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Table 1 Brief descriptions of drain care education with a nurse and rehabilitation with an occupational therapist

From: Study protocol: a pilot quasi-experimental trial of tele-rehabilitation and tele-drain care post-mastectomy

Drain Care Education Arm and Shoulder Massage Exercise
Drain care education provides information on how to manage the drainage devices and fluids collected post-mastectomy. These include proper and safe physical handling of the drainage devices, and proper sequences to empty, measure, and dispose fluids from the drainage devices. Arm and shoulder massage are performed with the aim of managing edema (reducing arm swelling) post-mastectomy. They consist of a series of actions to facilitate pushing fluid out of the affected areas back into the bloodstream, therefore preventing fluid accumulation and limb swelling. The exercises are performed with the aim of maintaining the active range of motion of the upper limbs, which concurrently helps to drain fluid. The exercises involve deep breathing and a series of movements including shoulder elevation, retraction, protraction and flexion, and elbow flexion and extension.
Sample Instructions
 Step 1. Wash your hand
 Step 2. Prepare your requisites
 Step 3. Drain fluid for measurement
 Step 4. Measure and record the amount of fluid drained, before disposal (twice a day)
Step 1. Take a deep breath
Step 2. Place your affected arm on your shoulder with your elbow pointing to your side
Step 3. Using the other hand, place it below your armpit
Step 4. Gently sweep downwards past your waistline
Step 5. Please ensure your palm has good contact with your body as you sweep downwards
Step 6. Repeat this 20 times
Note. The arm/hand doing the massage is the contralateral side massaging the affected side.
Step 1. Begin the exercise by clasping both hands and bringing them to the chest
Step 2. Slowly bring both arms forward, making sure that your elbows are straight
Step 3. Repeat this 5 times