Comparive Effect of Complex Decongestive Physical Therapy Alone and Along with Intermittent Pneumatic Compression Pump on Shoulder Range of Motion, Heaviness, and Upper Extremity Circumfference in Patients with Secondary Upper Extremity Lymphedema Post Breast Cancer Tretments

Breast cancer is the most common cancer type among women and one of its complications is ipsilateral upper extremity lymphedema. Lymphedma is a chronic condition of lymphatic system that leads to swelling of the involved extremity and, if left untreated, leads to limitation in shoulder range of motion, dysfunction, and feeling of heaviness in the upper limb. The aim of the present study was to compare the effect of complex decongestive physical therapy with combination of intermittent pneumatic compression pump and complex decongestive physical therapy on shoulder range of motion, heaviness and upper extremity circumfference in patients with secondary upper extremity lymphedema post.

A total of 20 female participants with scondary upper extremity lymphedema were selected after breast cancer treatments, reffered by general and cancer surgeons, according to inclusion and exclusion criteria. After the initial assessment, participants were randomly divided into two groups. Participants in the first group were only treated with complex decongestive physical therapy techniques and patients in the second group, in addition to complex decongestive physical therapy techniques, were trated with intremittent compression pump. These techniques include manual lymphatic drainage, bandaging, therapeutic exercise, and skin care and intremittent compression pump. Patients were treated for 2 weeks, 5 days per week. Involved extremity circumference, intensity of limb heaviness, and shouldre range of motion were measured prior to and after the treatment. Also, limb heaviness was evaluated using Visual Analog Scale.

No significant difference was found in the demographic characteristics between the two groups. Following two weeks of treatment, the mean of affected limb circumference in total areas showed statistically significant decrease after treatment compared to that priro to the treatment and heaviness intensity showed statistically significant decrease after treatment compared to that before the treatment. The means of shoulder abduction and flexion showed statistically significant increase after treatment compared to those before treatment in both groups. In addition, there was no significant difference in the means of affected limb circumference and shoulder range of motion between the two groups. However, a statistically significant difference was found in the mean of heaviness intensity between the two groups.

The results of the current study showed, the combination of complex decongestive physical therpy and intremittent compression pump are useful as a means of improving affected limb circumference, intensity of heaviness, and shoulder range of motion.