유방암 수술 후 환자를 위한 운동 중재 프로그램이 어깨 관절 가동 범위에 미치는 영향 : 체계적 문헌고찰 및 메타분석
The Effects of an Exercise Intervention Program on Shoulder Range of Motion in Patients After Breast Cancer Surgery: A Systematic Review and Meta-Analysis
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본연구는 유방암 수술 후 환자를 대상으로 시행된운동 중재 프로그램이어깨 관절 가동 범위(Range of Motion, ROM)에미치는영향을체계적으로고찰하고, 메타분석을통해그효과를 정량적으로평가하고자하였다. PICO 프레임워크에따라2000년1월부터2025년8월까지발표된 연구들을 검토하였으며, 총 12편의 문헌을 문헌고찰 대상으로, 8편을 메타분석 대상으로 선정되었다. 운동 중재는 근력 강화, 스트레칭, 감각 운동, 수중 운동, 견갑 안정화 운동 등 다양하였고, 메타분석결과, 전체통합효과크기(SMD)는0.86(95% CI: 0.61–1.12)로운동군이 대조군에비해어깨관절가동범위전반에있어통계적으로유의미한개선을보였다. 특히굴곡, 신전, 외전, 내전, 외회전영역에서통계적으로유의한효과가나타났으나, 내회전에서만통계적 유의하지않았다. 본연구는운동중재가특정시기에국한되지않고다양하게적용된연구들을 포함하였으며, 유방암환자수술후운동의유익성을객관적으로제시하였다. 향후연구에서는 운동중재의도입시기, 강도, 빈도에대한표준화연구와함께장기추적을통한지속적효과검증이 필요하다.
Abstract
This study systematically reviewed the effects of an exercise intervention program on shoulder range of motion (ROM) in patients after breast cancer surgery and quantitatively evaluated the effects through a meta-analysis. Studies published between January 2000 and August 2025 were reviewed using the PICO(Population, Intervention, Comparison, Outcome) framework. A total of 12 studies were included in the systematic review and eight were selected for meta-analysis. Exercise interventions included muscle strengthening, stretching, sensory training, aquatic exercises, and shoulder stabilization exercises. The findings of this meta-analysis support the effectiveness of exercise interventions, with an overall pooled effect size (SMD) of 0.86 (95% CI: 0.61–1.12), indicating statistically significant improvements in the overall shoulder joint range of motion in the exercise group compared to the control group. Significant effects were observed in flexion, extension, abduction, adduction, and external rotation, but not in internal rotation. This study included studies that applied exercise interventions in a variety of settings, regardless of the specific time period, and objectively demonstrated the benefits of exercise in patients after breast cancer surgery. Future research is recommended to standardize the timing, intensity, and frequency of exercise interventions and to verify their sustained effectiveness through long-term follow-up