Rowing and adapted physical activity for breast cancer survivors: effects on lymphedema, mobility, strength and psychological well-being

INTRODUCTION: In women with breast cancer, the most common complications after surgery include the development of lymphedema and a reduction in mobility and strength in the operated limb, leading to a negative impact on psychological well-being1. Studies suggest that rowing or an adapted physical activity (APA) program may be a viable strategy to mitigate the negative effects of breast cancer and its treatment2,3. The purpose of the study was to examine the effects of rowing on arm lymphedema, mobility, strength and psychological well-being in breast cancer survivors participating in a 6-month APA program. METHODS: The project Effect and efficacy of RowIng in breast CancEr survivors (ERICE) involved 27 women with breast cancer (age: 56.6±6.5 yrs; BMI: 23.9±3.0 kg/m2; stages I, II, or III; surgery at least 6 months to a maximum of 20 years ago), who trained 3 times a week for 6 months with sculling (a form of sliding-seat rowing moving the boat with two oars per rower), online APA sessions and walking. The analysis conducted at baseline (T0) and at the end of the training program (T1) included arm lymphedema (Arm Volume_AV), mobility (Back Scratch_BS) and strength (Hand Grip_HG) evaluation. Additionally, Functional Assessment of Cancer Therapy – Lymphedema (FACT-B+4) and Rosenberg Self-Esteem Scale (RSES, Italian version) were administered. A minimum adherence of 75% to the program was required. RESULTS: During the 6-month intervention, 19 women completed the program and 13 of them achieved the required adherence (N: 6_NAD vs N: 13_AD). No variation in AV of both operated (OA) and non-operated (NOA) arms was observed (OA: T0, 1566.7±274.6 vs T1, 1567.8±279.3; NOA: T0, 1513.1±254.3 vs T1, 1557.5±265.4 cm3). Despite this, an improvement in both operated and non-operated arms BS (OA: T0, 2.0±7.6 vs T1, 3.0±7.8; NOA: T0, 3.3±7.3 vs T1, 4.1±7.2 cm) was noticed, with a greater improvement in HG performance in women who achieved the required adherence (OA: ΔAD, 1.2±2.4 vs ΔNAD, -3±1.4 kg, p=0.0029; NOA: ΔAD, 1±1.7 vs ΔNAD, -2.6±2.2 kg, p=0.0044). Psychological well-being (FACT-B+4: T0, 123.0±15.1 vs T1, 122.3±14.8 score) and self-esteem (RSES: T0, 20.0±5.1 vs T1, 20.74±5.87 score) remained stable. CONCLUSION: An APA program combined with sculling revealed to have a positive impact on flexibility and strength. It is important to emphasize that improvements in physical parameters were observed only among participants achieving at least 75% of adherence.