Home exercise adherence after breast cancer surgery: incidence and risk factors

Authors

DOI:

https://doi.org/10.29289/2594539420220015

Keywords:

breast neoplasms, surgery, exercise, patient compliance, treatment adherence and compliance

Abstract

ABSTRACT: Introduction: Functional limitations in women undergoing breast cancer treatment are common and have negative impacts during patient treatment. Physical exercise after breast cancer surgery has been shown to be safe and beneficial, as well as necessary during all stages in order to minimize the negative impact of complications that compromise functionality. This study aims to assess adherence to home exercises and associated factors in women undergoing breast cancer surgery. Methods: A prospective cohort study with an inclusion of women with indication for curative breast cancer surgery and an axillary approach. During the postoperative period, patients were instructed to perform home exercises and received a home guide that should be completed daily for 30 days. Patient adherence and perception about exercise difficulty and discomfort, and the presence of pain, insecurity and fear were assessed. A descriptive analysis of socio-demographic and clinical variables was performed, and a simple logistic regression was carried out to identify whether symptoms interfered with exercise adherence. Results: A total of 465 women were included, of which 43.6% fully adhered to the exercises, 31.6% partially adhered, and 24.7% either did not deliver the home guide, delivered it blank or containing illegible information. Arm discomfort was the most frequent subjective symptom (63.1%), followed by pain (51.6%). No variables were associated to exercise adherence. Conclusions: Patients undergoing breast cancer surgery presented total (43.6%) or partial (31.6%) exercise adherence in the first thirty postoperative days. Subjective symptoms and patient perception did not interfere in exercise adherence rates.

Downloads

Download data is not yet available.

References

Instituto Nacional de Câncer José Gomes de Alencar. Estimativas da incidência e mortalidade por câncer. Rio de Janeiro: INCA; 2020.

Instituto Nacional de Câncer José Gomes de Alencar. Ações e programas. Rio de Janeiro: INCA; 2016.

Bergmann A, Ribeiro MJP, Pedrosa E, Nogueira EA, Oliveira ACG. Physical therapy in breast cancer: clinical protocol at the Cancer Hospital III/INCA. Rev Bras Cancerol. 2006;52(1):97-109.

Pereira ACPR, Koifman RJ, Bergmann A. Incidence and risk factors of lymphedema after breast cancer treatment: 10 years of follow-up. Breast. 2017;36:67-73. https://doi.org/10.1016/j.breast.2017.09.006

Macedo FO, Bergmann A, Koifman RJ, Torres DM, Costa RM, Silva IF. Axillary surgery in breast cancer: acute postoperative complications in a hospital cohort of women of Rio de Janeiro, Brazil. Mastology. 2018;28(2):80-6. https://doi.org/10.29289/2594539420180000377

Lee SA, Kang JY, Kim YD, An AR, Kim SW, Kim YS, et al. Effects of a scapula-oriented shoulder exercise programme on upper limb dysfunction in breast cancer survivors: a randomized controlled pilot trial. Clin Rehabil. 2010;24(7):600-13. https://doi.org/10.1177/0269215510362324

Yang EJ, Kang E, Kim SW, Lim JY. Discrepant trajectories of impairment, activity, and participation related to upper-limb function in patients with breast cancer. Arch Phys Med Rehabil. 2015;96(12):2161-8. https://doi.org/10.1016/j.apmr.2015.08.426

Silva G, Santos MA. Stressors in breast cancer post-treatment: a qualitative approach. Rev Lat Am Enfermagem. 2010;18(4):688-95. https://doi.org/10.1590/s0104-11692010000400005

Izydorczyk B, Kwapniewska A, Lizinczyk S, Sitnik-Warchulska K. Psychological resilience as a protective factor for the body image in post-mastectomy women with breast cancer. Int J Environ Res Public Health. 2018;15(6):1181. https://doi.org/10.3390/ijerph15061181

Lee CE, Von Ah D, Szuck B, Lau YK. Determinants of Physical Activity Maintenance in Breast Cancer Survivors After a Community-Based Intervention. Oncol Nurs Forum. 2016;43(1):93-102. https://doi.org/10.1188/16.ONF.43-01AP

Gutiérrez MGR, Bravo MM, Chanes DC, Vivo MCR, Souza GO, et al. Adherence to an early rehabilitation program among women who underwent mastecmoty. Acta Paul Enferm. 2007;20(3):249-54. https://doi.org/10.1590/S0103-21002007000300002

Ribeiro IL, Moreira RFC, Ferrari AV, Alburquerque-Sendín F, Camargo PR, Salvini TF. Effectiveness of early rehabilitation on range of motion, muscle strength and arm function after breast cancer surgery: a systematic review of randomized controlled trials. Clin Rehabil. 2019;33(12):1876-86. https://doi.org/10.1177/0269215519873026

Amaral MTP, Teixeira LC, Derchain SFM, Nogueira MD, Pinto e Silva MP, Gonçalves AV. Orientação domiciliar: proposto de reabilitação física para mulheres submetidas à cirurgia por câncer de mama. Rev Ciênc Méd. 2012 [cited on Dec 8, 2020];14(5):405-13. Available from: https://seer.sis.puc-campinas.edu.br/cienciasmedicas/article/view/1151

Cnossen IC, van Uden-Kraan CF, Witte BI, Aalders YJ, Goede CJ, Bree R, et al. Prophylactic exercises among head and neck cancer patients during and after swallowing sparing intensity modulated radiation: adherence and exercise performance levels of a 12-week guided home-based program. Eur Arch Otorhinolaryngol. 2017;274(2):1129-38. https://doi.org/10.1007/s00405-016-4367-9

Sagen A, Kaaresen R, Sandvik L, Thune I, Risberg MA. Upper limb physical function and adverse effects after breast cancer surgery: a prospective 2.5-year follow-up study and preoperative measures. Arch Phys Med Rehabil. 2014;95(5):875-81. https://doi.org/10.1016/j.apmr.2013.12.015

Essery R, Geraghty AW, Kirby S, Yardley L. Predictors of adherence to home-based physical therapies: a systematic review. Disabil Rehabil. 2017;39(6):519-34. https://doi.org/10.3109/09638288.2016.1153160

Telles TCB, Araruna LC, Almeida MS, Melo AK. Adhesion and adherence to exercise: a bibliographical study. Rev Bras Psicol Esporte. 2016;6(1):109-20. https://doi.org/10.31501/rbpe.v6i1.6725

Sant'anna KD, Almeida V, Petito EL, Gutierrez MGR. Adherence to the practice of exercises for functional rehabilitation of women with breast cancer: a literature review. Cienc Enferm. 2010;16(1):97-104. http://doi.org/10.4067/S0717-95532010000100011

Rafn BS, Hung S, Hoens AM, McNeely ML, Singh CA, Kwan W, et al. Prospective surveillance and targeted physiotherapy for arm morbidity after breast cancer surgery: a pilot randomized controlled trial. Clin Rehabil. 2018;32(6):811-26. http://doi.org/10.1177/0269215518757292

Matarán-Peñarrocha GA, Palomo ICL, Soler EA, Gil-Martínez E, Fernández-Sánchez M, Aguilar-Ferrándiz ME, et al. Comparison of efficacy of a supervised versus non-supervised physical therapy exercise program on the pain, functionality and quality of life of patients with non-specific chronic low-back pain: a randomized controlled trial. Clin Rehabil. 2020;34(7):948-59. http://doi.org/10.1177/0269215520927076

Kampshoff CS, van Mechelen W, Schep G, Nijziel MR, Witlox L, Bosman L, et al. Participation in and adherence to physical exercise after completion of primary cancer treatment. Int J Behav Nutr Phys Act. 2016;13(1):100. http://doi.org/10.1186/s12966-016-0425-3

Teodózio CGC, Marchito LO, Fabro EAN, Macedo FO, Aguiar SS, Thuler LCS, et al. Shoulder amplitude movement does not influence postoperative wound complications after breast cancer surgery: a randomized clinical trial. Breast Cancer Res Treat. 2020;184(1):97-105. http://doi.org/10.1007/s10549-020-05826-9

Petito EL, Nazário AC, Martinelli SE, Facina G, Gutiérrez MG. Application of a domicile-based exercise program for shoulder rehabilitation after breast cancer surgery. Rev Lat Am Enfermagem. 2012;20(1):35-43. http://doi.org/10.1590/s0104-11692012000100006

Lokapavani Y, Krishna SR, Madhavi K. Influence of preoperative physical therapy education and exercise on post-operative shoulder ranger of motion and functional activities in subjects with modified radical mastectomy. Int J Physio. 2014[cited on Dec 8, 2020];1(4):170-7. Available from:

Downloads

Published

2026-04-17

How to Cite

Teodózio, C. G. C., Silva, V. de F. M. da, Aguiar, S. S. de, Thuler, L. C. S., & Bergmann, A. (2026). Home exercise adherence after breast cancer surgery: incidence and risk factors. Mastology, 32. https://doi.org/10.29289/2594539420220015

Issue

Section

Original Articles