Early Postoperative Exercise To Promote Recovery Of Shoulder Function In Breast Cancer Patients: Randomized Controlled Trial

PURPOSE: Breast cancer surgery can impair shoulder function, but the effects of rehabilitation exercise during early recovery are uncertain. Tailoring exercises based on patient characteristics and recovery status could potentially benefit shoulder function. This study aims to evaluate the efficacy of early exercise intervention on shoulder function recovery at one and six months post-surgery. METHODS: A total of 58 breast cancer patients (Stage 0-3, mean age 50.2 ± 6.6 years) scheduled for surgery were randomly assigned to an exercise or usual care group (1:1). The exercise group received four tailored exercise education sessions, starting postoperative day 1 and continuing for three weeks after surgery. Participants were provided with exercise resources for home-based workouts. The primary outcome measure was the proportion of participants achieving 95% of their pre-surgery shoulder ROM and strength at one and six months post-surgery. Secondary outcomes measures included shoulder pain and disability index (SPADI), physical activity, and body composition. Surgical complications were monitored. All participants were measured shoulder function, quality of life, body composition, and physical activity level five times from the day before surgery to six months post-surgery RESULTS: Of the 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 had significantly lower shoulder pain and disability scores at one and six months, along with higher physical activity levels at six months. Incidence of surgical complications did not differ between groups. CONCLUSIONS: Tailored exercise during early rehabilitation significantly improved shoulder function beyond pre-surgery levels. This study has important clinical implications for the efficacy and safety of early rehabilitation exercise in post-surgery recovery among breast cancer patients. NRF-2020S1A5B5A17090332, KBCF-2020 U002