Muscle Oxygenation and Function in Breast Cancer Survivors

September 9, 2026 updated by: ATİYE KAŞ ÖZDEMİR, Pamukkale University

Upper Extremity Muscle Oxygenation Dynamics and Functional Performance in Breast Cancer Survivors

Persistent impairments in upper extremity function are well documented among breast cancer survivors even after completion of cancer treatment. These impairments are frequently attributed to fatigue and other treatment-related complications. Upper extremity function in patients undergoing breast cancer surgery may be affected by multiple factors, including surgical tissue trauma, axillary lymph node dissection or sentinel lymph node biopsy, radiation-induced fibrosis, pain, restricted shoulder range of motion, loss of muscle strength, and lymphedema. Muscle oxygenation may also be impaired through various mechanisms following breast cancer surgery and is considered one of the important microvascular mechanisms potentially underlying upper extremity functional impairments. However, muscle oxygenation has not been sufficiently investigated in this population. Existing studies have predominantly focused on lower extremity muscles, whereas changes in upper extremity muscle oxygenation have yet to be adequately investigated. This gap in the literature may limit the development and targeted implementation of appropriate exercise interventions and the identification of optimal exercise modalities aimed at improving upper extremity function in daily life, enhancing independence, facilitating participation in social and occupational activities, and ultimately improving quality of life among breast cancer survivors.

In this project, the investigators aim to investigate the relationship between tissue-level muscle oxygenation parameters and clinical measures of upper extremity function, including muscle strength, upper extremity functional capacity, and the score on the Disabilities of the Arm, Shoulder and Hand Questionnaire-Quick Version (QuickDASH). By examining these associations, the investigators intend to contribute to a better understanding of the pathophysiological mechanisms underlying functional impairments in breast cancer survivors and to provide a basis for the development of more effective and targeted rehabilitation protocols, including interventions designed to enhance microcirculation and aerobic exercise capacity.

Breast cancer survivors followed at the Breast Clinic of the Department of General Surgery at Pamukkale University and healthy individuals will be included in two study groups. Upper extremity muscle oxygenation and functional performance will be assessed using a hand-held dynamometer, near-infrared spectroscopy (NIRS), the six-minute pegboard and ring test, and the Disabilities of the Arm, Shoulder and Hand Questionnaire-Quick Version (QuickDASH).

By comparing upper extremity muscle oxygenation and functional performance between breast cancer survivors and healthy individuals, the findings of this project are expected to provide a better understanding of the muscle characteristics underlying upper extremity functional impairments in breast cancer survivors. These findings may contribute to the development and refinement of exercise interventions within rehabilitation programs and highlight the importance of selecting appropriate exercise modalities to improve upper extremity function in this population.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
80

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.
  • Name: Atiye KAŞ ÖZDEMİR, Lecturer PhD
  • Phone Number: +905364720293
  • Email: akas@pau.edu.tr

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

breast cancer survivors: At least 40 cases of patients aged 18 and older who met the inclusion criteria, who had undergone breast surgery (at least 6 months to a maximum of 15 years had elapsed since mastectomy and curative treatment), and who were being followed up at the General Surgery Breast Clinic of Pamukkale University healty individuals: At least 40 healthy individuals who are undergoing routine follow-up at the General Surgery Breast Clinic of Pamukkale University, have no history of cancer, and meet the criteria for inclusion in the control group

Description

Inclusion Criteria:

  • Individuals diagnosed with stage 1, 2, or 3 unilateral breast cancer
  • who completed breast cancer treatment at least 6 months ago
  • whose clinical condition is stable

Exclusion Criteria:

  • having an upper extremity disability or musculoskeletal disorder that could affect physical performance
  • having undergone bilateral breast surgery
  • development of recurrence or metastasis
  • uncontrolled chronic cardiopulmonary diseases (hypertension, heart failure, peripheral artery disease, COPD, asthma, etc.), uncontrolled chronic conditions such as diabetes or neuromotor disorders, anemia, smoking, or cognitive impairment
  • having participated in a regular exercise program within the last 6 months

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Breast cancer survivors
At least 40 cases of patients aged 18 and older who met the inclusion criteria, who had undergone breast surgery (at least 6 months to a maximum of 15 years had passed since mastectomy and curative treatment), and who were being followed up at the General Surgery Breast Clinic of Pamukkale University
Healthy individuals
At least 40 healthy individuals who are undergoing routine follow-up at the General Surgery Breast Clinic of Pamukkale University, have no history of cancer, and meet the criteria for inclusion in the control group

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Muscle oxygenation will be assessed a noninvasive technique, using near-infrared spectroscopy (NIRS). NIRS can measure local muscle oxygen saturation (SmO₂) in the capillary bed of the underlying muscle tissue.
Time Frame: october 2026 to august 2027
The NIRS sensor will be secured using a fiber-elastic band over the midline of the lateral deltoid muscle, immediately inferior to the acromion. Physiological variables, including the minimum, maximum, and change values of muscle oxygen saturation, will be recorded at rest and during and after the Six-Minute Pegboard and Ring Test. Muscle oxygenation will be expressed as the percentage of oxyhemoglobin relative to the sum of oxyhemoglobin and deoxyhemoglobin. Bilateral musce oxygenation of the middle portion of the deltoid muscle will be assessed before, during, and after the test. During exercise, an inability to adequately meet the increased oxygen demand of the working muscle may result in reduced SmO₂ levels. SmO₂ is influenced by shifts in the hemoglobin dissociation curve as well as by other chemical and neural factors.
october 2026 to august 2027

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
upper extremity muscle strength
Time Frame: october 2026 to august 2027
The strength of the middle and anterior portions of the deltoid muscle will be assessed using a hand-held dynamometer. The test will be performed with the participant in an unsupported sitting position, with the shoulder positioned at 90° of abduction and 90° of flexion, in neutral rotation, and with the elbow fully extended. Resistance will be applied using the dynamometer over the distal humerus, and the participant will be instructed to attempt to elevate the arm with maximal force. Three measurements will be obtained, and the highest value will be recorded in Newtons (N).
october 2026 to august 2027

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Functional performance of upper extremity
Time Frame: october 2026 to august 2027
Upper extremity functional exercise capacity will be assessed using the Six-Minute Pegboard and Ring Test. Participants will sit on an adjustable chair in front of a pegboard consisting of two lower horizontal bars positioned at shoulder height and shoulder width, one on the right and one on the left, and two upper bars positioned 20 cm above the lower bars. Each upper bar will contain 10 rings. Participants will be instructed to transfer the rings from the lower bars to the upper bars and then back to the lower bars as quickly as possible, using both arms simultaneously. If a participant requires rest, they will be permitted to rest while the test duration continues, with instructions to resume the test as soon as possible. The number of rings transferred during the 6-minute test will be recorded. Two rings removed and placed simultaneously will be counted as two rings.Blood pressure, heart rate, and peripheral oxygen saturation will be recorded before and immediately after the test.
october 2026 to august 2027
upper extremity disability
Time Frame: october 2026 to august 2027

Upper extremity disability will be assessed using the Disabilities of the Arm, Shoulder and Hand Questionnaire-Quick Version (QuickDASH). The Turkish version of the QuickDASH, which has been demonstrated to be valid and reliable, will be used. The QuickDASH consists of 11 items, with each item scored on a 5-point scale ranging from 1 to 5 (1 = no difficulty, 2 = mild difficulty, 3 = moderate difficulty, 4 = severe difficulty, and 5 = unable to perform). The questionnaire assesses pain severity, activity-related pain, tingling, weakness, stiffness, difficulty performing physical activities due to upper extremity problems, and the impact of upper extremity problems on social activities, work, and sleep.

The QuickDASH score ranges from 0 to 100, with higher scores indicating greater disability (0 = no disability; 100 = maximum disability). A score of ≥20 indicates clinically significant functional impairment.
october 2026 to august 2027

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Pamukkale University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Atiye KAŞ ÖZDEMİR, Lecturer, PhD., Pamukkale University
  • Study Chair: Sevda YILMAZ, Assoc. Prof. Dr., Pamukkale University
  • Study Chair: Orçin TELLİ ATALAY, Prof. Dr., Pamukkale University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
October 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 1, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
November 1, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 30, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 9, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
September 14, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
September 14, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 9, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
August 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2026TAP034 (Other Grant/Funding Number: Pamukkale University Scientific Research Projects Department)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

There are currently no plans to share individual participant data with other researchers. Study results will be reported only in aggregated form, and no personally identifiable information will be disclosed.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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