Shoulder Exercise Training on Pain, Range of Motion, and Functional Limitations in Women Following Unilateral Mastectomy

Inclusion Criteria:

* Participants must meet all of the following criteria:

  1. Female adults between 30 and 65 years old.
  2. History of unilateral breast cancer managed with either:

     * Modified radical mastectomy, or
     * Breast-conserving surgery with axillary clearance.
  3. Postoperative interval between 4 and 12 weeks before enrollment.
  4. Objective evidence of impaired shoulder mobility or function including:

     * Reduction of ROM ≥ 15% compared to the contralateral side,
     * VAS pain ≥ 3/10 during shoulder movement, or
     * DASH functional score \> 25.
  5. Ability to ambulate independently and follow therapist instructions.
  6. Willingness to commit to the full rehabilitation protocol for 8 weeks.

Exclusion Criteria:

* Participants will be excluded if they have:

  * Previously diagnosed shoulder disorders (adhesive capsulitis, rotator cuff tear, fracture/dislocation).
  * Active or untreated lymphedema Grade II-III.
  * Ongoing chemotherapy-induced neuropathy causing shoulder dysfunction.
  * History of neurological or rheumatological disorders affecting the upper limb.
  * Metastatic disease or local recurrence.
  * Recent infection, seroma, or unhealed surgical wounds.
  * Participation in another physical therapy or exercise program in the past 4 weeks.
  * Cognitive impairment or psychiatric conditions interfering with adherence.