A Pilot Test of the Breast Cancer Pre-habilitation and Prospective Surveillance to Prevent, Detect, and Optimize Physical and Functional Recovery (B-PREPeD)

Lay Abstract. The National Cancer Institute has identified a critical need for research that addresses short and long-term physical and functional side effects (PFs) of cancer to advance health promotion and care coordination particularly during the transition to follow-up care. This study will use a small randomized controlled pilot test of a novel physical-therapy “pre-habilitation” intervention (Moving On After Breast Cancer - MOve-ABC) designed to prepare and empower breast cancer (BC) patients and oncology providers for prevention, early detection, and reduction of cancer-related PFs. Data from this study will support a planned R01 grant submission to the NCI. Scientific Abstract. Physical and functional symptom burden is high among breast cancer survivors and in need of chronic care management. PFs from surgery, radiation, and chemotherapy include joint pain, fatigue, muscle weakness, loss of range of motion, altered skin sensation/neuropathy, postural abnormality, skin integrity, lymphedema. Our research shows that over 80% of BC survivors report an average of 3 long-lasting (>11years) PF effects. This persistence is alarming and largely preventable indicating serious unmet need pre-habilitation (pre-hab) by physical therapy (PT) to plan for recovery and manage PFs before they become chronic problems. PT is the primary rehabilitation discipline recommended for treatment of PFs yet PT is completely absent from standard, usual cancer care planning and treatment. At Northwestern, we have begun to address this gap in cancer care with enhanced usual care (EUC) with monthly patient reported outcome surveys of PF via NMPRO through our electronic health record, Epic. We propose a pilot test to combine NMPRO with our PT-centered pre-hab intervention - MOve-ABC - which consists of pre-hab patient education, physical therapy (PT) evaluation, PF monitoring via NMPRO, and individualized PT treatment in response to PF surveillance during the first 6 months after a bre