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KMID : 0901419960010010024
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Journal of Research Institute for Hospice & Palliative Care
1996 Volume.1 No. 1 p.24 ~ p.38
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Effects of Aquatic Exercise Program on the Shoulder Joint Function, Immune Response and Emotional State in postmastectomy Patients
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Yoo Yang-Sook
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Abstract
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This study was designed to investigate the effects of an aquatic exercise program on the shoulder joint funcdtion, immune response and emotional state among the patients who received modified radical mastectomy between 6 to 12 months prior to their visits. The subjects were 31 women aged between 40 and 60 who visited the out-patient department at Kang Nam St. Mary’s Hospital for follow-up care, and were not under the treatment of intravenous cancer chemotherapy or radiation therapy, and had no complications. Twelve of them were assigned to the control group, while nineteen subjects to the experimental group. The aquatic exercise program was developed by the author with the assistance of exercise specialists. The program includes warming up, aerobic and cooling down exercises in water. The aquatic exercise program for the experimental group was carried out 3 times a week with 60 minutes in each time for 8 weeks from September 20th to November 15th. 1995 in a regular swimming pool in Seoul. Changes in the range of motion of the shoulder joint, muscle strength, immune response, and emotional state were examined after the completion of treatment. The data were collected through isokinetic muscle strength evaluation, blood sampling and questionnaire survey before and after the treatment. Faired and unpaired t-test were adopted to analyze the data. The results were as follows : 1. The increment in the range of motion of the shoulder joint in the experimental group after the exercise was significantly greater than those in the control group. 2. The peak torque of shoulder girdle muscles increased significantly after the exercise in the experimental group only. 3. In flexor and abductor, the ratio of peak torque of shoulder girdle muscles between the affected and unaffected side decreased significantly in the experimental group only after the exercise. 4. Grip strength in both hands increased significantly after the exercise in the experimental group only. 5. The physical symptom score decreased significantly after the exercise in the experimental group only. 6. In the experimental group, the ratio of the natural killer cell in lymphocytes increased significantly after the exercise. By contrast, control group showed no significant change in immune response. 7. The experimental group revealed significantly lower level of anxiety and of depression after the exercise compared with those before the exercise, whereas the control group showed no significant changes in those levels. These findings may indicate that the aquatic exercise program is effective in increasing the range of motion of the shoulder joint, muscle strength and immune response, and also effective in decreasing physical symptoms, the level of anxiety and depression in postmastectomy patients. Accordingly, the acquatic exercise program can be adopted as an effective nursing intervention for postmastectomy rehabilitation.
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