Effects of traditional Chinese exercises for upper-limb dysfunction following breast cancer surgery: protocol for a systematic review and meta-analysis.

Abstract

Upper-limb dysfunction commonly occurs after breast cancer surgery and can impair the quality of life. Traditional Chinese exercises are a category of mind-body practices derived from traditional Chinese culture and exercise traditions. They involve physical postures, breathing techniques and mental focus and have the potential to improve postoperative upper limb function. This protocol outlines the methods used for a systematic review and meta-analysis evaluating traditional Chinese exercises for upper limb dysfunction following breast cancer surgery. Randomised controlled trials evaluating traditional Chinese exercises for upper-limb dysfunction among individuals following breast cancer surgery will be searched in MEDLINE (PubMed), Embase (Ovid), Cochrane Library (Wiley), Web of Science (Clarivate), China National Knowledge Infrastructure (CNKI), Wanfang Database (Wanfangdata), VIP Database (cqvip), and China Biology Medicine Database (Sinomed) from inception to April 2026. The search strategy combined terms for participants (eg, breast neoplasms), interventions (eg, Tai Chi, Baduanjin and Qigong) and study design (randomised controlled trials). The primary outcome is upper limb function, assessed using validated scales (eg, the Disability of the Arm, Shoulder and Hand questionnaire and its quick version and the Upper Extremity Functional Index). Secondary outcomes include shoulder range of motion (goniometry), pain intensity (Visual Analogue Scale and the Numeric Pain Rating Scale), upper limb circumference (cm), upper limb strength (dynamometers) and adverse events (haematoma, infection and lymphoedema). After study selection and data extraction, the risk of bias assessment will be performed using the Cochrane Risk of Bias Tool 2.0. Standard pairwise meta-analysis will be conducted using Stata V.16.0 software. Next, sensitivity and subgroup analysis will be performed. The Grading of Recommendations, Assessment, Development and Evaluation system will assess evidence quality for the primary outcome. This review may inform clinical decision-making on the rehabilitation of individuals following breast cancer surgery. Ethical approval is not required as study data will be drawn from published randomised controlled trials. The systematic review results will be published in a peer-reviewed journal. CRD420251143499.