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The American Society of Breast Surgeons.
Annals of Surgical Oncology

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Effects of Progressive Upper Limb Exercises and Muscle Relaxation Training on Upper Limb Function and Health-Related Quality of Life Following Surgery in Women with Breast Cancer: A Clinical Randomized Controlled Trial

Kaina Zhou PhD, Wen Wang MS candidate, Jinghua An PhD candidate, Minjie Li PhD candidate, Jin Li PhD, Xiaomei Li PhD
Breast Oncology
Volume 26, Issue 7 / July , 2019



The aim of this study was to examine the effects of progressive upper limb exercises and muscle relaxation training (PULE-MRT) on upper limb function and health-related quality of life (HRQoL) following surgery in Chinese mainland women with breast cancer (BC).


Overall, 102 patients following surgery (i.e. mastectomy or breast-conserving surgery, with sentinel lymph node biopsy or axillary lymph node dissection) were randomly allocated to the intervention (n = 51) or control (n = 51) groups. The former received PULE-MRT plus routine nursing care, whereas the latter received only routine nursing care for 6 months. Upper limb function and HRQoL were measured at baseline and 1, 3, and 6 months using Constant–Murley scores (CMS) and Functional Assessment of Cancer Therapy-Breast version 4.0 (FACT-Bv4.0), respectively.


All patients in the intervention group completed the exercises and training, with 100% compliance and no adverse events. The intervention group had significantly higher total CMS and FACT-Bv4.0 scores at 1-, 3-, and 6-month follow-up than the control group. The significant effects in total CMS comparisons were group (F = 25.30, p < 0.001), time (F = 18.02, p < 0.001), and group-by-time interaction (F = 9.95, p < 0.001), and, in FACT-Bv4.0, total score comparisons were group (F = 15.87, p < 0.001), time (F = 17.92, p < 0.001), and group-by-time interaction (F = 7.88, p < 0.001). Similar results were observed for the scale scores of CMS and FACT-Bv4.0.


PULE-MRT had positive effects on improving upper limb function and HRQoL following surgery in women with BC and could be used as an optional rehabilitation management strategy in post-surgery BC patient populations.

Trial Registration ChiCTR-IOR-16008253 (; 9 April 2016).

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