Physical rehabilitation program for cardiorespiratory health and quality of life among breast cancer survivors in UAE: a randomized control trial.
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BACKGROUND: Breast cancer treatment has improved significantly, contributing to a 5-year relative survival rate of 99% for localized cases. However, post-treatment survivors are reported to have significantly poor cardiovascular fitness which affects their health-related quality of life (HRQoL). In the United Arab Emirates (UAE), evidence for practice addressing post-treatment concerns is scarce. OBJECTIVE: To analyse the changes in cardiorespiratory fitness and HRQoL domains for breast cancer survivors in the UAE using a 2-month physical rehabilitation program. METHODOLOGY: DESIGN: Parallel-group, randomized controlled trial PARTICIPANTS AND SETTING: The study included breast cancer survivors who were treated with chemotherapy and/or radiotherapy, aged 18-65 years, and able to provide informed consent. Participants were recruited by referral from Al Tawam Hospital, a national referral center for oncology, and Dubai Hospital. INTERVENTIONS: The intervention group (IG) received a 2-month supervised physical rehabilitation program focusing on aerobic training with 2 supervised sessions and 3 at-home sessions per week. The sessions were held at Thumbay Physical Therapy and Rehabilitation Hospital. The control group (CG) received standard care at their treatment facility. Randomization for subject allocation was double-blinded (conducted by a third party not involved in the research). OUTCOME: The changes in cardiorespiratory fitness were assessed by measuring peak oxygen uptake (VO2peak) during a 2 km walk test using Cosmed fitmate Pro and Peak Expiratory Flow Rate (PEFR) was assessed using a peak flow meter. The HRQoL was measured by the QLQ-C30 questionnaire. Outcomes were measured at baseline, post-intervention, and 3 months post-intervention. Allocation of intervention was not blinded due to the nature of the intervention; however, the outcome accessors were blinded. RESULTS: A total of 62 breast cancer survivors were randomly allocated to the intervention group (n = 31) and the control group (n = 31). Data from all participants who completed the 5-month trial was analyzed. The intervention group showed a significant improvement from baseline to follow-up in terms of cardiorespiratory fitness: VO2peak increased by 8.3 ± 4.6 ml/kg/min and PEFR by 81 ± 2.73 L/min, while the control group demonstrated a decrease of 1.1 ± 2.1 ml/kg/min and 4 ± 2.48 L/min, respectively (between-group difference, p < 0.001 for both measures). The intervention program was also significantly effective in improving HRQoL in all functional domains except cognitive and social, and there was a notable reduction in the symptoms of fatigue, dyspnea, pain, and sleep disturbances (p < 0.05). CONCLUSIONS: The intervention group showed significant improvement in cardiorespiratory fitness and multiple domains of HRQoL among breast cancer survivors in the UAE, which were sustained at 3 months. CLINICAL TRIALS REGISTRATION NUMBER: Clinical Trials.gov NCT06013527. Registered on 28 August 2023.