The influence of physical post-operative rehabilitation interventions to improve upper limb strength in women undergoing breast cancer surgery: A Systematic Review of the literature.
Zoe Chia, Michael O'Brien, Jessica Shortland, Holly M Holmes, Dana Giza, An Ngo-Huang, Kwok Leung Cheung, Ruth M Parks
Author Information
Zoe Chia: Nottingham Breast Cancer Research Centre, University of Nottingham, UK; Royal Derby Hospital, University Hospitals of Derby and Burton NHS Trust, UK.
Michael O'Brien: School of Medicine, University of Nottingham, UK.
Jessica Shortland: School of Medicine, University of Nottingham, UK.
Holly M Holmes: Division of Geriatric and Palliative Medicine, University of Texas Health Science Centre, McGovern Medical School, Houston, TX, USA.
Dana Giza: Division of Geriatric and Palliative Medicine, University of Texas Health Science Centre, McGovern Medical School, Houston, TX, USA.
An Ngo-Huang: The University of Texas MD Anderson Cancer Centre, Section of Physical Medicine and Rehabilitation, Department of Palliative, Rehabilitation, and Integrative Medicine, USA.
Kwok Leung Cheung: Nottingham Breast Cancer Research Centre, University of Nottingham, UK; School of Medicine, University of Nottingham, UK.
Ruth M Parks: Nottingham Breast Cancer Research Centre, University of Nottingham, UK; School of Medicine, University of Nottingham, UK. Electronic address: Ruth.Parks@nottingham.ac.uk.
BACKGROUND: Breast cancer is the most prevalent cancer globally. Primary treatment commonly involves surgery to the breast and axilla, which can potentially cause a variety of physical impairments, negatively affecting patients' quality of life. Consequently, effective rehabilitation techniques may help patients recover their physical function following surgery. Therefore, this review aims to identify whether post-operative rehabilitation interventions improve upper limb strength in women following breast cancer surgery and to compare the efficacy of different approaches. METHODS: The literature search was completed in October 2023 using MEDLINE, EMBASE and Cochrane databases. Eligible studies included full-text English articles of studies performed in patients who have undergone breast cancer surgery and subsequent post-operative rehabilitation to assess the outcome on upper limb strength. RESULTS: Nine studies were included with 786 women who underwent breast cancer surgery and subsequent post-operative rehabilitation. Six studies were rated as level-I evidence, whilst three studies represented level-II evidence. Five studies reported an increase in upper limb strength following rehabilitation with multimodal therapy and proprioceptive neuromuscular facilitation. Findings regarding the optimal duration of intervention and the best time to commence rehabilitation following surgery were inconclusive. CONCLUSION: This review has demonstrated heterogeneous findings regarding the impact of post-operative rehabilitation on upper limb strength. Furthermore, the ideal time point to initiate rehabilitation post-surgery, as well as the appropriate length of intervention needs further investigation. Therefore, additional research is necessary to better inform clinical practice in this area.
