{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:33:12Z","timestamp":1787009592619,"version":"build-2736575974"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2019,7,16]],"date-time":"2019-07-16T00:00:00Z","timestamp":1563235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["K07CA160718"],"award-info":[{"award-number":["K07CA160718"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR001855"],"award-info":[{"award-number":["UL1TR001855"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR000130"],"award-info":[{"award-number":["UL1TR000130"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,28]]},"abstract":"<jats:title>Abtract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adverse upper limb musculoskeletal effects occur after surgical procedures and radiotherapy for breast cancer and can interfere with activities of daily living.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study was to examine the effects of a 16-week exercise intervention on shoulder function in women who are overweight or obese and have breast cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This study was a randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was performed at the Division of Biokinesiology and Physical Therapy at the University of Southern California.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>One hundred women with breast cancer were randomly allocated to exercise or usual-care groups. The mean (SD) age of the women was 53.5 (10.4) years, 55% were Hispanic white, and their mean (SD) body mass index was 33.5 (5.5) kg\/m2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>The 16-week exercise intervention consisted of supervised, progressive, moderate to vigorous aerobic and resistance exercise 3 times per week.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Shoulder active range of motion, isometric muscular strength, and patient-reported outcome measures (including Disabilities of the Arm, Shoulder, and Hand and the Penn Shoulder Scale) were assessed at baseline, after the intervention, and at the 3-month follow-up (exercise group only). Differences in mean changes for outcomes were evaluated using mixed-model repeated-measures analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with the usual-care group, the exercise group experienced significant increases in shoulder active range of motion (the mean between-group differences and 95% confidence intervals (CIs) were as follows: shoulder flexion\u00a0=\u00a036.6\u00b0 [95% CI\u00a0=\u00a055.2\u201320.7\u00b0], external rotation at 0\u00b0\u00a0=\u00a023.4\u00b0 [95% CI\u00a0=\u00a031.1\u201312.5\u00b0], and external rotation at 90\u00b0\u00a0=\u00a034.3\u00b0 [95% CI\u00a0=\u00a045.9\u201326.2\u00b0]), improved upper extremity isometric strength, and improved Disabilities of the Arm, Shoulder, and Hand and Penn Shoulder Scale scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations<\/jats:title>\n                    <jats:p>Limitations include a lack of masking of assessors after the intervention, an attention control group, and statistical robustness (shoulder function was a secondary end point).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A 16-week exercise intervention effectively improved shoulder function following breast cancer treatment in women who were overweight or obese, who were ethnically diverse, and who had breast cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ptj\/pzz096","type":"journal-article","created":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T07:09:13Z","timestamp":1562656153000},"page":"1334-1345","source":"Crossref","is-referenced-by-count":42,"title":["Aerobic and Resistance Exercise Improves Shoulder Function in Women Who Are Overweight or Obese and Have Breast Cancer: A Randomized Controlled Trial"],"prefix":"10.1093","volume":"99","author":[{"given":"Frank C","family":"Sweeney","sequence":"first","affiliation":[{"name":"Division of Biokinesiology and Physical Therapy, University of Southern California , Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Demark-Wahnefried","sequence":"additional","affiliation":[{"name":"Department of Nutrition Sciences, University of Alabama at Birmingham , Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry S","family":"Courneya","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology, Sport, and Recreation, University of Alberta , Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Sami","sequence":"additional","affiliation":[{"name":"Division of Biokinesiology and Physical Therapy, University of Southern California , Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyuwan","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Biokinesiology and Physical Therapy, University of Southern California , Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debu","family":"Tripathy","sequence":"additional","affiliation":[{"name":"Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center , Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimiko","family":"Yamada","sequence":"additional","affiliation":[{"name":"Division of Biokinesiology and Physical Therapy, University of Southern California , Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A","family":"Buchanan","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Keck School of Medicine, University of Southern California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darcy V","family":"Spicer","sequence":"additional","affiliation":[{"name":"Department of Medicine, Keck School of Medicine, University of Southern California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Division of Biomarkers of Early Detection and Prevention, Beckman Research Institute, City of Hope, Duarte, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne E","family":"Mortimer","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology and Experimental Therapeutics , City of Hope"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina M","family":"Dieli-Conwright","sequence":"additional","affiliation":[{"name":"Department of Supportive Care Medicine , City of Hope, 1500 East Duarte Road, Duarte, CA 91010 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