Background: Breast cancer survivors frequently experience reduced physical capacity, fatigue, upper-limb dysfunction, and impaired quality of life (QoL) following treatment. Exercise and physiotherapy-based rehabilitation programs are increasingly prescribed, but the magnitude and consistency of their benefits remain under debate. Objective: This systematic review aimed to evaluate the effectiveness and safety of supervised exercise and physiotherapy interventions on functional mobility, muscular strength, fatigue, upper-limb function, and QoL in breast cancer survivors. Methods:A comprehensive literature search of PubMed, Scopus, Web of Science, Cochrane CENTRAL, and ClinicalTrials.gov was conducted up to March 2025. Randomized controlled trials (RCTs) comparing supervised exercise or physiotherapy interventions with usual care, waitlist, or non-exercise controls in adult breast cancer survivors were included. Data were extracted on intervention characteristics, participant demographics, outcomes, and adverse events. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and certainty of evidence was graded using GRADE. Results: Twenty-two RCTs involving 2,260 participants were included. Interventions encompassed aerobic, resistance, and combined programs; water-based therapy; yoga; manual therapy; and multimodal rehabilitation, with durations ranging from 3 weeks to 12 months. Significant improvements in cardiorespiratory fitness were observed across 18 trials, with VO₂max gains of 2.5–4.8 mL/kg/min and six-minute walk distance improvements of 35–90 meters. Muscular strength improved by 10–25% in 12 studies, with resistance training demonstrating the largest effects. QoL increased significantly in 15 trials, with improvements exceeding clinically meaningful thresholds (+7.5 to +10 points on validated scales). Fatigue was reduced in nine RCTs, with moderate pooled effect sizes (SMD ≈ –0.35). Seven trials reported enhanced upper-limb function and range of motion following supervised stretching, strengthening, or manual therapy. No serious intervention-related adverse events were reported. Conclusions: Supervised exercise and physiotherapy interventions are safe and effective in improving fitness, strength, QoL, fatigue, and upper-limb function among breast cancer survivors. Findings support their integration into survivorship care plans, with combined aerobic-resistance programs demonstrating the broadest benefits. Further large-scale RCTs with longer follow-up are warranted to confirm sustained outcomes.
Uddin et al. (Tue,) studied this question.
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