Strength After Breast Cancer

Course Description

This course prepares therapists to deliver the Strength After Breast Cancer program which is an evidence-based rehabilitative exercise program for breast cancer survivors. The Strength ABC program is based on the Physical Activity and Lymphedema (PAL) Trial which assessed the safety and efficacy of slowly progressive weightlifting for breast cancer survivors with or at risk for lymphedema. The results of the PAL trial were published in the New England Journal of Medicine, JAMA, and the Journal of Clinical Oncology among other peer-reviewed scientific journals. This weightlifting intervention decreased lymphedema exacerbations by 50%; decreased the onset of lymphedema by 70% (among women with 5+ nodes removed); improved body composition, body image, and upper body symptoms; and prevented the decline in physical function that is observed to occur in breast cancer survivors. The course provides all the materials needed to set up the program in your own facility.

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Upon completion of the course, the student will be able to:

  • Cite the scientific research evidence that led to the Strength ABC Program
  • Identify the structure and function of the lymphatic system, particularly relating to the risks and benefits of slowly progressive resistance training among breast cancer survivors.
  • Convey the Strength ABC program flow, logistical considerations, and business model.
  • Describe appropriate methods to safely and effectively teach breast cancer survivors to independently perform slowly progressive weightlifting exercise.
  • Identify established methods for motivating participants to do the Strength ABC program regularly (twice weekly).
  • Instruct participants on how to progress resistance appropriately, reduce resistance after not exercising for more than a week, use appropriate biomechanical form, monitor symptoms, and get appropriate evaluation for any change in symptoms that lasts a week or longer.

This online course covers all aspects of setting up and running the Strength After Breast Cancer program including how to:

  • Obtain referrals from oncology clinicians
  • Screen participants
  • Coordinate with a Certified Lymphatic Therapist
  • Educate participants about lymphedema
  • Teach the 4-session exercise program
  • Instruct patients on how to log their progress
  • Motivate participants
  • Handle logistical considerations
  • Manage discharge and wrap-up

Materials you will receive include:

  • PAL trial results
  • Lymphedema Education Session in PowerPoint format
  • Lymphedema risk-reduction guidelines
  • Exercise instructions with photos
  • Decision Tree for tracking adherence
  • Self-Check List for program objectives
  • Guidance for support staff
  • Helpful information about billing codes
  • Weight Training Workout Logs

Upon receipt of your registration and payment, you will receive an email requesting your acceptance of a confidentiality clause and the KTC Online Courses Student Agreement. Within three business days of receiving your response, you will be sent your username, password, and instructions on how to access and navigate the online course. You will have 3 MONTHS of access to the online course, starting from the time you receive your username and password by email.

Kathryn Schmitz, PhD, MPH, FACSM Kathryn (Katie) Schmitz is a professor at the University of Pennsylvania’s Perelman School of Medicine. She is an exercise interventionist who has led multiple trials, including a large randomized controlled trial, the Physical Activity and Lymphedema Trial (PAL), to assess the safety of upper body exercise among 295 breast cancer survivors with and without lymphedema. In Spring 2011, her research group began work to translate the PAL intervention to become more broadly disseminable through oncology clinics and physical therapists (R21-CA152451). Katie’s research extends from the role of physical activity in the prevention and etiology of obesity related cancers, to the usefulness of activity for rehabilitation and health promotion in cancer survivors of all cancers. Her meta-analyses on the topic of exercise interventions in cancer patients and survivors, published in 2005 and 2010, provide a starting point for clinicians to understand the effects of exercise among cancer survivors.

Katie has published over 160 peer reviewed scientific papers (scopus h-index of 39) and has had continuous NIH funding for her research since 2001, including three R01s, two R21s and a TREC Center (Transdisciplinary Research on Energetics and Cancer). She has also received research support from the Robert Wood Johnson Foundation, Susan G. Komen for the Cure, and the Agency for Health Care Research and Quality.

Katie has served on the expert panel for the YMCA/Lance Armstrong Foundation Cancer Survivorship Collaborative, wrote the cancer survivorship section of the recently published U.S. DHHS report of the Physical Activity Guidelines Advisory Committee, served on the ad hoc committee that developed the ACSM Cancer Exercise Trainer certification, and is the lead author of the ACSM Roundtable on Exercise for Cancer Survivors, which published guidance for exercise testing and prescription for cancer survivors in July 2010.

In 2010, the National Lymphedema Network awarded Katie the Catalyst Award, which recognizes a researcher whose work has stimulated thought, discussion, and debate that leads to improvement in patient care for those with lymphedema. Katie’s long-term professional goal is to see that all oncologists, fitness trainers, and cancer patients will eventually be as cognizant of the usefulness of exercise for cancer control as they are in its role in controlling heart disease.

Professional affiliations include:

  • Professor, Perelman School of Medicine, University of Pennsylvania
  • Division of Epidemiology
  • Department of Biostatistics and Epidemiology
  • Department of Family Medicine and Community Health
  • Senior Fellow, Leonard Davis Institute of Health Economics
  • Senior Fellow, Center for Public Health Initiatives
  • Senior Scholar, Center for Clinical Epidemiology and Biostatistics
  • Full Member, Abramson Cancer Center

Contact information:


Licensed Physical Therapist, Occupational Therapist, Athletic Trainer Certified, or Nationally-Certified Fitness Professional* WITH access to a Certified Lymphedema Therapist (CLT).

*Nationally-Certified Fitness Professionals must have a certification specific to working with cancer patients (e.g. ACSM’s Cancer Exercise Trainer certification or the Cancer Exercise Training Institute Course) AND documentation of 500 hours of direct contact working with cancer survivors in a fitness intervention setting AND documentation of partnership with a CLT who can evaluate survivors and to whom survivors can be referred if there is a change in symptoms.

NOTE: Other licensed health professionals may take this course but the skills they acquire may be outside their scope of practice. It is the student’s responsibility to know the legal limits of their profession.

The tuition for this online course is .00. The full amount is due upon registration. You may register online or print the registration form and fax or email it to Klose Training.

The following agreement must be signed and submitted before you begin your course.

KTC Online Courses Student Agreement

To receive a Certificate of Completion, students must successfully complete an online quiz.

Upon completion of the course and successfully passing the quiz, the student will receive a Certificate of Completion verifying online course hours. The Strength After Breast Cancer course offers 4.5 contact hours of online continuing education to Physical, Occupational and Massage Therapists. Online course hours are approved for Lymphology Association of North America (LANA) re-certification. For more information about KTC’s CEU approvals, visit our CEU Approvals page.

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