Background

In both the United Kingdom (UK) and Brazil, women undergoing mastectomy should be offered breast reconstruction. Patients may benefit from physical therapy to prevent and treat muscular deficits. However, there are uncertainties regarding which physical therapy program to recommend.

Objective

The aim was to investigate the clinical practice of physical therapists for patients undergoing breast reconstruction for breast cancer. A secondary aim was to compare physical therapy practice between UK and Brazil.

Methods

Online survey with physical therapists in both countries. We asked about physical therapists’ clinical practice.

Results

181 physical therapists completed the survey, the majority were from Brazil (77%). Respondents reported that only half of women having breast reconstruction were routinely referred to physical therapy postoperatively. Contact with patients varied widely between countries, the mean number of postoperative sessions was 5.7 in the UK and 15.1 in Brazil. The exercise programs were similar for different reconstruction operations. Therapists described a progressive loading structure over time: range of motion (ROM) was restricted to 90° of arm elevation in the first two postoperative weeks; by 2–4 weeks ROM was unrestricted; at 1–3 months muscle strengthening was initiated, and after three months the focus was on sports-specific activities.

Conclusion

Only half of patients having a breast reconstruction are routinely referred to physical therapy. Patients in Brazil have more intensive follow-up, with up to three times more face-to-face contact with a physical therapist than in the UK. Current practice broadly follows programs for mastectomy care rather than being specific to reconstruction surgery.

中文翻译：

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目前接受乳腺癌乳房重建的患者的物理治疗护理：英国和巴西的实践调查

 背景

在英国和巴西，接受乳房切除术的女性应该接受乳房再造。患者可能会受益于物理治疗来预防和治疗肌肉缺陷。然而，推荐哪种物理治疗方案还存在不确定性。

 客观的

目的是调查物理治疗师对乳腺癌乳房重建患者的临床实践。第二个目的是比较英国和巴西之间的物理治疗实践。

 方法

两国物理治疗师的在线调查。我们询问了物理治疗师的临床实践。

 结果

181 名物理治疗师完成了调查，大多数来自巴西（77%）。受访者报告说，只有一半接受乳房再造的女性在术后常规接受物理治疗。各国与患者的接触情况差异很大，英国术后平均次数为 5.7 次，巴西为 15.1 次。不同的重建手术的演习计划是相似的。治疗师描述了随着时间的推移渐进式负载结构：术后前两周，运动范围 (ROM) 限制为手臂抬高 90°； 2-4周后ROM不受限制； 1-3 个月开始进行肌肉强化，三个月后重点关注特定运动活动。

 结论

只有一半的乳房再造患者会定期接受物理治疗。巴西患者接受更密集的随访，与物理治疗师面对面接触的次数比英国多三倍。目前的实践广泛遵循乳房切除术护理计划，而不是特定于重建手术。