scholarly journals Upper Limb Sensory Evaluations in Women With Breast Cancer Related Lymphedema Receiving Complex Decongestive Physiotherapy: An Ultrasonographic Study

2021 ◽  
Author(s):  
Emine Baran ◽  
Levent Özçakar ◽  
Serap Özgül ◽  
Sercan Aksoy ◽  
Türkan Akbayrak
Keyword(s):  
Breast Cancer ◽  
Upper Limb ◽  
Phase 1 ◽  
Subcutaneous Fat ◽  
Pressure Pain Threshold ◽  
Clinical Trial Registration ◽  
Tactile Localization ◽  
Complex Decongestive Physiotherapy ◽  
Registration Number ◽  
Breast Cancer Related Lymphedema

Abstract Purpose: The aim of this study was to investigate if/how the presence of lymphedema affected the sensation of the upper limb, and to assess whether complex decongestive physiotherapy (CDP) had a favorable impact on the sensory testings.Methods: A total of 27 patients with unilateral stage 2 breast cancer related lymphedema (BCRL) were included in the study. Bilateral ultrasonographic (epidermis, dermis, and subcutaneous fat thicknesses) and circumferential measurements were peformed at 10 cm distal to the elbow crease. Semmes-Weinstein monofilament (SWM), static and moving two-point discrimination, pressure pain threshold (PPT) and tactile localization tests were also applied at the same site. After their initial evaluation, all patients underwent CDP phase 1 program (five times a week, for three weeks). All the evaluations were repeated at the end of their treatment as well.Results: Before CDP, affected sides had significantly higher values than the unaffected sides in terms of SWM (p<0.001), static (p=0.002) and moving two-point discrimination (p=0.011), PPT (p=0.001), and tactile localization (p<0.001) values. After CDP, SWM (p=0.002), static (p=0.009) and moving two-point discrimination (p=0.024), PPT (p=0.014) and tactile localization (p<0.001) values decreased significantly on the affected sides.Conclusion: BCRL seem to reduce light touch, static and moving two-point discrimination, PPT and tactile localization sensations whereas CDP seems to improve these sensory perceptions in women with BCRL. Of note, ultrasonographic measurements also appear to be promising for prompt and convenient follow up in the management of these patients. Clinical Trial Registration Number: NCT04296929Date of registration: March 5, 2020

scholarly journals Electronic Moxibustion for Breast Cancer-Related Lymphedema: A Pilot Clinical Trial

2020 ◽  
Vol 19 ◽  
pp. 153473542096285
Author(s):  
Kyungsun Han ◽  
Ojin Kwon ◽  
Hyo-Ju Park ◽  
Ae-Ran Kim ◽  
Boram Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Range Of Motion ◽  
Upper Limb ◽  
Life Questionnaire ◽  
Breast Cancer Patients ◽  
Shoulder Range Of Motion ◽  
Breast Cancer Related Lymphedema ◽  
Shoulder Range

This is a preliminary study to investigate the feasibility of electronic moxibustion in breast cancer patients with upper limb lymphedema. As current treatment options for lymphedema are unsatisfactory and time consuming, there have been attempts to manage symptoms using integrative treatments. Electronic moxibustion was developed to compensate for the shortcomings of conventional moxibustion and is widely used in clinical practice. However, there have been no studies on using electronic moxibustion in breast cancer-related lymphedema. To investigate the feasibility of electronic moxibustion in treating breast cancer-related lymphedema, this study included subjects who completed primary cancer treatment at least 6 months ago and had more than 10 mm difference in arm circumference of upper limbs. All subjects were assigned to the treatment group. Subjects were treated with 16 sessions (30 minutes/session) of electronic moxibustion for 8 weeks followed by 4 weeks of follow-up. For outcome measures, upper limb circumferences, shoulder range of motion, bioimpedance analysis, and quality of life questionnaire were assessed. All 10 subjects completed the study. The effective index showed 38.21% reduction after treatment ( P = .0098) and 29.35% ( P = .0039) after 4 weeks of follow-up compared to the baseline. The reduction of lymphedema was most prominent at 10 cm above the elbow crease, where the mean reduction of circumference difference was 7.5 mm ( P = .0430) and continued to improve after treatment (mean reduction of 8.3 mm, P = .0156). There was significant improvement in shoulder range of motion only in flexion and internal rotation at week 9. There were 7 adverse events, and most were irrelevant to the treatment. Only 1 participant had a mild burn on the acupuncture point. Here, we demonstrate for the first time that electronic moxibustion treatment is a feasible treatment for breast cancer-related lymphedema. Electronic moxibustion may reduce differences in upper limb circumference and improve shoulder range of motion. A future comparative clinical trial is needed to confirm the clinical efficacy of this treatment.

Complex Decongestive Therapy Enhances Upper Limb Functions in Patients with Breast Cancer-Related Lymphedema

2018 ◽  
Vol 16 (5) ◽  
pp. 446-452 ◽  
Author(s):  
Didem Sezgin Ozcan ◽  
Meltem Dalyan ◽  
Sibel Unsal Delialioglu ◽  
Ulku Duzlu ◽  
Cemile Sevgi Polat ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Upper Limb ◽  
Complex Decongestive Therapy ◽  
Breast Cancer Related Lymphedema ◽  
Decongestive Therapy

scholarly journals Hand Passive Mobilization Performed with Robotic Assistance: Acute Effects on Upper Limb Perfusion and Spasticity in Stroke Survivors

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Massimiliano Gobbo ◽  
Paolo Gaffurini ◽  
Laura Vacchi ◽  
Sara Lazzarini ◽  
Jorge Villafane ◽  
...  
Keyword(s):  
Upper Limb ◽  
Near Infrared ◽  
Muscle Tone ◽  
Joint Stiffness ◽  
Tissue Perfusion ◽  
Robotic Assistance ◽  
Acute Effects ◽  
Clinical Trial Registration ◽  
Registration Number ◽  
Passive Mobilization

This single arm pre-post study aimed at evaluating the acute effects induced by a single session of robot-assisted passive hand mobilization on local perfusion and upper limb (UL) function in poststroke hemiparetic participants. Twenty-three patients with subacute or chronic stroke received 20 min passive mobilization of the paretic hand with robotic assistance. Near-infrared spectroscopy (NIRS) was used to detect changes in forearm tissue perfusion. Muscle tone of the paretic UL was assessed by the Modified Ashworth Scale (MAS). Symptoms concerning UL heaviness, joint stiffness, and pain were evaluated as secondary outcomes by self-reporting. Significant (p=0.014) improvements were found in forearm perfusion when all fingers were mobilized simultaneously. After the intervention, MAS scores decreased globally, being the changes statistically significant for the wrist (from 1.6±1.0 to 1.1±1.0; p=0.001) and fingers (from 1.2±1.1 to 0.7±0.9; p=0.004). Subjects reported decreased UL heaviness and stiffness after treatment, especially for the hand, as well as diminished pain when present. This study supports novel evidence that hand robotic assistance promotes local UL circulation changes, may help in the management of spasticity, and acutely alleviates reported symptoms of heaviness, stiffness, and pain in subjects with poststroke hemiparesis. This opens new scenarios for the implications in everyday clinical practice. Clinical Trial Registration Number is NCT03243123.

scholarly journals Upper extremity function and quality of life in patients with breast cancer related lymphedema

2016 ◽  
Vol 73 (9) ◽  
pp. 825-830 ◽  
Author(s):  
Dragana Bojinovic-Rodic ◽  
Svetlana Popovic-Petrovic ◽  
Sanja Tomic ◽  
Stanislava Markez ◽  
Dobrinka Zivanic
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Mental Health ◽  
Upper Extremity ◽  
Upper Limb ◽  
Limb Function ◽  
Upper Limb Function ◽  
Upper Extremity Function ◽  
Breast Cancer Related Lymphedema

Background/Aim. Upper limb lymphedema is one of the most frequent chronic complications after breast cancer treatment with a significant impact on the upper extremity function and quality of life (QoL). The aim of this study was to estimate health-related quality of life (HRQoL) in patients with breast-cancer-related lymphedema and its correlation with upper limb function and the size of edema. Methods. The cross-sectional study included 54 breast-cancer-related lymphedema patients. The quality of life was evaluated by the Short Form 36-Item Health Survey (SF-36). Upper limb function was assessed by the Quick Disability of the Arm, Shoulder and Hand questionnaire (Quick DASH). The size of lymphedema was determined by the arm circumference. Results. The higher HRQoL score was assessed for mental health (47.0 ? 12.2) than for physical one (42.2 ? 7.5). The highest values of SF-36 were found in the domains of Mental Health (67.7 ? 22.9) and Social Function (70.1 ? 23.1). The lowest scores were registered in the domains of Role Physical (46.9 ? 39.1) and General Health (49.3 ? 20.1). Upper extremity function statistically significantly correlated with the domains Role Physical, Bodily Pain and Physical Composite Summary and also, with the domain Role Emotional (p < 0.01). There was no statistically significant correlation between size of lymphedema and tested domains of quality of life (p > 0.05). Conclusions. Physical disability in patients with breast cancer-related lymphedema influences quality of life more than mental health. Upper limb function has a significant impact on quality of life, not only on the physical, but also on the mental component. The presence of breast-cancer-related lymphedema certainly affects upper limb function and quality of life, but in this study no significant correlation between the size of edema and quality of life was found.

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