Results from PROSPER RCT: Does Post-Surgical Exercise Improve Shoulder Mobility Outcomes After Breast Cancer Surgery?
BACKGROUND AND PURPOSE:
Bruce et al. (BMJ, 2021) assessed whether a structured exercise program improved functional and health related quality of life outcomes compared with usual care for women after breast cancer surgery
Multicenter, pragmatic, superiority, randomized controlled trial with economic evaluation
Women undergoing breast cancer surgery
High risk for postoperative upper limb morbidity
Planned axillary node
Planned radiotherapy to the axilla or supraclavicular fossa
Existing shoulder problems
Subsequent axillary surgery after sentinel lymph node biopsy
Planned axillary or supraclavicular radiotherapy within six weeks of primary surgery
Usual care (information leaflets) only
Usual care plus a physiotherapy led exercise program
Stretching | Strengthening | Physical activity | Behavioral change techniques to support adherence to exercise
Introduced at 7 to 10 days postoperatively | 2 more appointments at 1 and 3 months
Randomized 1:1 to an intervention group
Analysis by intention to treat
Disability of Arm, Hand and Shoulder (DASH) questionnaire at 12 months (0 score for no disability to 100 for most severe disability)
Pain using Numerical rating scale (Moderate to severe pain 4 to 10)
Health related quality of life using Functional Assessment of Cancer Therapy-Breast+4 (FACT-B+4), a validated quality of life tool designed to assess the impact of arm morbidity on patients following breast cancer surgery
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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