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Postoperative rehabilitation of breast cancer patients
Postoperative rehabilitation of breast cancer patients. Precautions for postoperative functional exercise.
Breast cancer is one of the most common malignant tumors in women. It is second only to uterine cancer in women’s incidence. Due to the development of early diagnosis technology and the improvement of comprehensive treatment, the survival rate of breast cancer patients has increased.
At present, the most effective treatment is surgery, but radical surgery may affect the pectoralis major muscle, pectoralis minor muscle, nerves, blood vessels, and lymphatic vessels, resulting in edema and dysfunction of the affected upper limb of the patient after surgery, which seriously affects the daily life of the patient And work.
Therefore, the rehabilitation of upper limb function of breast cancer patients has always been a concern.
What is the significance of functional exercise after surgery?
1. Reduce the incidence of lymphedema
2. Promote an increase in the mobility of the shoulder joint
3. Help reduce fatigue
4. Enhance patients’ daily life and work ability, and return to family and society as soon as possible
Timing of the start of postoperative functional exercise
It is generally believed that finger exercises can be done on the day of surgery, and patients can do wrist and elbow flexion and extension exercises 1-2 days after surgery; they can get out of bed after 48 hours, but a sling is required to lift the affected side; 3- 4 days for elbow joint flexion and extension; 5 days for palm to touch the opposite shoulder and ipsilateral auricle; if there is no abnormal condition, start to do shoulder activities within 1 week of the operation, such as raising the shoulder joint, naturally do the arm circle movement, or bend the waist ; 10-12 days after the wound has healed, encourage the patient to take steps and increase shoulder functional exercises. Postoperative functional exercises should be maintained for more than half a year.
Methods of postoperative functional exercise
Rehabilitation exercise methods include patient active exercise plus therapist-assisted treatment, and postoperative home rehabilitation exercises.
1. Local lymphatic circulation therapy is mainly divided into active therapy and passive therapy:
(1) Active therapy generally involves the patients themselves taking the initiative to perform health-care functional activities, such as health exercises, Tai Chi, and Baduan Jin. You can also do some simple wall-climbing, swinging arms, and natural surrounding exercises. But it must be gradual.
(2) Passive therapy is mainly completed by the therapist or the patient’s family.
Manipulations are often used to promote lymphatic reflux, coupled with basic joint activities to loosen local adhesions, in order to achieve the purpose of eliminating edema. Manipulation generally adopts the circulatory direction from the local to the whole, and then to the local for treatment. It can also be treated in the direction of return from the proximal end to the distal end and then to the proximal end.
In addition to manual rehabilitation, elastic bandages can also be used for centripetal compression and air wave pressure therapy.
2. The range of motion, muscle strength and flexibility training of the affected joint
Immobilization after breast cancer surgery, scar adhesion caused limited joint movement, coupled with postoperative edema, the muscle strength and flexibility of the affected limb gradually decreased. The therapist assesses the degree of limitation of the shoulder joint, and gradually loosens the flexion, abduction, and extension. After the joint is loosened, the rehabilitation device can be used for uniform movement to consolidate the degree of motion after the joint is loosened. Patients can perform simple weight training and isokinetic training to enhance the muscle strength of the affected upper limbs according to the actual situation. Can also carry out daily living ability training to enhance flexibility. When exercising, you should adhere to the method of moving from the distal end to the proximal end of the affected limb (from the wrist joint to the elbow joint to the shoulder joint).
3. Daily life ability training and psychological counseling
Encourage patients to carry out self-care training, such as brushing teeth, combing hair, washing face, eating, and simple light-load housework activities.
4. Family rehabilitation exercise process
According to the characteristics of the physiological changes of patients after breast cancer surgery, rehabilitation exercises are generally performed in three stages: early rehabilitation exercises within two weeks after surgery, mid-term rehabilitation exercises within 3 months after surgery, and late rehabilitation exercises at 3 months after surgery. Cooperate with swimming, table tennis and other sports.
Precautions for postoperative functional exercise
1. The functional exercise is mainly self-exercise, with appropriate amount of body exercise, pay attention to persistence for 3-6 months, which is beneficial to the recovery of the patient’s mental state
2. Functional exercises should be gradual and moderate, especially early postoperative exercises should be moderate, pay attention to the intensity of activities, from far to near, from simple to complex, avoid overwork and prolonged sagging of the affected limb, and avoid strenuous exercise to avoid causing limbs. Swelling, shoulder movement is limited to not producing obvious pain.
3. To grasp the condition of the disease, exercise in a stable condition without complications.
Breast cancer patients should treat their disease rationally. Breast cancer treatment plans are becoming more mature. It is necessary for patients to get out of the “mystery” of the disease as soon as possible, get rehabilitation treatment as soon as possible, improve the quality of life, and better return to society and family.
(source:internet, reference only)