Physiotherapy Interventions for Breast Cancer Survivors: Practice Patterns and Perceived Barriers in Tripoli, Libya

Post-operative physiotherapy is a cornerstone in enhancing the quality of life and functional recovery of breast cancer survivors. Despite its recognized importance, there is a paucity of data regarding physiotherapy practices, referral patterns, and clinical challenges in the management of post-operative breast cancer patients in Libya. This study aimed to investigate the clinical practices, referral trends, and therapeutic interventions employed by physiotherapists in Tripoli, Libya, in managing post-operative breast cancer patients. Additionally, it sought to identify key barriers hindering the delivery of optimal physiotherapy care in this population. A descriptive cross-sectional study was conducted from June 4 to July 4, 2022, involving 35 physiotherapists working in major public hospitals and private rehabilitation centers across Tripoli. Participants were selected based on their prior experience with breast cancer patients. Data were collected using a structured, pre-validated questionnaire adapted from international sources, and data were analyzed using SPSS version 26. Most of the physiotherapists surveyed were female (74.3%) and between the ages of 25 and 35. While 60% had less than five years of experience managing breast cancer cases, nearly two-thirds (62.9%) reported not having received any formal training in oncology rehabilitation. Most participants treated fewer than 20 breast cancer patients per year, and 60% indicated that physiotherapy referrals were typically made only after surgery. The most reported barriers to effective care included patients’ psychological distress (77.1%), followed by low adherence to treatment and insufficient professional training. Regarding treatment methods, passive mobilization, postural correction, and manual therapy were frequently used during the first two weeks post-surgery. Strengthening and range-of-motion exercises were usually introduced later in the subacute recovery phase, while electrotherapy was the least commonly applied. A statistically significant difference (p < 0.001) in the timing and frequency of interventions points to a lack of standardized physiotherapy practices across facilities. The findings underscore a pressing need for structured training programs, the development of standardized physiotherapy protocols, and the integration of physiotherapy services into the early stages of breast cancer care in Libya. Improving education for physiotherapists and refining referral mechanisms may substantially enhance rehabilitation outcomes and overall quality of life for breast cancer survivors. Furthermore, future research is recommended to assess the long-term effects of physiotherapy on physical and psychological outcomes in post-operative breast cancer patients. Larger, multi-center studies are needed to develop evidence-based guidelines suited to the Libyan context.