Kai Bing Choo

365 Cancer Prevention Society, Singapore

Title: ArmStrong Exercise Pilot Programme: A Resistance Exercise Initiative for Breast Cancer Survivors

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Biography

Choo Kai Bing is a Senior Physiotherapist at 365 Cancer Prevention Society in Singapore. She graduated with Bachelor of Science (Honours) in Physiotherapy from the joint degree programme by Trinity College Dublin and the Singapore Institute of Technology in 2018. Her professional focus is on rehabilitation for both musculoskeletal disorders and the oncology population, currently providing services to cancer survivors in the community. She is also a certified Exercise Oncology Instructor with Maple Tree Cancer Alliance, focusing on the integration of exercise in cancer rehabilitation.

Abstract

Background:

Up to 40% of breast cancer patients who undergo lymph node removal face lifelong risk of lymphedema, a chronic condition that negatively impacts physical function, psychosocial well-being, and overall quality of life (QoL). While exercise was once thought to exacerbate lymphedema, current research supports the safety and benefits of supervised resistance exercise (RE).

Objective:

To evaluate the feasibility and preliminary outcomes of a 10-week RE programme aimed at: (1) restraining lymphedema development, (2) regaining grip strength, and (3) reinstating QoL in breast cancer survivors.

Methods:

This is a prospective, single-arm, quasi-experimental pilot study led by 365 Cancer Prevention Society, a non-profit organisation serving cancer fighters and survivors. Participants (n=8 in Cycle 1) were recruited from the society based on inclusion criteria: post–breast cancer surgery with lymph node removal, stable or no lymphedema, and functional shoulder range. The intervention comprised a 10-week, once-weekly 1-hour class led by a physiotherapist or therapy assistant, using resistance bands for upper limb RE. Assessments pre- and post-programme included ECW ratio (InBody 580) for lymphedema monitoring, grip strength (hydraulic dynamometer), shoulder range of motion (ROM), and QoL (adapted Lymph-ICF-UL).

Results:

No worsening of lymphedema was detected post-intervention (ECW ratio, p = 0.8183) as shown in Figure 1. Significant improvements were observed in grip strength (+2.2 kg; p = 0.0394), shoulder abduction (+4.9°; p = 0.028), and QoL (mean score change = -10.5; p = 0.026). Other ROM measures showed non-significant changes.

Conclusion:

Preliminary results suggest that a supervised, community based RE programme is a safe and effective strategy to improve upper limb function and QoL in breast cancer survivors. Ongoing cycles aim to enrol 30 participants to further assess programme scalability and public health relevance.