Physical Therapist-Led Exercise Boosts Function
And Improves Quality Of Life In Breast Cancer Patients
Breast cancer is the second most common type of cancer in women, as about 1 in 8 women will be diagnosed with it at some point in their lives. Each year, about 240,000 new cases of breast cancer are detected, and about 40,000 women lose their lives to the disease. Over the past 10 years, the number of women diagnosed with breast cancer has remained stable, while the associated death rate has declined slightly. Still, breast cancer remains a major health concern for women today.
Many women diagnosed with breast cancer will undergo a surgical procedure at some point, such as a breast biopsy, lymph node biopsy or removal, lumpectomy, mastectomy, or breast reconstruction. Frequently, this is in addition to other common cancer interventions like radiation and/or chemotherapy. After completing these treatments, a sizable percentage of women go to experience various side effects, such as pain and stiffness in the chest, shoulder, and back muscles, or nerve irritation that can cause numbness, pain, and tingling.
Each patient’s recovery differs depending on the severity of the cancer and what treatments were used, but side effects often reduce flexibility and range of motion, which can prevent women from returning to their normal daily activities. In addition, many women that undergo various treatments and hospitalizations become deconditioned due to lack of physical activity, which can have further repercussions on their health.
Lack of research prompts new study on exercise for breast cancer patients
Therefore, general exercise and physical therapy are strongly recommended for women recovering from breast cancer treatment. A carefully designed physical therapy program will focus on improving qualities like strength, range of motion, and endurance to allow these women to reestablish their previous level of activity; however, research is lacking on structured exercise for breast cancer patients and if there are any safety concerns in high-risk patients. In response, a robust type of study called a randomized-controlled trial was conducted to evaluate the effectiveness of a physical therapist led exercise program for women at high risk for disability after breast cancer treatment.
For the study, 392 women newly diagnosed with breast cancer who were scheduled to have surgery and considered to be at high risk for upper limb disability served as the primary study group. These women were randomly and evenly assigned to either exercise plus usual care or usual care alone. Women in the usual care alone group received information leaflets recommending exercise and general advice for after surgery, and no further interventions were performed. Women in the exercise plus usual care group underwent a structured exercise program supervised by a physical therapist. The program consisted of various upper extremity exercises targeting the shoulder and was intended to restore range of motion of the shoulder, improve strength, and increase physical activity levels. All patients were assessed before and after completing these programs with various outcome measures.
Patients in the Exercise Group had a Better Outcome
Twelve months later, patients who underwent the exercise program reported significantly better scores on a questionnaire that measured disability of the shoulder, arm, and hand. These patients also reported less pain intensity and fewer activity limitations, participation restrictions, and impairments than the usual care alone group, and the intervention did not lead to any increase in complications or lymphedema symptoms. Finally, the exercise program, which only cost an average of $178 per patient, was found to be significantly more cost effective than usual care.
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This study shows that physical therapy can lead to improved upper limb function, postoperative pain, arm symptoms, and physical quality of life at 12 months compared with usual care alone in women at high risk of upper limb disability after breast cancer treatment. So if you’re affected by breast cancer and scheduled to have surgery, we strongly encourage you to reach out to us to get set up for your postoperative program.