Physiotherapy Interventions for the Management of Treatment-related Complications in Breast Cancer: Systematic Literature Review

Abstract

Introduction: The prevalence of treatment-related complications remains high throughout the course of cancer treatment resulting a decline in quality of life. Physiotherapy can have a positive influence on various domains of Quality of Life (QoL), potentially alleviating the severity of perceived complications. Aim: To evaluate the physiotherapy interventions used for managing treatment-related complications among breast cancer patients. Materials and Methods: Databases including Medical Literature Analysis and Retrieval System Online (MEDLINE), Science Direct, Cochrane Library, and Scopus from year 2000 to 2022 was searched with Mesh terms for trials with breast cancer patients >18 years of age participating in physiotherapy program. The primary outcome measure of interest was a significant improvement in treatment-related complications from pre- to post intervention. Change in quality of life was evaluated as secondary outcome measure. Cochrane risk of bias tool was used to assess the risk of bias and quality of included studies. Results: A total of 20 randomised controlled trials with 2019 patients incorporated various physiotherapy interventions to manage and alleviate treatment-related complications. For physical functioning (p=0.04) and the pain-sleep-fatigue cluster (p=0.006 to 0.044) different types of exercises were included. Complex Decongestive Therapy (CDT) combined with other electrotherapy modalities was embraced to manage lymphedema (p<0.05). For shoulder and arm dysfunction (p<0.05) passive stretching, mobilisation and strengthening exercises were incorporated. Furthermore, regular practice of exercise and physiotherapy exhibited positive impacts on overall health-related quality of life (p=0.0001 to 0.01) along with improvements in anxiety, depression, self-esteem and emotional function. Conclusion: Physiotherapy interventions are exceedingly effective in managing and providing relief from breast cancer treatment-related complications. Consequently, the integration of physiotherapy into cancer treatment protocols has the potential to enhance the overall QoL of patients.