These exercises done by patients who underwent mastectomy or the surgical removal on one or both of breasts.
> To increase blood circulation
> To increase muscular strength.
> Prevents joints stiffness and contractures
> To restore full range of motion of the arms and shoulder.
> Checks doctor’s order
> This exercise should be performed three times a day for 20 minutes at a time
> Let patient shower with warm water prior to exercise
> Administer analgesic 30 minutes prior to exercise
> If the patient has a graft, exercises may need to be prescribed and introduces gradually.
> Rod or broom stick (1.5 – 2 meters long)
> Rope (1.5 – 2 meters long)
1. Check doctor’s order and identify the patient.
Rationale: To be sure that the exercise is not contraindicated to the patient.
2. Explain procedure to the patient.
Rationale: To gain patient’s cooperation and also give her time to prepare.
3. Assume/place patient in a standing/sitting position.
Rationale: Allow the patient to a full range of motion.
4. Ball squeezing. A rubber ball or a crumpled newspaper squeeze in the hand of the involved side.
Rationale: This does not strain the patient while preparing her for more strenuous exercise.
5. Wall climbing. The women sit/stand facing the wall with her toes next to the wall. Place both hands on the wall with uninvolved arm followed by the involved arm.
Rationale: This increases circulation and muscular strength, prevent elbow and shoulder joint stiffness and contractures, and restore full range of motion of the shoulders and arms.
6. Pendulum or arm swinging. The points bends at the waist and swing her arms from side to side without bending the elbows.
Rationale: This will prevent shoulder joint stiffness that may result to frozen shoulder as a result of the surgery.
7. Fitting clasped hands. The patient clasps her hands and lifts them slowly over head, keeping the elbows straight.
Rationale: To restore arm and shoulder joints full range of motion and muscle strength prevents stiffness as well as increase blood circulation.
8. Elbow spread. The patient interlocks her hands behind her neck and raises her elbows to chin level, then gradually brings the elbows together.
Rationale: To restore arms ans shoulder joints full range of motion and restore elbow strength.
9. Pulley or rope pulling. The patient pulls the string down and opposite arm is raised.
Rationale: To restore the abduction and adduction range of motion of the shoulder joints to prevent the frozen shoulder syndrome.
10. Deep breathing. The patient is placed on sitting position, her hand over the involve portion of her chest and takes a deep breath through the nose, feeling her chest expand as the breath is inhaled, as she exhaled, the chest and shoulder sags and reflex.
Rationale: To support muscles in affected side during chest expansion.
11. Make patient comfortable.
Rationale: Allowing patient to rest for the next sessions of post mastectomy exercises.
12. Chart procedure done, time and reaction of patient.
Rationale: Record and allow nurse and therapist to adjust to patient’s capability.
Kozier, Barbara, et.al Fundamentals of Nursing. Philippines: Pearson Educations South Asia PTE LTD. 2004 pp.