乳癌縮小手術(乳房温存術,胸筋温存乳房切除術)を受けた患者の術後回復過程に関する研究(1)肩関節可動域の回復遅延に関わる要因の分析 [in Japanese] Recovery of patients after minimally invasive surgery for breast cancer (breast-conserving surgery or pectoral muscle-conserving mastectomy) : report 1 : analysis of factors causing delayed recovery of shoulder joint range of motion [in Japanese]
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The present study was undertaken to identify factors responsible for delay in recovery of the shoulder joint ROM (range of motion) after minimally invasive surgery for breast cancer (i.e., surgery not involving pectoral muscle excision), with the goal of facilitating better postoperative rehabilitation. The subjects of this study were 39 patients who were followed during 12 weeks of functional rehabilitation after breast-conserving surgery or pectoral muscle-conserving surgery for breast cancer. They were divided into the good recovery group and the delayed recovery group according to the smoothness in recovery of shoulder joint ROM. Shoulder joint ROM, pain and activity of daily living (ADL) were compared between these two groups. Analysis of the data from the delayed recovery group allowed us to identify the pain during movement of the surgical wound as a leading factor affecting the recovery of shoulder joint ROM. Failure to practice exercise after surgery due to pain during motion of the wound was identified as the second leading cause for delayed recovery. These results suggest that in cases where postoperative recovery in should joint ROM is delayed, recovery may be facilitated by monitoring the progress of rehabilitation, advising the patient to continue exercise until day 12 after surgery and guiding the patient to practice shoulder joint ROM training with the help of the nurse.
JNI 1(1), 19-25, 2003-03