Effects of digital exercise therapy and cognitive behavioral therapy on body image and social distance of postoperative patients with breast cancer: study protocol for a randomized controlled trial

BACKGROUND: Modified radical mastectomy is a widely used operative method for patients with breast cancer. Although it can significantly improve the survival rate, it can also lead to various adverse reactions, such as the loss of sexual characteristics, skin damage, and hair loss, which in turn can cause body image disorders and social avoidance among postoperative patients. Exercise therapy and cognitive behavior therapy are frequently employed as rehabilitation treatments to increase the mental well-being and stress coping styles of patients with breast cancer. However, no studies have directly explored the impact of exercise therapy and cognitive behavior therapy on the body image and social distance of patients with breast cancer. METHODS: This is a three-arm randomized controlled trial. A total of 60 patients who underwent modified radical mastectomy for breast cancer will be recruited and divided into three groups: the exercise therapy group, the cognitive behavior therapy group, and the combined treatment group. The intervention will be delivered in a hybrid mode combining online and offline sessions. All participants will receive a 60-min intervention twice a week for 8 weeks. The primary outcomes are the Body Image Scale and the Social distancing test, which will be conducted before and after the intervention, as well as at the 3-month follow-up. DISCUSSION: This study aims to evaluate a rehabilitation program combining digital exercise therapy and cognitive behavioral therapy for postoperative breast cancer patients, focusing on improving body-image disturbances and abnormal social-distance adjustment following modified radical mastectomy. The intervention is expected to help patients return to family and society in a positive and confident state, achieving psychophysiological-social rehabilitation. The use of digital remote intervention in research can not only ensure the security of patients' personal information but also reduce the time and money spent on commuting and seeing doctors, providing new ideas for clinical treatment. TRIAL REGISTRATION: This trial was registered with Chinese Clinical Trial Registry (ChiCTR2400084427) on May 16, 2024.