Supportive Progressive Resistance Training Combined With Adjuvant Hypofractioned Radiation Therapy Improves Shoulder Complex Muscle Strength in Women With Breast Cancer

Tuğrul, E, Darandeli, A, Tuğrul, F, Knicker, AJ, Soylu, AR, and Ertan, H. Supportive progressive resistance training combined with adjuvant hypofractioned radiation therapy improves shoulder complex muscle strength in women with breast cancer. J Strength Cond Res 40(3): e313-e323, 2026-Despite its benefits, radiation therapy (RT) causes a range of side effects that adversely affect individuals undergoing breast cancer (BC) treatment. Exercise is considered a simultaneous treatment alongside radiation therapy to mitigate side effects and to facilitate effective recovery in patients. The aim of this study was to investigate the effects of progressive resistance training (PRT) combined with adjuvant hypofractionated radiation therapy (HFRT) on shoulder complex muscle strength and muscle activation in patients with BC. Thirty-one patients with BC were assigned to either an exercise group (EG, n = 15) or a control group (CG, n = 16). EMG and force signals were recorded while the patients performed isokinetic shoulder internal and external rotation with their surgery limb and the contralateral limb at angular velocities of 1.047 rad/s and 2.094 rad/s. Common terminology criteria for adverse events (CTCAE) were used to evaluate the side effects of HFRT. Torque and EMG data for pre- and postintervention were compared between the 2 groups using linear mixed models. The torque produced during shoulder internal and external rotation at all angular velocities showed significantly greater improvement in EG compared with CG ( p < 0.0001). Group and time interaction was statistically significant for mean functional control ratio (FCR) and maximal voluntary contraction torque values ( p < 0.0001). Similarly, group and time interaction was statistically significant for peak EMG values ( p < 0.0001). There was no statistically significant difference in CTCAE between the EG and the CG ( p > 0.05). PRT combined with adjuvant HFRT is effective in increasing shoulder complex muscle strength, and FCR in women with BC.