345P - The effect of early post-operative exercise on shoulder function in breast cancer patients: A randomised controlled trial

Background

Breast cancer surgery can impair shoulder function, and the effects of rehabilitation exercise during early recovery remain uncertain. This study aims to assess the effectiveness of tailored exercise intervention on shoulder function recovery at one and six months post-surgery.

Methods

A total of 122 breast cancer patients (Stage 0-3) scheduled for surgery were evaluated, and 58 patients (mean age 50.2±6.6 years) were randomly assigned to an exercise or usual care group (1:1). The exercise group underwent five tailored exercise education sessions, starting one day before hospital discharge and continuing for four weeks after surgery. Participants received exercise diaries, online links, and QR codes for home-based workouts. The primary outcome measured the proportion of participants achieving 90% of their pre-surgery shoulder ROM and strength at one and six months post-surgery. Secondary measures included DASH and SPADI scores, physical activity levels, and body composition.

Results

Out of 58 participants, 56 (96.6%) completed the trial, with a 96.6% exercise compliance rate one month after surgery. In the exercise group, 92.9% and 96.2% achieved pre-surgery shoulder strength levels at one and six months post-surgery, respectively, compared to 3.7% and 32.1% in the control group. The exercise group also exhibited significantly lower shoulder pain and disability scores (SPADI) at one and six months after surgery, as well as higher physical activity levels at six months. Table: 345P

Change in shoulder strength among postoperative breast cancer patients

Mean±SD, P=represented the results of independent T-test (the p-value adjusted for Bonferroni method (0.05/6=0.0083), *=represented paired t-test [**p<0.01 vs. baseline, ***p<0.001 vs. baseline (p-value adjusted for Bonferroni method)] Abbreviation: early postoperative exercise therapy; EPET

Conclusions

Early implementation of tailored exercise during rehabilitation significantly improved shoulder function beyond pre-surgery levels. This study provides essential insights into the efficacy and safety of early rehabilitation exercises for breast cancer patients during the post-surgery recovery phase.

Clinical trial identification

The Institutional Ethics Review Board of Severance Hospital and WHO International Clinical Trials Registry Platform (ICTRP; KCT0006997) approved the trial.

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

This research was supported by the Ministry of Education of the Republic of Korea, the National Research Foundation of Korea (NRF-2020S1A5B5A17090332) and Korea Breast Cancer Foundation (KBCF-2020U002).

Disclosure

All authors have declared no conflicts of interest.