Feasibility of a Hydrotherapy and Self-Management Education Program for Breast Cancer Patients with Shoulder Impairment

Abstract

<h3>Research Objectives</h3> To evaluate the feasibility and acceptability of a multidimensional hydrotherapy and self-management education program for breast cancer patients. Secondary objectives were to explore change on shoulder disability measured by validated patient reported outcomes and therapist measured shoulder range of motion (ROM) and grip strength. <h3>Design</h3> This retrospective cohort study analyzed pre- and post-intervention data collected between January 2017 and March 2020. <h3>Setting</h3> Outpatient rehabilitation clinic in Toronto, Canada. <h3>Participants</h3> A total of 114 participants' charts were reviewed during the study period. Participant selection utilized a clinically referred sample of breast cancer patients with moderate to severe shoulder impairment and deemed medically fit to participate in aquatic based therapies. <h3>Interventions</h3> Six weekly, small group (n=3-7), supervised, hydrotherapy and educational sessions targeting shoulder mobility, scar management, lymphedema, and pain. <h3>Main Outcome Measures</h3> Feasibility was defined as ≥ 60% retention and ≥ 80% session attendance. Acceptability was defined as ≥ 80% satisfaction (≥ 4 on a 5 point Likert scale). <h3>Results</h3> A total of 88 (82.2%) participants attended at least 80% of the education sessions and 78 (76.5%) attended at least 80% of the aquatic sessions. 60 (96.8%) participants reported satisfaction with educational material; 44 (95.7%) reported satisfaction with hydrotherapy sessions. Statistically significant improvements were observed in DASH, SPADI, grip strength, and most ROM measures. <h3>Conclusions</h3> Combined hydrotherapy and self-management education appears to be a feasible and acceptable rehabilitation intervention for breast cancer survivors with shoulder impairment. While this could represent a potential adjunct to traditional land based therapies, future prospective randomized control trials are required to confirm causation and to explore the effect on functional outcome measures. <h3>Author(s) Disclosures</h3> None