EFFECTS OF REHABILITATION IN POSTMASTECTOMY PERIOD

Effects of rehabilitation after mastectomy were investigated for recovery rate of movable range of the affected shoulder joint and swelling rate of affected upper limb. Patients undergone Stewart's transverse incision and closed without skin graft were subjected. On a preoperative day, postoperative 7th day, the day of discharge, and one year after operation, movable range of various exercises of the shoulder joint and circumference length of the forearm and upper arm were measured to calculate the recovery rate of movable range and swelling rate of upper limb. Correlations between the recovery rate and operative procedures, conservation of the pectoral nerve, and the between-flaps tension, as well as changes in the swelling rate were studied. As a result, there were little effects on impaired movement function of the shoulder joint due to resection of pectoralis major and/or minor muscle. In one year after mastectomy around 90% of movable range could be recovered in all kinds of exercise. Resection of the pectoral nerve produced atrophy of pectoralis major muscle and impaired the exercise function. If the between-flaps tensions were within 200 g or less, the tension gave no effect on the recovery rate of movable range. The maximum increase in the circumference length of the forearm and upper arm appered on the first year after mastectomy, which were both 3.5 cm, and no remarkable swelling disturving daily activities of patients were observed.