研究是否在乳腺癌手术后，与指南推荐的时间相比提前开始康复训练，对肩膀功能和生活质量的恢复是否有益。前瞻性、观察性、单中心、随机对照试验。研究进行于2018年9月至2019年12月，包括12周的监管干预和6周的家庭锻炼期，并在2020年5月结束。200名乳腺癌患者接受腋淋巴结清除手术。参与者被招募并随机分为A、B、C和D四组。A组在手术后7天开始关节活动幅度训练，并在手术后4周开始逐渐增加阻力的训练。B组在手术后7天开始ROM训练，并在手术后3周开始PRT训练。C组在手术后3天开始ROM训练，并在手术后4周开始PRT训练。D组在手术后3天开始ROM训练，并在手术后3周开始PRT训练。主要结果指标是Constant-Murley评分。次要结果指标包括ROM、肩膀力量、握力、EORTC QLQ-BR23和SF-36。还评估了不良反应（引流和疼痛）和并发症（瘀斑，皮下血肿，淋巴水肿）的发生率。开始ROM训练于术后3天的患者在移动性、肩膀功能和EORTC QLQ-BR23评分方面获得了更多的益处，而在术后3周开始PRT的患者在肩膀力量和SF-36方面得到了改善。所有四组中不良反应和并发症的发生率都很低，四组之间没有显着差异。将ROM训练起始时间提前至手术后3天或将PRT训练延迟至手术后3周，能更好地恢复乳腺癌手术后的肩膀功能，并加速提高生活质量。 Copyright ©2023 Elsevier Inc.出版。

To investigate whether advancing the initiation of rehabilitation training compared to the time recommended by the guidelines after breast cancer (BC) surgery is beneficial to the recovery of shoulder function and quality of life.Prospective, observational, single center, randomized controlled trial SETTING: The study was conducted between September 2018 and December 2019, with a 12-week supervised intervention and 6-week home-exercise period concluding in May 2020.Two hundred BC patients received axillary lymph node dissection.Participants were recruited and randomly allocated into 4 groups (A, B, C, and D). Group A started range of motion (ROM) training at 7 days postoperative and progressive resistance training (PRT) at 4 weeks postoperative; Group B started ROM training at 7 days postoperative and PRT at 3 weeks postoperative; Group C started ROM training at 3 days postoperative and PRT at 4 weeks postoperative; and Group D started ROM training at 3 days postoperative and PRT at 3 weeks postoperative.The primary outcome measure was Constant-Murley Score. Secondary outcome measures included ROM, shoulder strength, grip, EORTC QLQ-BR23, and SF-36. Incidence of adverse reactions (drainage and pain) and complications (ecchymosis, subcutaneous hematoma, lymphedema) were also assessed.Participants who started ROM training at 3 days postoperative obtained more benefits in mobility, shoulder function, and EORTC QLQ-BR23 score, while patients who started PRT at 3 weeks postoperative saw improvements in shoulder strength and SF-36. Incidence of adverse reactions and complications were low in all four groups, with no significant differences among the four groups.Advancing ROM training initiation to 3 days postoperative or PRT to 3 weeks postoperative can better restore shoulder function after BC surgery and lead to faster quality of life improvement.Copyright © 2023. Published by Elsevier Inc.