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| The effect of nonsupervised physical activity before and after breast cancer surgery on quality of life: results from a randomized controlled trial (PhysSURG-B) | 
| Heiman J, Onerup A, Bock D, Haglind E, Olofsson Bagge R | 
| Scandinavian Journal of Surgery 2022 Dec;111(4):75-82 | 
| clinical trial | 
| 3/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: No; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* | 
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                     BACKGROUND AND OBJECTIVE: The PhysSURG-B trial of prehabilitation before breast cancer surgery randomized patients to a nonsupervised physical activity or a control group. The effects of the intervention on short- and long-term quality of life (QoL) were examined, with a subgroup analysis of patients receiving adjuvant chemotherapy. METHODS: Female patients planned for surgery were randomly assigned to either an intervention of 30 min of self-administered physical aerobic activity daily 2 weeks before and 4 weeks after surgery or control. QoL was assessed with questionnaires at baseline, 4 weeks and 12 months postoperatively using the instruments FACT-B, RAND-36, and EQ-VAS. RESULTS: Of 354 included participants at 12 months after surgery, 287 were available for analysis. FACT- B scores at 4 weeks and 12 months showed no differences between intervention compared to control, odds ratio (OR) of 0.975 (95% confidence interval (CI) 0.636 to 1.495) and 0.883 (95% CI 0.581 to 1.342), respectively. There was no difference in EQ-VAS comparing intervention to control at 4 weeks and 12 months, respectively, OR 1.163 (95% CI 0.760 to 1.779) and 0.817 (95% CI 0.559 to 1.300). RAND-36 domains "role limitations due to physical health" and "pain" showed a decrease at 4 weeks in both groups, returning toward baseline at 12 months follow-up. The subgroup who received adjuvant chemotherapy had significantly lower QoL measured using FACT-B at 12 months compared to patients not receiving chemotherapy (OR 0.475; 95% CI 0.300 to 0.753). CONCLUSIONS: An intervention of non-supervised physical activity before and after surgery for breast cancer showed no effect on short or long-term QoL, compared to control. TRIAL REGISTRATION: ClinicalTrials.gov registration number: NCT02560662.  
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