Physiotherapy Interventions and Assessment Tools for Physical Function in Breast Cancer Patients: A Systematic Review and Meta-analysis

Introduction: Breast cancer (BC) and its treatment impart a variety of physical impairments in body causing physical functional decline even after the completion of active treatment. Physiotherapy plays an important role in managing physical functional limitations. However, there is lack of data regarding efficacy of physiotherapeutic interventions in improving physical functional impairments and assessment tools used to evaluate Physical Function (PF) in individuals with BC. Aim: To evaluate the efficacy of physiotherapy interventions on PF and analyse the assessment tools used for evaluating PF in BC. Materials and Methods: Randomised Controlled Trials were searched in PubMed and Scopus databases, published from inception to December 2023, in which the effect of physiotherapeutic interventions on PF was evaluated in individuals with BC. Keywords used to search literature were: (BC) AND (physiotherapy intervention) AND (PF). The mean change in PF was primary outcome measure, and tools used to assess PF in included studies were also analysed. The quality of the studies and the risk of bias were evaluated. A meta-analysis of included studies was done using Review Manager (Software, version 5.4). Results: Overall 333 trials were retrieved, of which nine were included in systematic review. Four studies were included in meta-analysis, which used Short Form-36 (SF-36) and European Organisation for Research and Treatment of Cancer (EORTC) QLQC30 questionnaire's "Physical functioning" subscale as measures to evaluate changes in PF at the end of the study. The meta analysis revealed statistically significant improvements in SF-36 "Physical functioning" subscale scores (Mean difference=2.87, 95% CI: 0.63 to 5.12, p=0.01) and EORTC QLQ-C30 "Physical functioning" subscale scores (Mean difference=8.77, 95% CI: 3.31 to 14.24, p=0.002), with low heterogeneity in treatment groups when compared to control group. Conclusion: Physiotherapeutic exercise interventions are effective in improving PF in individuals with BC, and SF-36 questionnaire "Physical functioning" subscale was the most commonly used tool to assess PF in BC patients and survivors.