 56 patients randomized (mean [SD] age, 50.3 [6.6] years), 54 completed the trial (96%), with 100% and 97% compliance to supervised and home-based exercise sessions, respectively. At 1 month postsurgery, 19 (67.9%) in the exercise group had fully recovered shoulder strength compared to 1 (3.6%) in the usual care group (P < .001). At 6 months, 22 (78.6%) in the exercise group had fully recovered shoulder ROM and 24 (85.7%) had fully recovered strength compared to 6 (21.4%) and 5 (17.9%), respectively, in the usual care group (P < .001). The exercise group exhibited less loss in muscle mass and improved physical activity and quality of life compared to the usual care group.Conclusion and RelevanceIn this trial, 1-month tailored exercise program, initiated immediately after breast cancer surgery and supplemented with supervised sessions coinciding with surgeon visits, significantly improved shoulder function in patients with breast cancer.Trial RegistrationWHO International Clinical Trials Registry identifier: KCT0006997

中文翻译：

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早期进行锻炼以促进乳腺癌手术后的恢复


重要性乳腺癌手术后肩部功能的恢复对于身体功能和生活质量至关重要。虽然早期实施肩部康复锻炼可能会促进康复，但最佳时机和锻炼计划仍不清楚。目的探讨术后 1 天开始并通过后续就诊持续 1 个月的早期锻炼干预是否可以改善肩关节活动度 (ROM)设计、设置和参与者 2020 年 6 月至 2021 年 10 月在韩国首尔乳腺癌中心进行了一项平行组、2 组随机临床试验。 56 名计划接受部分或全乳房切除术的早期乳腺癌患者（119 名筛查患者）被随机分为定制阻力运动组 (n = 28) 或常规护理组 (n = 28)。数据分析时间为 2021 年 11 月至 2022 年 6 月。 干预运动干预在术后 1 天开始，包括 4 次监督运动教育课程，与外科医生就诊和术后第一个月的每日家庭锻炼相对应。根据个人肩部功能恢复状况调整量身定制的计划，包括拉伸和力量练习。主要结果和措施主要终点是术后 1 个月和 6 个月的肩关节活动度和力量。在 6 个月时评估体力活动、身体成分和生活质量。结果 56 名随机患者（平均 [SD] 年龄，50.3 [6.6] 岁）中，54 名完成了试验（96%），依从性分别为 100% 和 97%分别进行监督锻炼和家庭锻炼。术后 1 个月，19 (67.运动组中 9%）的肩部力量完全恢复，而常规护理组中只有 1 人 (3.6%) 完全恢复了肩部力量 (P < .001)。 6 个月时，运动组中有 22 人（78.6%）的肩关节活动度完全恢复，24 人（85.7%）的力量完全恢复，而常规护理组中分别有 6 人（21.4%）和 5 人（17.9%）完全恢复了力量。 P＜0.001）。与常规护理组相比，运动组的肌肉质量损失较少，身体活动和生活质量得到改善。结论和相关性在这项试验中，乳腺癌手术后立即开始为期 1 个月的定制运动计划，并辅以与常规护理组一致的监督课程。外科医生就诊，显着改善了乳腺癌患者的肩部功能。试验注册世界卫生组织国际临床试验注册标识符：KCT0006997