Article

OBJECTIVE: To evaluate prospective surveillance and targeted physiotherapy (PSTP)
compared to education (EDU) on the prevalence of arm morbidity and describe the
associated program cost. DESIGN: Pilot randomized single-blinded controlled
trial. SETTING: Urban with assessments and treatment delivered in hospitals.
PARTICIPANTS: Women scheduled for breast cancer surgery. INTERVENTIONS:
Participants were randomly assigned (1:1) to PSTP ( n = 21) or EDU ( n = 20) and
assessed presurgery and 12 months postsurgery. All participants received usual
care, namely, preoperative education and provision of an education booklet with
postsurgical exercises. The PSTP group was monitored for arm morbidity every
three months and referred for physiotherapy if arm morbidity was identified. The
EDU group received three education sessions on nutrition, stress and fatigue
management. MAIN OUTCOME MEASURES: Arm morbidity was based on changes in the
surgical arm(s) from presurgery in four domains: (1) shoulder range of motion,
(2) strength, (3) volume, and (4) upper body function. Complex arm morbidity
indicated >/=2 domains impaired. Second, the cost of the PSTP program was
described. RESULTS: At 12 months, 18 (49%) participants (10 PSTP and 8 EDU) had
arm morbidity, with EDU participants presenting more complex arm morbidity
compared to PSTP participants. PSTP participants attended 4.4 of 5 assessments
with 90% retention. The PSTP program cost was $150 covered by the Health Care
Provider and the Patient Out-of-Pocket Travel cost was CAN$40. CONCLUSION: Our
results suggest that PSTP is feasible among women with breast cancer for early
identification of arm morbidity. A larger study is needed to determine the cost
and effectiveness benefits.

Langue : ANGLAIS