Plyometric Strength-Endurance Exercise in Breast Cancer

March 10, 2026 updated by: Yoana González González, University of Vigo

Therapeutic Plyometric-Based Strength-Endurance Exercise Program for Breast Cancer Patients and Survivors to Improve Quality of Life and Physical and Mental Function

This study aims to compare an adapted plyometric strength-endurance exercise program with conventional strength training in women who are breast cancer survivors or currently undergoing treatment and who participate in provincial support associations. The goal is to determine whether a targeted plyometric intervention can provide additional benefits in physical and mental health outcomes.

Using a cluster-randomized clinical trial design, the study will assess indicators such as functional capacity, muscle strength, fatigue levels, symptoms related to lymphedema, and overall quality of life. The findings are expected to contribute to a better understanding of how structured exercise programs can support recovery, physical function, and well-being in women affected by breast cancer.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Breast cancer is the most common malignancy among women worldwide. Despite significant advances in diagnosis and treatment that have improved survival rates, many patients and survivors continue to experience physical and psychological impairments that negatively affect their quality of life. Historically, intense or repetitive upper-limb exercise was discouraged due to concerns about triggering or worsening lymphedema. However, current evidence supports supervised therapeutic exercise as both safe and effective for this population. Strength training, in particular, has demonstrated benefits in muscle mass, physical function, bone health, fatigue reduction, and emotional well-being.

Most existing research has focused on conventional strength training programs, leaving a gap in the evidence regarding more dynamic approaches, such as strength-endurance training involving plyometric exercises. Research on plyometrics within oncology remains limited and has been conducted primarily in pediatric populations, such as survivors of childhood leukemia or children with neurofibromatosis type 1. Nevertheless, plyometric training-traditionally used in athletic performance and in patients with neurological or musculoskeletal conditions-may offer significant therapeutic potential for women living with or recovering from breast cancer.

Plyometric exercises are known to enhance muscular power, balance, proprioception, and neuromuscular control, all of which are essential for restoring functional capacity and independence. Their dynamic, progressive nature may also support greater motivation and adherence, potentially translating into improvements in mental health, self-esteem, and body image.

In summary, plyometric-based strength-endurance training represents an innovative and promising approach to improving quality of life, functional performance, and overall well-being in women who are survivors of breast cancer or currently undergoing treatment. This study aims to address the existing evidence gap by evaluating the therapeutic effects of an adapted plyometric program compared with conventional strength training within a controlled clinical trial framework.

Study Type

Interventional

Enrollment (Estimated)

51

Phase

  • Not Applicable

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

  • Name: Yoana Gonzalez-Gonzalez, PhD
  • Phone Number: (+34) 986 801767
  • Email: yoana@uvigo.gal

Study Contact Backup

Study Locations

  • Spain
    • Galicia
      • Pontevedra, Galicia, Spain, 36001
        • Faculty of Physiotherapy
        • Contact:
          • Yoana Gonzalez Gonzalez, PhD
          • Phone Number: +34) 986801767
          • Email: yoana@uvigo.gal

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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Women aged 18 years or older.
  • Prior diagnosis of breast cancer.
  • History of mastectomy, including unilateral procedures, total breast surgery, or breast-conserving surgery.
  • Completion of postoperative chemotherapy or radiotherapy, when indicated.
  • Absence of contraindications for physiotherapy or therapeutic exercise.
  • Willingness to voluntarily participate in the study.
  • Ability to understand and sign the informed consent form.
  • Availability to participate in the training program for the entire intervention period (approximately 12 weeks).

Exclusion Criteria

  • Participants will be excluded if any of the following conditions are present:
  • Active metastasis to other organs or tissues (e.g., liver, kidney, lung, brain) or stage IV cancer that prevents safe participation in the therapeutic exercise program.
  • Current diagnosis of cardiovascular, respiratory, neuromuscular, or musculoskeletal diseases that contraindicate physical exercise or impair safe completion of the program.
  • Major surgery within the previous 6 months without medical clearance to resume physical activity.
  • Cognitive impairment or mental health conditions that limit comprehension of instructions or safe engagement in the intervention.
  • Current pregnancy.
  • Lack of medical clearance for moderate-to-vigorous physical activity (as indicated by a medical certificate specifying the duration of the restriction and the conditions under which exercise may be resumed).

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

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Plyometric Strength-Endurance Training Program

Participants in the experimental group will take part in an adapted plyometric strength-endurance training program delivered through supervised 60-minute sessions, twice per week, over a 12-week period (24 sessions total). A minimum rest interval of 48 hours will be maintained between sessions. The frequency and duration of the intervention follow the recommendations of the National Strength and Conditioning Association (NSCA) for the safe implementation of plyometric and strength-endurance exercise in adult populations.

A total battery of 22 plyometric exercises has been designed based on previous scientific literature in which plyometric movements were adapted for individuals with various clinical conditions. These exercises are progressively structured to ensure safe neuromuscular adaptation, gradual increases in intensity, and individualized progression according to each participant's tolerance and functional capabilities.
Other: Plyometric Strength-Endurance Training
Participants in the experimental group will take part in an adapted plyometric strength-endurance training program delivered through supervised 60-minute sessions, twice per week, over a 12-week period (24 sessions total). A minimum rest interval of 48 hours will be maintained between sessions. The frequency and duration of the intervention follow the recommendations of the National Strength and Conditioning Association (NSCA) for safe implementation of plyometric and strength-endurance exercise in adult populations.
Active Comparator: Conventional Strength Training
Participants assigned to the control group will perform a conventional strength training program. This program has been designed as an active and structured intervention to allow a meaningful comparison with the effects of the plyometric training implemented in the experimental group. The exercise circuit will include functional movements aimed at global strengthening, with an emphasis on multi-joint patterns that promote transfer of improvements to activities of daily living. The program will be organized as a circuit of strength exercises performed after the warm-up phase and before the cool-down phase, delivered over a 12-week period through supervised 60-minute sessions held twice per week with at least 48 hours of rest between sessions to allow for adequate muscular recovery. Training volume will progress from 1-3 sets of 8 repetitions in weeks 1-2, increasing to 12-14 reps, and up to 4 sets in the final week based on tolerance.
Other: Conventional Strength Training
Participants assigned to the control group will perform a conventional strength training program. This program has been designed as an active and structured intervention to allow a meaningful comparison with the effects of the plyometric training implemented in the experimental group. The exercise circuit will include functional movements aimed at global strengthening, with an emphasis on multi-joint patterns that promote transfer of improvements to activities of daily living.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Quality of life (Breast Cancer-Specific Quality of Life)
Time Frame: From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

EORTC QLQ-BR42: European Organisation for Research and Treatment of Cancer (EORTC) to assess breast cancer-specific quality of life.

Description:

The EORTC QLQ-BR42 is a validated 42-item questionnaire designed to assess breast cancer-specific quality of life. It evaluates physical, emotional, and functional well-being, as well as symptoms and treatment-related side effects relevant to contemporary breast cancer therapies. The measure covers domains such as body image, sexual functioning, systemic therapy side effects, breast symptoms, and arm symptoms.

Scoring:

Items are scored according to the EORTC scoring manual. Scores are linearly transformed to a 0-100 scale. Higher scores on functional scales indicate better functioning; higher scores on symptom scales indicate greater symptom burden.
From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Cardiorespiratory capacity
Time Frame: From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

6-Minute Walk Test (6MWT) Description: The Six-Minute Walk Test is a standardized assessment of cardiorespiratory capacity that measures the total distance walked (in meters) over a six-minute period at a self-paced speed. It reflects functional exercise tolerance and global physical endurance.

Score Range:

Minimum possible score: 0 meters Maximum possible score: No fixed upper limit (performance-dependent; healthy individuals may reach 300-700 meters) Interpretation: Higher scores indicate a better outcome, reflecting greater cardiorespiratory capacity.
From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period
Cancer-related fatigue
Time Frame: From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

FACIT-F (Functional Assessment of Chronic Illness Therapy - Fatigue) Description: The Functional Assessment of Chronic Illness Therapy - Fatigue Subscale (FACIT-Fatigue) is a validated patient-reported questionnaire assessing cancer-related fatigue and its impact on daily functioning. It contains 13 items, each rated on a Likert scale from 0 ("not at all") to 4 ("very much").

Score Range:

Minimum possible score: 0 points (indicates the worst fatigue) Maximum possible score: 52 points (indicates the least fatigue) Interpretation: Higher scores indicate a better outcome, representing less fatigue and better functional well-being.
From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period
Mobility and range of motion
Time Frame: From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

Goniometry and flexibility testing Description: Goniometric and flexibility tests will be used to assess joint mobility of the upper and lower limbs and trunk. Goniometry quantifies joint range of motion in degrees using a standardized instrument (goniometer), while flexibility tests measure muscle and soft-tissue extensibility. These tests evaluate functional mobility relevant to daily activities.

Score Range:

Minimum: 0 degrees (no active movement) Maximum: varies by joint Interpretation:Higher scores indicate better mobility and joint range of motion.
From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period
Muscle strength
Time Frame: From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

Hand-held dynamometry (MicroFET II - Maximal isometric strength) Description: Maximal isometric strength will be assessed using a hand-held dynamometer (MicroFET II). This device measures force output (in Newtons or kilograms-force) during standardized resisted movements of the upper limb.

Score Range:

Minimum: 0 (no measurable force) Maximum: device-dependent; MicroFET II typically measures up to 300 pounds-force (≈1334 N), though functional values are lower in clinical practice.

Interpretation:

Higher scores indicate a better outcome, reflecting greater muscular strength.
From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period
Proprioception
Time Frame: From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

Outcome measure: Joint position sense and force-matching tests Description: Proprioception will be evaluated using joint position sense testing (ability to reproduce specific joint angles) and force-matching tasks (ability to replicate a target force level). These tests assess neuromuscular control, sensorimotor acuity, and accuracy in joint and force detection.

Score Range: Joint position sense: error values typically expressed in degrees (°).

Minimum error: 0° (perfect accuracy) Maximum error: no fixed upper limit; depends on test range Force-matching: error expressed as difference from target force. Minimum error: 0 (perfect accuracy) Maximum: no predefined limit

Interpretation:

Lower error values indicate a better outcome (greater proprioceptive accuracy).
From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period
Upper limb functionality
Time Frame: From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

Outcome measure 1: Disabilities of the arm, shoulder and hand questionnaire (DASH) Description: The DASH is a 30-item patient-reported outcome measure assessing physical function and disability of the upper limb. It evaluates difficulty performing daily activities, symptom severity, and functional limitations.

Score Range:

Minimum: 0 (no disability → best outcome) Maximum: 100 (severe disability → worst outcome)

Interpretation:

Higher scores indicate a worse outcome (greater disability).

Outcome Measure 2: Constant-Murley shoulder score

Description:

The Constant-Murley Score is a clinician-reported composite measure evaluating shoulder function through four domains: pain, daily living activities, range of motion, and strength. Total score ranges from 0 to 100.

Score Range:

Minimum: 0 (worst shoulder function) Maximum: 100 (normal shoulder function)

Interpretation:

Higher scores indicate a better outcome (greater shoulder function).
From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period
Presence of lymphedema
Time Frame: From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

Outcome measure: Presence of lymphedema (Yes/No), symptom severity, and limb circumference measurements.

Description:

Lymphedema will be assessed through a combination of:

  • Presence/absence (Yes/No) of swelling;
  • Subjective symptoms (heaviness, tightness, pain) measured using a visual analog scale (0-10);
  • Circumference measurements (circumetry) at standardized anatomical points of the upper limb.

Score Range:

Visual analog scale: 0 (no symptoms) to 10 (worst symptoms). Circumference: no fixed minimum/maximum, values recorded in centimeters.

Interpretation:

Higher symptom scores and larger circumference values indicate worse lymphedema.
From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period
Sleep quality
Time Frame: From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

Outcome measure: Pittsburgh Sleep Quality Index (PSQI) Description: The PSQI evaluates overall sleep quality across seven components (sleep latency, duration, efficiency, disturbances, etc.). The questionnaire includes 19 items.

Score Range:

Minimum: 0 Maximum: 21 Higher scores = worse sleep quality. Interpretation: A global score > 5 typically indicates poor sleep quality.
From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period
Kinesiophobia
Time Frame: From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

Tampa Scale for Kinesiophobia - 11-item Version (TSK-11) Description: The TSK-11 assesses the fear of movement or reinjury, using 11 Likert-scale items rated from 1 (strongly disagree) to 4 (strongly agree).

Score Range:

Minimum: 11 Maximum: 44 Higher scores indicate greater fear of movement. Interpretation: Higher scores = worse outcome.
From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period
Enjoyment of physical activity
Time Frame: From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

Measure 1: Enjoyment of physical activity (Physical Activity Enjoyment Scale - PACES-18)

Description:

18-item validated scale assessing enjoyment of physical activity; items rated on a 7-point Likert scale.

Score Range:

Min: 18 (lowest enjoyment) Max: 126 (highest enjoyment)

Interpretation:

Higher scores = greater enjoyment of physical activity. Measure 2: Leisure-Time Physical Activity (Leisure-Time Physical Activity Questionnaire)

Description:

Self-reported weekly minutes of moderate and vigorous physical activity performed during leisure time.

Score Range:

Min: 0 minutes/week Max: No fixed upper limit

Interpretation:

Higher scores = greater leisure-time physical activity (better outcome).
From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period
Exercise adherence rate
Time Frame: From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

Description: Adherence will be calculated using the formula:

(Number of sessions completed / Number of scheduled sessions) × 100.

Score Range:

Minimum: 0% Maximum: 100%

Interpretation:

Higher percentages indicate better adherence.
From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period
Intervention acceptability
Time Frame: To the end of treatment at 12 weeks

Custom Likert-Scale Acceptability Questionnaire (Ad Hoc) Description: A custom Likert-type questionnaire (1-5) will evaluate the participant's perceived acceptability of the intervention, including clarity, comfort, and usability.

Score Range:

Minimum: 1 (least acceptable) Maximum: 5 (most acceptable) Interpretation: Higher scores indicate greater acceptability.
To the end of treatment at 12 weeks
Satisfaction with the intervention
Time Frame: To the end of treatment at 12 weeks

Custom Likert-Scale Satisfaction Questionnaire (Ad Hoc) Description: A custom Likert-scale questionnaire will assess participant satisfaction with the intervention, including perceived usefulness and overall experience.

Score Range:

Minimum: 1 (least satisfied) Maximum: 5 (most satisfied) Interpretation: Higher scores indicate greater satisfaction
To the end of treatment at 12 weeks
Adverse events
Time Frame: To the end of treatment at 12 weeks

Systematic adverse event log Description: Systematic recording of any adverse events occurring during the program, documented according to standard clinical criteria.

Score Range: Not applicable (qualitative/quantitative event logging)

Interpretation:

Higher number or severity of adverse events indicates poorer safety.
To the end of treatment at 12 weeks
Back pain
Time Frame: From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

Outcome measure: Brief Pain Inventory (BPI) Description: The Brief Pain Inventory assesses pain intensity (0-10) and pain interference with daily activities.

Score Range:

Intensity: 0 = no pain; 10 = worst imaginable Interference score: 0 = no interference; 10 = complete interference Interpretation: Higher scores indicate worse pain and greater functional impact.
From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period
Pelvic Floor distress
Time Frame: From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

Pelvic Floor Distress Inventory (PFDI) Description: The Pelvic Floor Distress Inventory evaluates symptoms of pelvic floor dysfunction, including urinary, colorectal, and pelvic organ prolapse symptoms.

Score Range:

Minimum: 0 Maximum: 300 (depending on subscales used) Interpretation: Higher scores indicate greater symptom burden (worse outcome).
From enrollment to the end of treatment at 12 weeks, followed by an additional 12-week follow-up period

Collaborators and Investigators

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

Sponsor

University of Vigo

Investigators

  • Principal Investigator: Yoana Gonzalez Gonzalez, PhD, University ofVigo
  • Principal Investigator: Gloria M Cascallar Cascallar, Graduate, SERGAS (Servicio galego de Saúde), Galician Health Service, Spanish Social Security System

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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)

April 20, 2026

Primary Completion (Estimated)

July 20, 2026

Study Completion (Estimated)

December 31, 2027

Study Registration Dates

First Submitted

March 3, 2026

First Submitted That Met QC Criteria

March 3, 2026

First Posted (Actual)

March 10, 2026

Study Record Updates

Last Update Posted (Actual)

March 13, 2026

Last Update Submitted That Met QC Criteria

March 10, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2025/263
  • 2025/001 (Other Identifier: COFIGA)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

The individual participant data (IPD) from this study will not be shared.

Data will remain confidential and will be used exclusively for the purposes of this research project. The decision not to share IPD is based on the following considerations:

The dataset contains sensitive personal and health information from oncology patients, and sharing it could compromise participant privacy.

Participants did not consent to external sharing of their individual data beyond the research team.

The study protocol prioritizes strict confidentiality in accordance with European data protection regulations (GDPR) and institutional policies.

The size and nature of the dataset increase the risk of re-identification, even after de-identification procedures.

For these reasons, no individual-level data will be made publicly available.

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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