Feedback from wearable devices accelerates recovery after breast cancer surgery

Axillary surgery for breast cancer is frequently associated with upper-limb morbidity, impacting quality of life. Structured exercise improves outcomes, but access to physiotherapy is inconsistent. Wearable devices offer objective post-operative monitoring and the potential for real-time rehabilitation support. This study aims to assess the impact of wearable-driven feedback on upper-limb recovery after axillary surgery, and to evaluate the usability, adherence, and acceptability of wearables during post-operative rehabilitation.

In this prospective observational cohort study, patients undergoing axillary surgery at a tertiary breast unit were equipped with wearable devices to monitor upper-limb activity. Participants were allocated to basic-feedback (BF; fixed 60-min goal) or dynamic-feedback (DF; personalised weekly clinician-adjusted goals). Recovery was defined as post-operative activity relative to pre-operative baseline. An earlier prospective no-feedback (NF) cohort served as comparator.

Forty-nine patients were included: 10 DF, 10 BF, and 29 NF. Adherence was high (mean compliance 89.4%, SD 17.9). By postoperative day (POD) 8, DF patients exceeded baseline activity (103.2%, SD 30.6), outperforming BF (80.2%, SD 13.9) and NF (86.2%, SD 55.8). Recovery plateaued earliest in DF (POD 4), followed by BF (POD 5) and NF (POD 7). Among SLNB-only patients, DF recovered faster than NF, while BF and NF showed similar trajectories.

Clinician-guided, wearable-driven feedback significantly accelerates upper-limb recovery following axillary surgery. These findings support further evaluation of this approach in larger randomized trials to determine clinical and cost-effectiveness.