PENGARUH ENHANCED RECOVERY AFTER SURGERY (ERAS) DAN LATIHAN EKSTREMITAS ATAS TERHADAP PEMULIHAN FUNGSI BAHU PASCA MODIFIED RADICAL MASTECTOMY (MRM)
Kata Kunci:
ERAS, Upper Limb Exercise, Modified Radical Mastectomy, Shoulder Range of Motion, Shoulder Muscle StrengthAbstrak
Breast cancer is the most common malignancy in women and is frequently treated with Modified Radical Mastectomy (MRM). However, this procedure often results in shoulder dysfunction, such as limited range of motion and reduced muscle strength. Objective: This study aims to evaluate the effect of Enhanced Recovery After Surgery (ERAS) protocol combined with Upper Limb Exercise (ULE) on the recovery of shoulder joint range of motion and muscle strength in post-MRM patients. Methods: A quasi-experimental design was applied with two intervention groups (ERAS+ULE and Non-ERAS). Shoulder mobility (active and passive) and muscle strength were measured pre- and post-intervention. Results: The ERAS+ULE group demonstrated significantly greater improvements in shoulder flexion, extension, abduction, adduction, internal and external rotation, as well as in muscle strength, compared to the Non-ERAS group. Conclusion: The integration of ERAS and ULE protocols effectively enhances functional recovery of the shoulder after MRM surgery and may be adopted as a standard postoperative rehabilitation protocol.
Referensi
1. WHO. Breast Cancer. Published online March 13, 2024. https://www.who.int/news-room/fact-sheets/detail/breast-cancer
2. Merino T, Ip T, Domínguez F, et al. Risk factors for loco-regional recurrence in breast cancer patients: a retrospective study. Oncotarget. 2018;9(54):30355 30362. doi:10.18632/oncotarget.25735
3. Akbas A, Dagmura H, Daldal E, Dasiran FM, Deveci H, Okan I. Association between Shoulder Range of Motion and Pain Catastrophizing Scale in Breast Cancer Patients after Surgery. Breast Care. 2021;16(1):66-71. doi:10.1159/000506922
4. Henry N, Shah P, Haider I, Freer P. Cancer of the Breast. In: Abeloff’s Clinical Oncology. 6th ed. Elsevier; 2020.
5. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36
6. Kuwajerwala N. Modified Radical Mastectomy. Medscape. Published online February 2024. overview?form=fpf https://emedicine.medscape.com/article/1830105
7. Ibrahim M, Muanza T, Smirnow N, et al. A Pilot Randomized Controlled Trial on the Effects of a Progressive Exercise Program on the Range of Motion and Upper Extremity Grip Strength in Young Adults With Breast Cancer. Clinical Breast Cancer. 2018;18(1):e55-e64. doi:10.1016/j.clbc.2017.06.007
8. Springer BA, Levy E, McGarvey C, et al. Pre-operative assessment enables early diagnosis and recovery of shoulder function in patients with breast cancer. Breast Cancer Res Treat. 2010;120(1):135-147. doi:10.1007/s10549-009 0710-9
9. Gustafsson UO, Scott MJ, Hubner M, et al. Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS® ) Society Recommendations: 2018. World j surg. 2019;43(3):659-695. doi:10.1007/s00268-018-4844-y
10. McNeely ML, Campbell K, Ospina M, et al. Exercise interventions for upper limb dysfunction due to breast cancer treatment. Cochrane Breast Cancer Group, ed. Cochrane Database of Systematic Reviews. Published online June 16, 2010.
