'Movement control may matter more than strength in breast cancer rehabilitation'

A research team at Seoul National University Bundang Hospital (SNUBH) found that a rehabilitation program focused on movement control, balance and coordination improved walking ability and postural stability without marked between-group differences in conventional physical fitness measures in breast cancer survivors.

The team, led by Professor Yang Eun-joo of the Department of Rehabilitation Medicine at SNUBH, and co-led by corresponding author Professor Chung Seung-hyun of the Department of Rehabilitation Medicine at the National Cancer Center, found that how patients control and coordinate movement may play a critical role alongside muscular strength in functional recovery after breast cancer treatment.

As cancer treatments improve, the number of cancer survivors who complete treatment continues to grow. However, many patients still experience difficulty walking, maintaining posture and controlling movement after surgery, chemotherapy or radiation therapy. These treatments can affect muscles and nerves, reducing the body’s ability to maintain postural stability.





Professor Yang Eun-joo of SNUBH (Credit: SNUBH)



The problem is particularly notable among breast cancer survivors who received chemotherapy. Previous studies have reported that approximately 20–40% of patients experience falls during or after treatment, especially among those treated with taxane-based chemotherapy, which is known to affect balance and sensorimotor function.

Despite this, conventional cancer rehabilitation has largely focused on muscle strengthening and aerobic exercise, while relatively less attention has been given to coordination and postural stability training.

To address this gap, the team developed Rehabilitation through Movement and Perception (ReMAP) and conducted a multicenter study with seven university hospitals in Korea to assess whether the program could improve walking ability and postural stability in breast cancer survivors.

ReMAP is designed to complement conventional rehabilitation programs centered on muscle strength and cardiopulmonary function. The program focuses on restoring balance and movement control through posture alignment, left-right balance and arm-leg coordination.

The study included 71 patients who had completed breast cancer treatment. Among them, 41 patients received ReMAP therapy, while 30 patients in the control group performed stretching and light exercise. The researchers compared outcomes over an eight-week period.

In the Timed Up and Go (TUG) test, which measures mobility by recording the time it takes for a person to stand up from a chair, walk three meters and return, the ReMAP group improved from an average of 7.85 seconds to 6.55 seconds. The control group showed only a modest improvement, from 7.27 seconds to 6.94 seconds, indicating a meaningful difference between the two groups.

Notably, there was no significant difference between the groups in physical fitness indicators such as grip strength and six-minute walk distance. The researchers said the findings suggest that movement coordination and postural control may contribute independently to functional recovery.

Video-based motion analysis also showed that patients in the ReMAP group had reduced body sway and more consistent movement patterns, indicating improved postural stability and coordination. However, there was no change in the level of energy used during movement, suggesting that the functional improvement came from changes in the way patients moved rather than from increased exercise intensity or volume.

“The key to functional recovery lies in how stably the body can control movement,” Yang said. “ReMAP could offer another recovery pathway that complements existing rehabilitation for patients who retain general physical capacity but continue to experience impaired movement coordination and postural instability.”

Many patients have sufficient strength but still experience awkward or unstable movement after treatment, Yang added.

Yang further explained that the team expects ReMAP to serve as an intermediate-stage rehabilitation program for such patients.

The findings were published in Breast Cancer Research and Treatment.

Source: https://www.koreabiomed.com/news/articleView.html?idxno=31585