Reduced physical function after breast cancer

Key points

• Breast cancer treatments can significantly reduce physical function in women, particularly affecting aerobic capacity and muscular strength.
• The systematic review provides insights into the current physical status of women diagnosed with breast cancer.
• It highlights the need for targeted physiotherapy interventions to improve overall physical function.
• This stresses the importance of integrating aerobic and resistance exercises in the rehabilitation of breast cancer patients.
• The study limitations include a lack of standardisation in testing protocols and the diverse nature of the participant groups.

Overview

The article titled “Aerobic capacity and upper limb strength are reduced in women diagnosed with breast cancer: a systematic review” explores the physical function impairments commonly observed in women undergoing breast cancer treatment. 

The review focuses on three main aspects of physical function: aerobic capacity, muscular fitness of the upper and lower extremities, and mobility. 

The findings indicate that women diagnosed with breast cancer often experience lower physical function levels compared to normative data, particularly during and after treatment.

Breast cancer in the world

Globally, breast cancer is the most commonly diagnosed cancer among women. The five-year survival rate has significantly improved due to advances in treatment, standing at approximately 88% in Canada. However, despite the increase in survival rates, breast cancer treatments can lead to acute and chronic impairments in physical function.

What do we know about physical function in woman with breast cancer?

The review aimed to summarise the available data on physical function in women diagnosed with breast cancer and compare these values to published normative data. The categories explored include:

1. Aerobic capacity: Assessed through maximal and submaximal exercise tests, such as VO2peak and the 6-minute walk test.
2. Muscular fitness: Evaluated through tests like grip strength and one repetition maximum (1RM) for bench and leg presses.
3. Mobility: Measured using the Timed Up and Go (TUG) test.

Aerobic capacity: The review found that aerobic capacity, as measured by VO2peak, was significantly lower in women on and off treatment compared to normative data. This decline is likely due to the combined effects of cancer treatment and reduced physical activity, leading to deconditioning.

Muscular fitness: Upper extremity strength, including grip strength, was generally lower than population norms. Lower extremity strength showed mixed results; while some women on treatment exhibited below-average strength, those off treatment displayed above-average levels, particularly in the leg press.

Mobility: The TUG test results indicated that women with breast cancer had slower mobility times compared to healthy populations. This highlights the impact of breast cancer and its treatment on functional mobility.

What does this mean for us?

For patients: Understanding the impact of breast cancer treatment on physical function is crucial for patients. Recognising potential impairments can motivate patients to seek targeted Physiotherapy interventions, which can help mitigate these effects and improve their quality of life.

For Physiotherapists: The review underscores the importance of incorporating both aerobic and resistance exercises in the rehabilitation programmes for breast cancer patients. Physiotherapists should focus on individualised assessment and treatment planning, considering the unique physical impairments and health status of each patient.

Contact us today so that our Physiotherapists is able to help you regain function! 

Ref:

Neil-Sztramko, S. E., Kirkham, A. A., Hung, S. H., Niksirat, N., Nishikawa, K., & Campbell, K. L. (2014). Aerobic capacity and upper limb strength are reduced in women diagnosed with breast cancer: a systematic review. Journal of Physiotherapy, 60(4), 189-200.

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