Wpływ interwencji skoncentrowanej na jakości ruchu i czuciowo-ruchowej na mobilność funkcjonalną u osób po leczeniu raka piersi: wieloośrodkowe randomizowane badanie kontrolowane

PURPOSE: Breast cancer survivors frequently experience reductions in physical capacity and sensorimotor impairments following treatment. However, improvements in strength and endurance do not always translate into improvements in functional mobility and balance-related outcomes. This study evaluated whether a sensorimotor-based rehabilitation program emphasizing movement control (Rehabilitation through Movement and Perception, ReMAP) could improve functional mobility and postural stability in breast cancer survivors. METHODS: In this multicenter randomized wait-list controlled trial, 71 breast cancer survivors (mean age 50.7 ± 8.9 years) with mild functional impairment who had completed curative breast cancer treatment at least 3 months prior to enrollment were assigned to a ReMAP intervention group (n = 41) or a wait-list control group (n = 30). The 8-week intervention consisted of supervised, low- to moderate-intensity sensorimotor exercises targeting postural alignment, coordination, and balance. Functional mobility was assessed using the Timed Up and Go (TUG) test. Secondary outcomes included handgrip strength and 6-min walk distance as indicators of physical capacity, disability assessed using the World Health Organization Disability Assessment Schedule (WHODAS 12), and postural stability quantified by kinematic measures of center-of-mass sway. RESULTS: Participants in the ReMAP group demonstrated a significantly greater improvement in functional mobility than controls, with a larger reduction in TUG time at 8 weeks (group × time interaction: β =  - 0.97 s, 95% CI 1.93 to - 0.01; p = 0.049). Postural stability improved significantly, as evidenced by reductions in mediolateral and anteroposterior center-of-mass sway. No significant between-group differences were observed in handgrip strength, 6-min walk distance, or self-reported disability. Exploratory analyses suggested that improvements in TUG performance were more closely associated with changes in movement quality than with changes in physical capacity. CONCLUSIONS: A sensorimotor-based rehabilitation program improved functional mobility and postural stability in breast cancer survivors with relatively preserved physical capacity. Targeting movement quality may address key mechanisms underlying balance-related vulnerability in survivorship care.