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Does a resistance training program affect between-arms volume difference and shoulder-arm disabilities in female breast cancer survivors? The role of surgery type and treatments. secondary outcomes of the EFICAN trial [with consumer summary]
Esteban-Simon A, Diez-Fernandez DM, Rodriguez-Perez MA, Artes-Rodriguez E, Casimiro-Andujar AJ, Soriano-Maldonado A
Archives of Physical Medicine and Rehabilitation 2024 Apr;105(4):647-654
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

The aims were (i) to assess the effects of a 12-week resistance training program on between-arms volume difference and shoulder-arm disabilities in breast cancer survivors and (ii) to evaluate whether the main risk factors for developing cancer-related lymphedema and shoulder-arm disabilities were associated with the effects of the training program. Randomized controlled trial. University facilities. 60 female breast cancer survivors participated. Eligibility criteria: to be a breast cancer survivor, and to have completed surgery, chemotherapy, and/or radiotherapy up to 10 years before recruitment. Exclusion criteria: metastatic breast cancer, a breast reconstruction intervention planned within 6 months, any absolute contraindication for exercise, to perform more than 300 minutes/week of structured exercise. Participants were randomized to an exercise group (12-week resistance training program) or a control group. Between-arms volume difference, shoulder-arm disabilities, and upper-limb muscular strength were evaluated at baseline and at week 12. Treatment-related information was registered from medical history. No between-group differences were observed on between-arms volume difference (1.207; 95% CI -0.964 to 3.377; p = 0.270) or shoulder-arm disabilities (2.070; 95% CI -4.362 to 8.501; p = 0.521) after the training program. Likewise, there was no association of surgery type, presence of lymph node resection, chemotherapy, radiotherapy, and hormone therapy with the changes in between-arms volume and perceived shoulder-arm disabilities after the intervention. However, a higher increase in upper limb muscular strength was associated with a reduced shoulder-arm disabilities (-0.429; p = 0.020) in the exercise group. The findings suggest that resistance training does not affect between-arms volume difference and shoulder-arm disabilities in female breast cancer survivors. The main risk factors for developing lymphedema were not associated with the effects of the intervention, although a higher increase in upper-limb muscular strength was associated with reduced shoulder-arm disabilities.

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