Prehabilitation for Breast Cancer Surgery

Prehabilitation for women diagnosed with breast cancer is commonly not part of the clinical pathways as little time (usually a few days) is left between diagnosis and surgery. However, a great proportion of these patients will undergo neoadjuvant chemotherapy which provides a window opportunity to improve patients' physical status to withstand surgery and minimize post-operative musculoskeletal complications associated with surgery. To this end, the aim of this study is to assess the efficacy of a prehabilitation program consisting of health education and a supervised nordic walking-based intervention in women diagnosed with breast cancer currently undergoing neoadjuvant chemotherapy to decrease post-operative musculoskeletal impairments and improve functionality of the affected arm. The study is an open-label, single-blind randomised controlled trial conducted at one tertiary hospital. Women diagnosed with breast cancer scheduled for surgery and currently undergoing chemotherapy will be randomised to either usual care (UC) or prehabilitation (PREHAB). Patients will be assessed for eligibility during the fourth out of six course of chemotherapy. Those randomised to the PREHAB group will participate in a supervised group-based nordic walking intervention twice weekly during 8 weeks (approximately 16 sessions). In addition, participants will receive written information regarding the benefits of exercise during cancer treatment and surveillance. Patients will be assessed prior to surgery as well as at 1, 3 and 6 months postoperatively.

Sex

Female

Minimum age

18 Years

Maximum age

75 Years

Inclusion Criteria:

* Diagnosis of breast cancer scheduled for surgery with or without lymphadenectomy
* Candidates to receive neoadjuvant chemotherapy
* Not currently undergoing any other physical therapy therapies or treatments

Exclusion Criteria:

* Cognitive impairment or inability to read Catalan or Spanish
* Prior diagnosis of shoulder impairment or injury
* Major musculoskeletal, neurological or cardiorespiratory limitations to prevent participation in the exercise program

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• DERIVEDCasanovas-Alvarez A, Estanyol B, Ciendones M, Padros J, Cuartero J, Barnadas A, Garcia-Valdecasas B, Gonzalez-Colom R, Sebio-Garcia R, Masia J. Effectiveness of an Exercise and Educational-Based Prehabilitation Program in Patients With Breast Cancer Receiving Neoadjuvant Chemotherapy (PREOptimize) on Functional Outcomes: A Randomized Controlled Trial. Phys Ther. 2024 Dec 6;104(12):pzae151. doi: 10.1093/ptj/pzae151. PMID 39423256