A study to prevent shoulder problems after breast cancer treatment (PROSPER)
Cancer type:
Status:
Phase:
This study looked at an exercise programme to reduce the risk of shoulder problems after surgery and radiotherapy for breast cancer. 
prescribed the exercise programme.
This study was open for women to join between 2016 and 2017. The results were published in 2021.
More about this trial
Most people with breast cancer have surgery to the breast and armpit (axilla). Some people also have radiotherapy. These treatments can cause a higher risk of shoulder problems. This can limit activities and affect . Starting arm exercises soon after surgery can prevent shoulder problems.
After surgery, people get information leaflets about shoulder exercises to do at home. This was the usual care when this study was done. These leaflets show exercises to do at different stages after surgery. Researchers wanted to see if following a specific exercise programme after surgery was better.
In this study, physiotherapists designed an exercise programme to do after surgery. Some people took part in the exercise programme and some didn’t.
The main aims of this study were to find out:
- how well the exercise programme works
- how the exercise programme affects quality of life
Summary of results
Study design
329 women who had breast cancer surgery took part. They were put into a group at random:
- 196 had only the information leaflets. This was usual care (group 1).
- 196 had the information leaflets and also took part in the exercise programme (group 2)
The information leaflets included arm and shoulder exercises. People could do these at home after breast cancer surgery.
In group 2, a physiotherapist met everyone in person and also gave everyone an exercise programme to follow. It included specific arm and shoulder exercises. The programme involved stretching and strengthening exercises as well as some physical activity. This was started about a week or two after surgery if possible. The physiotherapist saw everyone again 1 month later and again at 3 months to see how they were getting on.
The team asked everyone taking part to fill in quality of life questionnaires. They did this at 6 weeks, 6 months and 1 year. These questionnaires asked about:
- how people felt
- arm and shoulder movement
- usual daily activities
Results
The researchers looked at:
- shoulder and arm movement
- pain, arm stiffness and swelling
- quality of life
They found that at 1 year people in the exercise programme group had better arm movement and less pain. They also had an improved quality of life. This was compared to those who only had the information leaflets.
The exercise programme didn’t increase the risk of over one year.
The study team also spoke to women taking part in the research. People in the exercise programme said it helped them to feel more confident to get moving after their surgery.
Conclusion
The study team concluded that the exercise programme worked better to prevent shoulder problems compared with usual care. This study supports using early exercise to help this group of people.
More detailed information
There is more information about this research in the references below.
Please note, these articles are not in plain English. They have been written for health care professionals and researchers.
Journal articles
Exercise versus usual care after non-reconstructive breast cancer surgery (UK PROSPER): multicentre randomised controlled trial and economic evaluation
J Bruce and others
British Medical Journal, 2021. Volume 375:e066542
Role of physiotherapy in supporting recovery from breast cancer treatment: a
qualitative study embedded within the UK PROSPER trial
S Rees and others
British Medical Journal, 2021. Volume 11, Issue 5, e040116
Where this information comes from
We have based this summary on the information in the articles above. These have been reviewed by independent specialists () and published in a medical journal. We have not analysed the data ourselves. As far as we are aware, the links we list above are active and the articles are free and available to view.
Recruitment start:
Recruitment end:
How to join a clinical trial
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Chief Investigator
Professor Julie Bruce
Supported by
National Institute for Health Research (NIHR)
University of Warwick
University Hospitals Coventry and Warwickshire
Other information
If you are a physiotherapist interested in learning more or completing training in the PROSPER exercise programme, please register with FutureLearn. You can register for free.
If you have questions about the trial please contact our cancer information nurses
Freephone 0808 800 4040
