A study to evaluate the effectiveness of a nurse-directed pre operative exercise program on post operative shoulder range of motion and pain in patients undergoing axillary lymph node dissection (ALND) in a tertiary care hospital.

This study aims to find out whether doing simple shoulder exercises before surgery can help reduce pain and improve shoulder movement after Axillary Lymph Node Dissection (ALND). ALND is a common procedure in breast cancer and other cancers, but it often causes shoulder stiffness, pain, and limited movement after surgery. In this non-randomized control trial, patients undergoing ALND will be divided into two groups. The experimental group will perform nurse-directed shoulder exercises (flexion, abduction, and external rotation) for seven days before surgery, three times a day. The control group will receive routine pre-operative care only. After surgery, both groups will be assessed for shoulder range of motion and pain from the third to seventh post-operative day using a goniometer and a numerical pain rating scale. The study will be conducted at AIIMS Mangalagiri with 28 participants. The expected result is that patients who perform pre-operative exercises will have better shoulder movement and less pain compared to those who do not. This study may help establish a simple, cost-effective, nurse-led prehabilitation program to improve recovery and quality of life for cancer patients undergoing ALND.