Clinical Study

Effects of a Multidisciplinary Educational Rehabilitative Intervention in Breast Cancer Survivors: The Role of Body Image on Quality of Life Outcomes

Table 1

Exercises’ program.

ExerciseDescription

Exercise 1
Relaxing
Diaphragmatic breathing and postural elements such as alignment of the midline.
The patient is supine on a mat with flexed knees and arms along the chest.

Exercise 2
Raising arm, opening and closing punches
Lying on the bed, arms at sides, flexed knees. Slowly, lift parallel the arms till the upright position, opening and clenching the fists in order to contract the muscles of the arms. Maintain up the position, opening and closing the punches five times, and return to the starting position. Repeat ten times.

Exercise 3
Stretching and releasing the arms. Recovery of the flexion.
Lying on the bed, flexed knees. Interlock the fingers and slowly bring to full flexion and then on the pillow; then put as much as possible while keeping your arms extended. Perform the technique of breathing for a minute. Repeat ten times.

Exercise 4
Turn the shoulders. Rotation-anteropulsion-retropulsion
Standing or sitting, rotate the shoulders for ten times.

Exercise 5
Abduction and adduction of the arms—isometric strengthening
Lying or standing, bring the arms out, with extended elbows. Maintain the position for six seconds. Return to the starting position, slowly. Repeat for ten times.

Exercise 6
Opening and closing elbows
Standing, legs apart. Place both hands on the hips with thumbs pointing backwards. Push your elbows back and forth without moving the hands. Repeat for ten times.

Exercise 7
Run up the wall—recovery of flexion
Getting closer to the maximum height possible completely to the wall, stopping for few seconds, and trying to gently remove the hands from the wall. Repeat ten times.

Exercise 8
Run up the wall by the side—recovery of abduction
With a bit of tape, standing with the unaffected side facing the wall, place the hand on the wall at shoulder height. Reaching a point with his hand, as high as possible, marking it with the piece of tape. Begin the exercise with the operated arm, and repeat ten times trying to get closer to the mark left on the wall.

Exercise 9
Hand on the operated shoulder—recovery of the adduction
Sitting or standing, arms along the sides. Bring the hand of the operated limb to the contralateral shoulder. Return to starting position. Repeat ten times.

Exercise 10
Rotate the arms—promoting the rotations
Standing with legs apart, raise your arms to the shoulder. Beginning with small movements, gradually increase the diameter up to do it without complaints. We recommend at least five full rotations. Finally, bring the arm down the side and remain at rest for a moment.

Exercise 11
Run up the back—promoting the extension and intrarotation
Standing, place the hands behind the back and take with the healthy hand, the hand of the operated limb. Slowly slide the hands along the spine upwards to its possible and maintain the position for a few seconds. Then decline slowly. Repeat for ten times.

Exercise 12
Opening and closing the elbows
Standing or sitting, with the feet firmly on the ground, interlock the hands ahead of face with the head upright. Slowly, raise the arms above the head and then behind the neck. Then open both elbows and close them for five times. If you feel discomfort at the wound, keep the position and work with the breathing.

Exercise 13
Bar
Sitting or standing, hold the bar (about 110 cm long). Bring the arms forward and upward at the elbows extended. Flex elbows and bring the bar behind the head. Return slowly to starting position. Repeat ten times.

Exercise 14
Codman’s pendulum
Lying on a bed in a prone position, the arm perpendicular to the floor, make a circular motion clockwise and counterclockwise slowly. Repeat for ten times.

Exercise 15
Flex on the front wall—to prevent the deficit of the scapula
Standing in front of the wall, put the hands against the wall parallel. Flex the arms. Repeat for ten times.