Effectiveness of Individualized Upper Extremity Exercise Program for Patients after Mastectomy

유방절제술 후 환자를 위한 맞춤형 상지 운동프로그램 효과

  • Lim, Kyung Hee (College of Nursing & Research Institute of Nursing Science, Keimyung University)
  • 임경희 (계명대학교 간호대학 & 간호과학연구소)
  • Received : 2018.07.19
  • Accepted : 2018.10.05
  • Published : 2018.10.31


This study was conducted to develop an individualized upper extremity exercise program for patients after mastectomy and evaluate its effectiveness. A nonequivalent control-group pretest-posttest design was used for this investigation. Research participants were patients with breast cancer who underwent mastectomy at two university hospitals (experimental group, n=17; control group, n=16). The experimental group received an individualized upper extremity exercise program three times a week for 7 weeks. Data were analyzed by the ${\chi}^2-test$, Fisher's exact test, Mann-Whitney U-test and Wilcoxon Signed Rank test using SPSS WIN 21.0. Inter-group comparison revealed significant differences between pre-test and post-test in hands behind the back, flexion, abduction, external rotation, internal rotation, and grip strength. Moreover, the experimental group showed significant improvements in hands behind the back, flexion, abduction, external rotation, internal rotation, and grip strength relative to the control. In conclusion, the individualized upper extremity exercise program was shown to be an effective intervention to improve physical functions in upper limbs and shoulders. Therefore, this program should be applied to patients after mastectomy in clinics since many patients have suffered from decreased physical functions in upper extremities.


Breast Cancer;Mastectomy;Exercise;Upper Extremity;Flexion;Rotation;Grip Strength


Supported by : 한국연구재단


  1. K. W. Jung, Y. J. Won, H. J. Kong, C. M. Oh, H. S. Cho, D. H. Lee et al. Cancer statistics in Korea: Incidence, mortality, survival, and prevalence in 2012. Cancer Research and Treatment. Vol.47.No.2, pp. 127-141. 2015. DOI:
  2. Korean Breast Cancer Society. Breast cancer facts & figures 2016[Internet]. Seoul: Korean Breast Cancer Society, 2016 [cited 2018 March 30]. Available from:
  3. B. Y. Chung, H. S. Byun, K. D. Kim, K. H. Kim. Risk factors of breast cancer. Asian Oncology Nursing, Vol.8, No.2, pp. 120-127, 2008.
  4. H. J. Won, J. I. Kim. The effect of cancer-overcome BeHaS exercise program on pain, flexibility, grip strength and stress in breast cancer patients following surgery. The Korean Journal of Fundamentals of Nursing. Vol.16, No.2, pp. 181-189, 2009.
  5. G. Isaksson, B. Feuk. Morbidity from axillary treatment in breast cancer: a follow-up study in a district hospital. Acta Oncologica, Vol.39, No.3, pp. 335-336. 2000.
  6. A. L. Cheville, J. Tchou. Barriers to rehabilitation following surgery for primary breast cancer. Journal of Surgical Oncology. No.5, pp. 409-418, 2007. DOI:
  7. S. Y. Park, J. I. Kim. Effects of BeHaS exercise program on flexibility, grip strength, stress and self-esteem in breast cancer survivors. The Journal of Muscle and Joint Health. Vol.20, No.3. pp. 171-179. 2013. DOI:
  8. Y. W. Kim, M. S. Kim. The change of upper body functional fitness on lymph massage and resistance exercise by the type of surgery for breast cancer. Korean Journal of Physical Education. Vol.49, No.1, pp. 491-497, 2010.
  9. O. H. Cho. Effects of a comprehensive rehabilitation program for mastectomy patients. Journal of Korean Academy of Nursing. Vol.34, No.5, pp. 809-819, 2004. DOI:
  10. M. L. McNeely, K. L. Campbell, B. H. Rowe, T. P. Klassen, J. R. Mackey, K. S. Courneya. Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. Canadian Medical Association Journal. Vol.175, No.1, pp. 34-41, 2006. DOI:
  11. D. R. Shamley, K. Barker, V. Simonite, A. Beardshaw. Delayed versus immediate exercises following surgery for breast cancer: a systematic review. Breast Cancer Research and Treatment. Vol.90, No.3, pp.:263-271, 2005. DOI:
  12. C. M. Kaelin. The breast cancer survivor's fitness plan. p.200-285, 1st ed. Bae HS, Translator. Seoul: Joyoon Communication; 2008.
  13. K. S. Courneya, R. J. Segal, J. R. Mackey, K. Gelmon, R. D. Reid, M. Friedenreich et al. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. American Society of Clinical Oncology. Vol.25, No.28, pp. 4396-404, 2007. DOI:
  14. A. Y. Eom. Effects of a TaiChi program for early mastectomy patients. Korean Journal of Women Health Nursing. Vol.13, No.1, pp. 43-50, 2007.
  15. Korea Sport Science Institute. The latest exercise regimen loans. p. 203-215, 3rd ed. Seoul: 21st Century Educator; 2010.
  16. American College of Sports Medicine(ACSM). ACSM's resource manual for guidelines for exercise testing and prescription. p. 437-447, 3rd ed. Philadelphia: Williams & Wilkins; 1998.
  17. D. L. Riddle, J. M. Rothstein, R. L. Lamb. Goniometric reliability in a clinical setting shoulder measurements. Journal of the American Physical Therapy Association. Vol.67, No.5, pp. 668-673, 1987.
  18. M. Von Korff, R. A. Deyo, D. Cherkin, W. Barlow. Back pain in primary care: Outcomes at 1 year. Spine Journal. Vol.18, No.7, pp. 855-862, 1993.
  19. K. S. Courneya, J. R. Mackey, L. W. Jones. Coping with cancer: can exercise help? Physician Sport medicine. Vol.28, No.5, pp. 49-73, 2000. DOI:
  20. T. Lee, S, Kilbreath, K. Refshauge, S. Pendlebury, J. Beith, I. M. Lee. Pectoral stretching program for women undergoing radiotherapy for breast cancer. Breast Cancer Research and Treatment. Vo.102, No.3, pp. 313-321, 2007. DOI:
  21. Y. M. Park. Effects of an early upper-limb exercise program on the shoulder joint function after breast cancer surgery, Unpublisehd master's thesis, Sahmyook University, Seoul, 2008.
  22. G. W. Lee, C. W. Yi, S. H. Cho, J. M. Park. The therapeutic effects of an early exercise program after mastectomy. Journal of the Korean Academy of University Trained Physical Therapists. Vol.89, No.1, pp.35-50, 2001.
  23. H. S. Park, K. Y. Cho, K. Y. Park. The effects of a rehabilitation program on physical health, physiological indicator and quality of life in breast cancer mastectomy patients. Journal of Korean Academy of Nursing. Vol.36, No.2, pp. 310-320, 2006. DOI:
  24. M. Y. Seoung. Effect of Tai Chi exercise program on physical functioning and psychological problems of breast cancer patients after surgery, Unpublished master's thesis, Chungnam University, Chungnam, 2008.
  25. Y. R. Chae, M. A. Choe. Effects of exercise on cardiopulmonary functions and shoulder joint functioning in breast cancer patients undergoing radiation therapy after breast surgery. Journal of Korean Academy of Nursing. Vol.31, No.3, pp. 454-466, 2001. DOI:
  26. Y. W. Kim, M. S. Kim. The effects of 12 week's yoga, elastic band swiss ball exercise program on physical function improvement for breast cancer survivor. Korean Journal of Sport Biomechanics. Vol.35, No.2, pp. 1051-1060, 2009.
  27. M. S. Kim. The change of physical function in accordance with rehabilitation exercise frequency for the breast cancer survivors. Korean Journal of Physical Education. Vol.49, No.4, pp. 315-323, 2010.
  28. S. L. Kilbreath, K. M. Refshauge, J. M. Beith, L. C. Ward, J. M. Simpson, R. D. Hansen. Progressive resistance training and stretching following surgery for breast cancer: study protocol for a randomised controlled trial. BMC Cancer. Vol.6, p.273, 2006. DOI:
  29. S. Modi, A. W. Stanton, R. H. Mellor, A. M. Peters, J. R. Levick, P. S. Mortimer. Regional distribution of epifascial swelling and epifascial lymph drainage rate constants in breast cancer-related lymphedema. Lymphatic Research and Biology. Vol.3, No.1, pp. 3-15, 2005. DOI: