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Kim Y, Park EY, Lee H. The effect of myofascial release in patients with breast cancer-related lymphedema: a cross-over randomized controlled trial. Eur J Phys Rehabil Med 2023; 59:85-93. [PMID: 36637800 PMCID: PMC10035446 DOI: 10.23736/s1973-9087.22.07698-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AIM This study aimed to compare the effects of myofascial release (MFR) on upper extremity volume in patients with breast cancer-related lymphedema (BCRL). DESIGN A randomized, single-blinded, cross-over, controlled trial. SETTING An outpatient rehabilitation clinical setting. POPULATION Thirty patients with BCRL. METHODS Within a crossover design with randomized treatment sequences, fifteen subjects received MFR for 4 weeks, followed by 4 weeks of washout period, and then received placebo MFR and the other fifteen subjects received interventions in the reverse order. Each session had a 60 min process including either MFR or placebo MFR for 30 min, followed by complete decongestive therapy for 30 min twice a week. Upper limb volume as the primary outcome and subjective pain, shoulder range of motion (ROM), chest mobility, shoulder function, and quality of life as secondary outcomes were assessed before and at the end of each intervention period. RESULTS There were significant differences in upper limb volume after both MFR and placebo MFR (P<0.05) while no significant difference between MFR and placebo MFR treatments was found (P>0.05). MFR-based treatment also achieved a greater improvement than placebo MFR-based treatment in subjective pain and shoulder ROM (P<0.05), except for internal rotation, and shoulder function. CONCLUSIONS MFR-based treatment showed clinical improvement in shoulder function, induced by decreased edema volume and pain, and improved ROM and chest mobility. However, a further study with parallel randomized controlled trials to confirm what was achieved in the present study. CLINICAL REHABILITATION IMPACT MFR-based treatment is considered an important part of BCRL rehabilitation. Moreover, MFR-based treatment may be safe for patients with BCRL.
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Affiliation(s)
- Yena Kim
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, South Korea
| | - Eun Y Park
- College of Nursing, Gachon University, Incheon, South Korea
| | - Haneul Lee
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, South Korea -
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Muñoz-gómez E, Arnal-gómez A, López Cascón A, Espí-lópez GV. Systematic review of aquatic therapeutic exercise efficacy in breast cancer survivors. Support Care Cancer 2023; 31:44. [DOI: 10.1007/s00520-022-07460-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/03/2022] [Indexed: 12/23/2022]
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Maccarone MC, Venturini E, Menegatti E, Gianesini S, Masiero S. Water-based exercise for upper and lower limb lymphedema treatment. J Vasc Surg Venous Lymphat Disord 2023; 11:201-9. [PMID: 35995327 DOI: 10.1016/j.jvsv.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 07/19/2022] [Accepted: 08/01/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Lymphedema is a debilitating illness caused by insufficient lymph drainage, which can have serious physical and psychological consequences. Although water-based exercise can be useful, at present, little evidence is available regarding the outcomes of aquatic treatment for patients with lymphedema. Therefore, the aim of the present scoping review was to evaluate, from reported studies, the effects of water-based exercise on pain, limb motor function, quality of life (QoL), and limb volume among patients affected by primary and secondary upper and lower limb lymphedema. METHODS We performed a scoping review to examine clinical studies and randomized controlled trials reported in English from 2000 to 2021 by screening the MEDLINE (PubMed) and PEDro databases. RESULTS The search produced a total of 88 studies. Eight randomized controlled trials and one clinical study of patients with primary or secondary lymphedema of upper or lower limbs who had undergone water-based treatment were included in the present study. Most trials had focused on breast cancer-related lymphedema. The shoulder range of flexion, external rotation, and abduction have been shown to improve after performing a water-based exercise protocol. Some evidence has also demonstrated that the lymphedematous limb strength can improve. Moreover, water-based exercise seemed to improve pain perception and QoL for patients with upper or lower limb lymphedema. In contrast, in the control groups, the QoL showed a tendency to worsen over time. Although some studies had not reported beneficial effects on the lymphedematous limb volume, most of the studies examined had reported a reduction in volume, especially in the short term. No adverse events were reported in the included studies. CONCLUSIONS The findings from the present review have shown the potential for aquatic exercise in lymphedema management. However, at the same time, the findings underline the multiple limitations resulting from the heterogeneity in the study populations and related physical activity protocols. The role of aquatic exercise in the conservative treatment of lymphedema requires further investigation in the future to define specific protocols of application.
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Hayes SC, Singh B, Reul-Hirche H, Bloomquist K, Johansson K, Jönsson C, Plinsinga ML. The Effect of Exercise for the Prevention and Treatment of Cancer-Related Lymphedema: A Systematic Review with Meta-analysis. Med Sci Sports Exerc 2022; 54:1389-1399. [PMID: 35320145 DOI: 10.1249/mss.0000000000002918] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The purpose of this systematic review and meta-analysis was to evaluate the effects of exercise on (i) the prevention of cancer-related lymphedema (CRL) and (ii) the treatment of CRL, lymphedema-associated symptoms, and other health outcomes among individuals with CRL. METHODS An electronic search was undertaken for exercise studies measuring lymphedema and involving individuals at risk of developing or with CRL. The Effective Public Health Practice Project Quality scale was used to assess study quality, and overall quality of evidence was assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. Meta-analyses were performed to evaluate effects of exercise on CRL incidence, existing CRL status, lymphedema-associated symptoms, and health outcomes. RESULTS Twelve studies ( n = 1955; 75% moderate-high quality) and 36 studies ( n = 1741; 58% moderate-high quality) were included in the prevention and treatment aim, respectively. Relative risk of developing CRL for those in the exercise group compared with the nonexercise group was 0.90 (95% confidence interval (CI), 0.72 to 1.13) overall and 0.49 (95% CI, 0.28 to 0.85) for those with five or more lymph nodes removed. For those with CRL in the exercise group, the standardized mean difference (SMD) before to after exercise of CRL was -0.11 (95% CI, -0.22 to 0.01), and compared with usual care postintervention, the SMD was -0.10 (95% CI, -0.24 to 0.04). Improvements after intervention were observed for pain, upper-body function and strength, lower-body strength, fatigue, and quality of life for those in the exercise group (SMD, 0.3-0.8; P < 0.05). CONCLUSIONS Findings support the application of exercise guidelines for the wider cancer population to those with or at risk of CRL. This includes promotion of aerobic and resistance exercise, and not just resistance exercise alone, as well as unsupervised exercise guided by symptom response.
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Affiliation(s)
| | - Ben Singh
- UniSA Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, AUSTRALIA
| | | | - Kira Bloomquist
- University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital, Copenhagen, DENMARK
| | - Karin Johansson
- Department of Health Sciences, Lund University, Lund, SWEDEN
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Reger M, Kutschan S, Freuding M, Schmidt T, Josfeld L, Huebner J. Water therapies (hydrotherapy, balneotherapy or aqua therapy) for patients with cancer: a systematic review. J Cancer Res Clin Oncol 2022. [PMID: 35171330 DOI: 10.1007/s00432-022-03947-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 02/04/2022] [Indexed: 11/27/2022]
Abstract
Background Water therapies as hydrotherapy, balneotherapy or aqua therapy are often used in the relief of disease- and treatment-associated symptoms of cancer patients. Yet, a systematic review for the evidence of water therapy including all cancer entities has not been conducted to date. Purpose Oncological patients often suffer from symptoms which in patients with other diseases are successfully treated with water therapy. We want to gather more information about the benefits and risks of water therapy for cancer patients. Method In May 2020, a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychInfo, CINAHL and PubMed) to find studies concerning the use, effectiveness and potential harm of water therapy on cancer patients. Results Of 3165 search results, 10 publications concerning 12 studies with 430 patients were included in this systematic review. The patients treated with water therapy were mainly diagnosed with breast cancer. The therapy concepts included aqua lymphatic therapy, aquatic exercises, foot bathes and whole-body bathes. Outcomes were state of lymphedema, quality of life, fatigue, BMI, vital parameters, anxiety and pain. The quality of the studies was assessed with the AMSTAR2-instrument, the SIGN-checklist and the IHE-Instruments. The studies had moderate quality and reported heterogeneous results. Some studies reported significantly improved quality of life, extent of lymphedema, neck and shoulder pain, fatigue and BMI while other studies did not find any changes concerning these endpoints. Conclusion Due to the very heterogeneous results and methodical limitations of the included studies, a clear statement regarding the effectiveness of water therapy on cancer patients is not possible.
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Ali KM, El Gammal ER, Eladl HM. Effect of Aqua Therapy Exercises on Postmastectomy Lymphedema: A Prospective Randomized Controlled Trial. Ann Rehabil Med 2021; 45:131-140. [PMID: 33849087 PMCID: PMC8137385 DOI: 10.5535/arm.20127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/23/2020] [Indexed: 11/29/2022] Open
Abstract
Objective To investigate the effect of aqua therapy resistance exercise on arm volume, pain, and shoulder range of movements in post-mastectomy lymphedema. Methods This was a single-blind randomized controlled trial. Fifty eligible breast cancer survivors (median, 10 years after surgery) with lymphedema (median, 21% inter-limb difference) were assigned randomly to group A (n=25) or control group B (n=25). The study group underwent 60 minutes of aqua therapy exercise comprising of warm-up for 10 minutes, 40 minutes of strengthening exercises, and 10 minutes of cooling down, three times a week for 8 weeks. The control group underwent 60 minutes of land-based exercise three times a week for 8 weeks. Arm volume calculated by measuring the arm circumference, shoulder flexion, and abduction range of motion (ROM), and pain using a visual analog scale (VAS) were assessed at baseline and after 8 weeks of treatment. Results There was a statistically significant difference in limb volume, shoulder flexion and abduction ROM, and VAS scores in favor of the study group (p<0.001) after 8 weeks of intervention. The mean±standard deviation for limb volume, shoulder flexion, abduction, and pain score were 2,108.71±200.97 mL, 169.68°±4.54°, 150.44°±3.92°, and 3.16±1.1 in the study group and 2,256.41±186.94 mL, 147.36°±5.32°, 131.32°±4.38°, and 5.68±0.94 in the control group, respectively. Conclusion Adding aqua therapy resistance exercise to routine physical therapy might be more effective in decreasing the limb volume and pain intensity and improving ROM of the shoulder in postmastectomy lymphedema.
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Affiliation(s)
- Khadra Mohamed Ali
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Eid Rizk El Gammal
- Department of Oncosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hadaya Mosaad Eladl
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Salacinski AJ, Doyle EJ, Damon R, Acevedo RA, Broeder CE. Effects of 12 weeks of water aerobics on body composition in those affected by breast cancer. Support Care Cancer 2020; 29:1205-1212. [PMID: 32607599 DOI: 10.1007/s00520-020-05596-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 06/23/2020] [Indexed: 11/30/2022]
Abstract
Exercise may prevent changes in body composition and provide an effective means of improving the side effects of treatment without causing lymphedema. PURPOSE Test the effectiveness of a 12-week water aerobics program on body composition and lymphedema risk in breast cancer survivors. METHODS Body composition analysis was completed at weeks 0, 6, and 12 weeks. RESULTS Ten females completed all testing. Baseline subject characteristics were as follows: age (59.40 ± 8.22 years), weight (169.91 ± 41.70 lbs), body fat percent (%BF) (40.15 ± 9.84%), body fat mass (BFM) (71.27 ± 31.50 lbs), lean body mass (LBM) (98.66 ± 13.24 lbs), skeletal muscle mass (SMM) (53.17 ± 8.09 lbs), intracellular water (ICW) (44.24 ± 6.18 lbs), and extracellular water (ECW) (28.91 ± 3.62 lbs). One-way ANOVA showed no statistically significant differences over time as determined for weight (F(2.27) = 0.002, P = 0.96), %BF (F(2.27) = 0.004, P = 0.97), BFM (F(2.27) = 0.001, P = 0.97), LBM (F(2.27) = 0.013, P = 0.95), SMM (F(2.27) = 0.027, P = 0.91), ICW (F(2.27) = 0.021, P = 0.93), and ECW (F(2.27) = 0.01, P = 0.94) across the 12 weeks. CONCLUSIONS A water aerobics program for 12 weeks was not enough to observe changes in body composition nor did it increase the risk for lymphedema and may be a safe exercise method for breast cancer survivors.
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Affiliation(s)
- A J Salacinski
- Department of Movement, Sport and Leisure Studies, Westfield State University, Woodward Center 215, Westfield, MA, 01086, USA.
| | - E J Doyle
- Department of Movement, Sport and Leisure Studies, Westfield State University, Woodward Center 215, Westfield, MA, 01086, USA
| | - R Damon
- Department of Nursing, American International College, Springfield, MA, USA
| | - R A Acevedo
- Department of Physical and Chemical Sciences, Westfield State University, Westfield, MA, USA
| | - C E Broeder
- Exercising Nutritionally, LLC, Lisle, IL, USA
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Río-González Á, Molina-Rueda F, Palacios-Ceña D, Alguacil-Diego IM. Comparing the experience of individuals with primary and secondary lymphoedema: A qualitative study. Braz J Phys Ther 2020; 25:203-213. [PMID: 32518025 DOI: 10.1016/j.bjpt.2020.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 04/09/2020] [Accepted: 05/20/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Lymphoedema is a chronic condition that has significant detrimental impact on patients' quality of life. Secondary lymphoedema often results from anti-tumour treatment, in contrast to primary lymphoedema which is the result of genetic abnormalities that leads to an abnormal development of the lymphatic system. OBJECTIVE To describe and compare the experience of individuals with primary and secondary lymphoedema. METHODS A total of 19 patients (mean ± standard deviation age: 56.7 ± 16.2 years), 8 with primary and 11 with secondary lymphoedema, participated in this qualitative phenomenological study. Purposeful sampling method was applied. We recruited participants from specialised lymphoedema units of two physical therapy clinics and the Lymphoedema Patient Association in Spain. Data collection methods included unstructured and semi-structured interviews. An inductive thematic analysis was used. RESULTS The findings suggest differences between the experience of living with primary or secondary lymphoedema. Also, those with lower extremity lymphoedema have more pain, fatigue, and functional limitations. Three primary themes emerged: "Emotional challenge", "Adapting your life to a new situation," and "lymphoedema management". CONCLUSIONS The experience of living with lymphoedema involves aspects of fear, suffering, coping, and management of the disease and differs between secondary and primary causes. However, it seems to be more dependent on its location than its cause.
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Affiliation(s)
- Ángela Río-González
- School of Sport Science and Physical Therapy, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Francisco Molina-Rueda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
| | - Isabel Mª Alguacil-Diego
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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Ferreira CHJ, Driusso P, Bø K. The Brazilian Journal of Physical Therapy (BJPT) Special Issue on Women's Health Physical Therapy. Braz J Phys Ther 2019; 23:77-78. [PMID: 30904128 DOI: 10.1016/j.bjpt.2019.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 02/26/2019] [Indexed: 11/27/2022] Open
Affiliation(s)
- Cristine Homsi Jorge Ferreira
- Department of Health Science, Postgraduation Program in rehabilitation and functional performance, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.
| | - Patrícia Driusso
- Department of Physical Therapy, Postgraduation Program in Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Kari Bø
- Norwegian School of Sports Science, Oslo, Norway
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