Self-managed non-pharmacological interventions for post-treatment upper limb dysfunction rehabilitation among breast cancer survivors: A systematic review

Abstract

Purpose

This study aims to identify commonly utilised self-managed non-pharmacological interventions for managing post-treatment ULD among breast cancer survivors, evaluate their effectiveness and safety, and identify the research gaps for future studies.

Methods

A systematic review was conducted, and eight English databases (PubMed, Cochrane Library, Embase, CINAHL, Web of Science, Scopus, PsycINFO, and ProQuest) were searched from their inception to 30 September 2025. Google and ResearchGate were also searched to identify any additional eligible studies. Narrative synthesis was used for data analysis. Risk of Bias version 2 was used to assess the quality of the included studies.

Results

5972 studies were identified by initial research, and eight studies were finally included. Commonly utilised self-managed non-pharmacological interventions for managing post-treatment ULD among breast cancer survivors were exercise-based strategies. Three studies reported a statistically significant effect on improving post-treatment ULD, and five studies reported unexpected events during interventions. Regarding the methodological quality, five studies had some concerns, and three had a high risk of bias.

Conclusions

Self-managed non-pharmacological interventions for post-treatment ULD in breast cancer survivors are predominantly exercise-based. However, evidence regarding their effectiveness and safety remains inconclusive due to the limited number, heterogeneity, and methodological limitations of existing studies. Notably, evidence on non-exercise self-managed approaches is lacking.

Implications for cancer survivors

Low-intensity, structured exercise programs incorporating upper limb stretching and movement-based exercises may represent a feasible self-managed option for improving upper limb function.

Keywords

non-pharmacological, breast cancer, survivor, upper limb dysfunction, systematic review

Link to Publisher Version (URL)

https://doi.org/10.1016/j.ejon.2026.103235

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