SRS124 - Beyond exercise leaflets: a randomised feasibility trial of wearable-driven shoulder rehabilitation after breast cancer surgery

Background Shoulder dysfunction is common after axillary surgery for breast cancer, impairing range-of-motion (ROM), strength, and quality-of-life (QoL). NHS rehabilitation is inconsistent, often limited to exercise leaflets without structured follow-up. Wearable devices may enable personalised, feedback-driven rehabilitation. This study evaluated feasibility, acceptability, and preliminary clinical outcomes of wearable-driven rehabilitation versus standard care. Methods In this single-centre feasibility trial, 72 patients undergoing axillary surgery were randomised 2:1:1 to feedback-enabled wearable rehabilitation, or to one of two control arms: standard care with passive monitoring or standard care alone. Feasibility outcomes included recruitment, retention, adherence, fidelity, and acceptability. Exploratory outcomes, assessed at baseline and four weeks, included upper-limb activity, ROM, strength, lymphoedema, and patient-reported pain, disability, and QoL. Results Feasibility targets were met, with 82% recruitment, 97% retention and high adherence and acceptability. Daily activity returned to baseline by day 10 in the intervention group (100.2%, 95% c.i. 97.8–102.6) but remained below baseline at day 30 in controls (83.6%, 95% c.i. 78.9–88.3). At four weeks, median recovery of shoulder ROM and strength was greater in the intervention arm: flexion ROM 98.9% (IQR 90.1–101.1) versus 78.7% (IQR 68.6–87.3); flexion strength 98.4% (IQR 95.4–105.1) versus 91.2% (IQR 88.6–93.9). Patient-reported outcomes also favoured the intervention, with less pain, lower disability, and higher QoL (P < 0.001). No differences were seen in lymphoedema or complications. Conclusions Wearable-driven rehabilitation after axillary surgery is feasible, safe, and acceptable. Early signals suggest functional and QoL benefits, supporting progression to a multi-centre RCT to test clinical efficacy.