Restriction of the range of arm elevation exercises for one week after surgery for breast cancer can reduce the incidence of lymphoedema.

Question: Does restriction of full shoulder mobilisation for one week reduce the incidence and severity of lymphoedema in women after axillary lymph node dissection (ALND) for breast cancer? Design: Randomised, controlled trial with concealed allocation and blinded assessment of some outcomes. Setting: Two hospitals in the United Kingdom. Participants: Adult women with early breast cancer admitted for surgery that included axillary lymph node dissection. Previous breast cancer, axillary surgery and local radiotherapy were exclusion criteria. Randomisation of 116 participants allotted 58 to a standard exercise regimen and 58 to the same regimen with restricted arm and shoulder movement for the first week. Interventions: All participants were prescribed four 10-minute exercise sessions per day, in which individual exercises were repeated slowly and rhythmically 3 to 4 times. The exercises included unresisted shoulder and elbow range-of-motion exercises while upright. The early mobilisation group commenced full shoulder mobilisation within two days after surgery. The exercises were modified for the delayed mobilisation Restriction of the range of arm elevation exercises for one week after surgery for breast cancer can reduce the incidence of lymphoedema