Marize Ibrahim1, Thierry Muanza2,3,4,5, Nadia Smirnow1, Warren Sateren6, Beatrice Fournier1, Petr Kavan7, Michael Palumbo8, Richard Dalfen9, Mary-Ann Dalzell10,11,12. 1. Rehabilitation & Exercise Oncology program, Jewish General Hospital, Hope & Cope, 3755 Côte-Sainte-Catherine, E-773, Montréal, Québec, H3T 1E2, Canada. 2. Experimental Medicine Department, Faculty of Medicine, McGill University, Montreal, QC, Canada. 3. Radiation Oncology Department, Jewish General Hospital, McGill University, Montreal, QC, Canada. 4. Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, QC, Canada. 5. Oncology Department, McGill University, Montreal, QC, Canada. 6. Rossy Cancer Network, Jewish General Hospital, 1980 Sherbrooke West, Suite 1123, Montréal, QC, Canada. 7. Department of Oncology, McGill University, Jewish General Hospital, Montréal, Canada. 8. Hematology-Oncology Department, Jewish General Hospital, McGill University, Montréal, QC, Canada. 9. Jewish General Hospital, McGill University, Montréal, QC, Canada. 10. Rehabilitation & Exercise Oncology program, Jewish General Hospital, Hope & Cope, 3755 Côte-Sainte-Catherine, E-773, Montréal, Québec, H3T 1E2, Canada. madalzell5@gmail.com. 11. Oncology Division, Canadian Physiotherapy Association, Ontario, Canada. madalzell5@gmail.com. 12. Web-Based Education and Professional Consultations, Ordre Professionelle de la Physiothérapie du Quebec, Anjou, QC, Canada. madalzell5@gmail.com.
Abstract
PURPOSE: Breast cancer (BC) diagnosis in young adults (YA) is rising, and both disease and treatments are aggressive in this population. Evidence supports the use of physical activity in reducing shoulder dysfunction, which is common among BC survivors. A pilot randomized clinical trial was performed to determine the effectiveness of a 12-week post-radiation exercise program in minimizing upper extremity dysfunction in YA with BC. METHODS: Participants were randomized to either an exercise arm or a control arm receiving standard care. Data was collected over six time points using: the Disability of Arm, Shoulder, and Hand (DASH); the Metabolic Equivalent of Task-hours per week (MET-hours/week), and a post hoc questionnaire on return to work. RESULTS: In total, 59 young women participated in the study (n = 29 exercise; n = 30 control). No statistically significant differences were found in overall DASH results between groups; however, those who underwent total mastectomy had residual upper limb dysfunction (p < 0.05). Both groups returned to pre-diagnosis activity levels by 18 months. Final evaluation showed that 86% of the women returned to work, and 89% resumed prior work activities with a decrease of 8.5 h/week. CONCLUSION: Although the short-term targeted exercise program had no effect on long-term upper limb function post-radiation, timing and program specificity may require consideration of tissue healing post-radiation and surgery type. The majority of participants returned to work, however not returning to pre-diagnosis work hours. IMPLICATIONS FOR CANCER SURVIVORS: Exercise interventions alone may not reverse the long-term sequelae of breast cancer treatment and allow young adult patients to return to work.
RCT Entities:
PURPOSE:Breast cancer (BC) diagnosis in young adults (YA) is rising, and both disease and treatments are aggressive in this population. Evidence supports the use of physical activity in reducing shoulder dysfunction, which is common among BC survivors. A pilot randomized clinical trial was performed to determine the effectiveness of a 12-week post-radiation exercise program in minimizing upper extremity dysfunction in YA with BC. METHODS:Participants were randomized to either an exercise arm or a control arm receiving standard care. Data was collected over six time points using: the Disability of Arm, Shoulder, and Hand (DASH); the Metabolic Equivalent of Task-hours per week (MET-hours/week), and a post hoc questionnaire on return to work. RESULTS: In total, 59 young women participated in the study (n = 29 exercise; n = 30 control). No statistically significant differences were found in overall DASH results between groups; however, those who underwent total mastectomy had residual upper limb dysfunction (p < 0.05). Both groups returned to pre-diagnosis activity levels by 18 months. Final evaluation showed that 86% of the women returned to work, and 89% resumed prior work activities with a decrease of 8.5 h/week. CONCLUSION: Although the short-term targeted exercise program had no effect on long-term upper limb function post-radiation, timing and program specificity may require consideration of tissue healing post-radiation and surgery type. The majority of participants returned to work, however not returning to pre-diagnosis work hours. IMPLICATIONS FOR CANCER SURVIVORS: Exercise interventions alone may not reverse the long-term sequelae of breast cancer treatment and allow young adult patients to return to work.
Entities:
Keywords:
Breast cancer; Exercise; Physical therapy; Radiation therapy; Rehabilitation; Young adult
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