Exercise benefits following breast cancer surgery – a narrative review

Mahalakshmi Venugopalan, Divya Varshini R, Ramamoorthy Veyilmuthu, C.K.V. Bhuvaneswari

Venugopalan, Divya Varshini R, Ramamoorthy Veyilmuthu, C.K.V. Bhuvaneswari – Exercise benefits following breast cancer surgery – a narrative review –  Fizjoterapia Polska 2024; 24(4); 392-395

DOI: https://doi.org/10.56984/8ZG01A8Z9Y3

Abstract
One of the most common cancer diseases among women is breast cancer. Treatment following breast cancer surgery leads to many complications. Exercises play an important role from the immediate post operative period which could help in preventing post-surgical complications. Prevention of complications improves the quality of life of women. Though women feel that performing exercises following treatment are difficult there are many positive effects of exercises. This current study was done with an objective to analyse the various effects of exercises especially on the resisted exercises in preventing Secondary lymphedema (SL) and to focus light on the benefits of the exercises during and after chemotherapy. Literature search of PubMed, Clinical Key and Google scholar was performed. For women recovering from breast cancer surgery, resisted exercises, either by themselves or in combination with aerobic exercises, were safe and effective. These exercises improved upper body strength, increased endurance, decreased adipose tissue, decreased waist and hip circumferences, increased lean body mass, improved cardiovascular fitness, improved self-esteem, and decreased depression. Women with breast cancer related lymphedema had a considerable improvement in pain after performing deep breathing exercises combined with upper limb movements. Exercise can help mitigate the negative effects of chemotherapy and helps to overcome cancer related fatigue. Along with conventional exercises including range of motion exercises and aerobic exercises, moderate-intensity upper body resistance exercises are recommended to be a part of exercise protocol prescribed and educated to the women following breast cancer surgery for them to lead a better quality of life.
Key words
Breast cancer, lymphedema, resisted, exercises, breathing, chemotherapy
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Effect of complete decongestive therapy on carpal tunnel syndrome post upper limb lymphedema

Sara Abd Elmohsen Ali El-Sayed, Haidy Nady Ashem, Yasser Mohammed Ahmed Abdelgwad, Mona Selim Mohamed Faggal, Khadra Mohamed Ali

Sara Abd Elmohsen Ali El-Sayed, Haidy Nady Ashem, Yasser Mohammed Ahmed Abdelgwad, Mona Selim Mohamed Faggal, Khadra Mohamed Ali – Effect of complete decongestive therapy on carpal tunnel syndrome post upper limb lymphedema –  Fizjoterapia Polska 2024; 24(3); 256-262

DOI: https://doi.org/10.56984/8ZG020AG0O

Abstract:
Purpose. To evaluate the therapeutic effects of CDT on carpal tunnel syndrome post upper limb lymphedema.
Methods. A randomized controlled trial involving 60 female patients aged 40‑60 years with CTS post upper limb lymphedema was conducted. Patients were randomly assigned to two groups: Group A received CDT along with standard medical treatment, and Group B received medical treatment and bandaging. Outcomes measured included pain (Visual Analogue Scale), upper limb volume, grip strength, and nerve conduction studies.
Results. Both groups showed significant improvement post-treatment in all measured outcomes. However, Group A (CDT) exhibited significantly greater improvements in pain reduction, decrease in upper limb volume, increase in grip strength, and nerve conduction compared to Group B (medical treatment and bandaging).
Conclusion. CDT significantly enhances outcomes in patients with CTS post upper limb lymphedema compared to medical treatment and bandaging. Implementing CDT in standard care for these patients is recommended to improve quality of life and functional outcomes.

Keywords:
lymphedema, mastectomy, carpal tunnel syndrome (CTS)

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The assessment of the early rehabilitation’s impact on the level of disorders occurring and the process of reinnervation, on the example of facial twigs of the motor nerve in patients with craniofacial injuries

Szymon Tyszkiewicz, Patrycja Ujma, Dominik Szczeciński, Klaudia Szczygieł, Marcin Kozakiewicz


Szymon Tyszkiewicz, Patrycja Ujma, Dominik Szczeciński, Klaudia Szczygieł, Marcin Kozakiewicz – The assessment of the early rehabilitation’s impact on the level of disorders occurring and the process of reinnervation, on the example of facial twigs of the motor nerve in patients with craniofacial injuries. Fizjoterapia Polska 2022; 22(4); 128-141

DOI: https://doi.org/10.56984/8ZG1A6t5I

Abstract
Introduction. Lymphoedema of the skull’s facial part is one of the main complications observed in a patient after surgical treatment of disorders of this area. Another noticeable and frequently reported complication by the patient is irregularities in facial expression muscles’ work. A relationship between them and reducing edema performed in patients in the first days after surgery will reduce the noted disturbances in motor branches’ function.
Aim. To investigate the impact of early swelling reduction on the extent of nervous system disorders and its reinnervation rate.
Materials and methods. Patients of the Maxillofacial Surgery Clinic of the University Clinical Hospital of the Military Medical Academy in Łódź were enrolled in the study. The study was conducted on 60 people who underwent maxillofacial surgery procedures from February to December 2019. Lymphatic drainage and dynamic taping were used to reduce patients’ edema. Forty-five people were divided into three equal groups. Fifteen patients constituted the comparative group. The research tools were a survey created following the author’s idea, linear measurements for measuring edema, and the Pietruski scale for assessing the state of reinnervation imaged by mimic muscle motility. On the first day after surgery, patients were examined four times, then on the third and seventh day after surgery, and finally four months after surgery.
Results. The use of anti-edema therapy noticeably (from 2-5 points on the Pietruski scale) reduces the disturbances in facial expression muscles’ function. The difference has been visible already on the third day after surgery. Regarding the patient’s pain, the lack of manual lymphatic system development resulted in pain sensations remaining in each of the three tests performed. The occurrence of edema, pain level, and level of facial expression muscle disorders were similar between groups and made the following research objective in terms of observed relationships.
Conclusions. The level of disturbances in the area of the mobility of expressive facial muscles (based on Pietruski scale) indicates that the implementation of anti edematous therapy, and thus the reduction of excess lymph, already in the first days after surgery provides a reduction of disorders of conduction of efferent impulses of motor fibers, appearing already in the first days after surgery. Increased drainage rate also accelerates the reinnervation process, shortens it by several weeks, and reduces pain symptoms.

Key words:
reinnervation, facial nerve, lymphatic oedema, dental physiotherapy

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The effectiveness of conservative methods of rehabilitation (PT) in treatment of lymphoedema after mastectomy operation

Dorota Hanasz-Sokołowska, Urszula Kaźmierczak, Wojciech Hagner, Magdalena Kaźmierczak

Dorota Hanasz-Sokołowska, Urszula Kaźmierczak, Wojciech Hagner, Magdalena Kaźmierczak – The effectiveness of conservative methods of rehabilitation (PT) in treatment of lymphoedema after mastectomy operation. Fizjoterapia Polska 2006; 6(1); 67-72

Abstract

Background. The aim of our research was to evaluate the effectivness of two methods of treatment of the lymphoedema after mastectomy operation. Method number 1 – classic method in treatment of lymphoedema after mastectomy operation. Treatment by using: lymphatic drainage, pneumatic massage, exercises in series 10/ 3 times a week. Method number 2 – complex methods that helps in restoration of patency: lymphatic drainage, pneumatic massage, exercises, bandaimy the upper limb, where lymphoedema appeared in series 10, 5 times a week. The examination aim was to evaluate subside of pain druing process of decreasing of lymphoedema. Material and methods. In our research we examinated patients with lymphoedema of upper limb after mastectomy operation, who were treated in Wojewódzkie Centrum Onkologii in Gdansk. Patients were devided into two groups of 15 patients each. In first group patients were treated in serie of 10, 3 times a week by classic method used: lymphatic drainage, pneumatic massage, exercises. In second group patients were treated by complex method of treatment, in series of 10, 5 times a week, by using classic treatment and adding the bandainy of upper limb, were lymphoedema appeared after operation. Results. Treatment of lymphoedema by using two methods had influence on our final results. Lymphoedema in group number 1, who were treated by classic method was located on level of forearm and elbow point. Lymphoedema in group number 2, who were treated by complex method was located over decvanon of vinov bone. Conclusions. Our research shows that conservative methods of rehabilitation had influence in process of decreasing lymphoedema, also helped to relieve pain in upper limb. The complex method is very effective treatment in lymphotic restor patency process.

Key words:
mastectomy, lymphoedema, rehabilitation
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The influence of kinesiotaping applications on lymphoedema of an upper limb in women after mastectomy

Anna Lipińska, Zbigniew Śliwiński, Wojciech Kiebzak, Tomasz Senderek, Janusz Kirenko

Anna Lipińska, Zbigniew Śliwiński, Wojciech Kiebzak, Tomasz Senderek, Janusz Kirenko – The influence of kinesiotaping applications on lymphoedema of an upper limb in women after mastectomy. Fizjoterapia Polska 2007; 7(3); 258-269

Abstract
Background. Doctor Kenzo Kase is a creator of the method Kinesio Taping. In the course of years-lasting experiences he worked out a plaster called Kinesio Tex, which applied during therapy in the form of application affects a patient not only during a visit, but also after its finishing supporting autotherapy of an organism. The usage of the method of kinesiotaping at women after mastectomy influences on the decrease of oedema lymphatic and normalization of muscular tension. Material and methods. Researches were conducted in Rehabilitation Ward of Swiętokrzyskie Oncology Centre in the period from November 2006 to February 2007. The group consisted of 25 women at the age of 40 to 70 years old (the average of their age 55,16 years) treated because of breast cancer with oedema lymphatic. Every woman taking part in the experiment was subjected to kinesiotaping therapy. The research of measurement of oedema lymphatic, the muscular strength of indicated muscular structures as well as the range of movement in a humeral joint, elbow joint, wristradial joint were carried out in four series: before the first application (research I), before every next (research II, III) and after the last application (research IV). In the break between researches a patient was obliged to follow rules referring to behaviour after mastectomy. Results. Assessment of the efficiency of an upper limb at women after mastectomy shows that a 20 – day cycle of improving with the use of lymphatic applications of the kinesiotaping method considerably reduced oedema lymphatic which 24%, increases range of motion 20 % and normalization of muscular tension brings satisfactory therapeutic effects. Conclusions. Lymphatic applications accelerate lymphatic and venous microcirculation, reduces the stasis of lymph in intercellular spaces. Decrease of oedema contributes to the improvement of movement range in all joints of an upper limb and normalization of muscular tension con-tributing to the increase of muscular strengt.
Key words:
Kinesio Taping Method, lymphatic applications, mastectomy, lymphoedema
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The influence of systematic physiotherapy on upper limb function in post-mastectomy women

Ewa Puszczałowska-Lizis, Paweł Lizis

Ewa Puszczałowska-Lizis, Paweł Lizis – The influence of systematic physiotherapy on upper limb function in post-mastectomy women. Fizjoterapia Polska 2011; 11(1); 41-48

Abstract
The aim of this paper was to evaluate the effect of physiotherapy on upper limb function in post-mastectomy women. Thirty-three women attending the Amazons Post-Mastectomy Women’s Club at the Holy Cross Cancer Centre in Kielce were examined on two occasions at three months’ interval. The participants were divided into Group I of 15 patients regularly attending rehabilitation and Group II of 18 patients practicing rehabilitation occasionally. Bilateral measurement of the angular range of motion in the shoulder was the basic method of assessment. A shoulder range of motion of the upper limb on the operated side smaller by more than 10° in relation to the opposite limb was regarded as ROM limitation. Upper limb circumferences were also measured at 10 cm above and below the lateral humeral epicondyle and in the central metacarpus excluding the thumb to an accuracy of 1 mm. Circumferences of the upper limb on the operated side greater by more than 2 cm compared to the opposite limb were regarded as lymphoedema. Our evaluation of statistical significance of correlations between qualitative parameters (influence of rehabilitation on limitation of the shoulder range of motion and incidence of lymphoedema) relied on the non-parametric Chi-square test (χ²).There was a statistically significant correlation between regular rehabilitation practice and the shoulder range of motion and persistence of upper limb lymphoedema on the mastectomy side.Physiotherapy improves ROM and effectively prevents deterioration of upper limb lymphoedema in post-mastectomy women.
Key words:
breast cancer, mastectomy, shoulder joint, range of motion, lymphoedema
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Comprehensive draining therapy in the treatment of lymphoedema in women after mastectomy

Marek Woszczak, Katarzyna Syrewicz, Iga Woźniak, Łukasz Goździewicz, Katarzyna Bogacz, Karolina Kossakowska

M. Woszczak, K. Syrewicz, I. Woźniak, Ł. Goździewicz, K. Bogacz, K. Kossakowska – Comprehensive draining therapy in the treatment of lymphoedema in women after mastectomy. Fizjoterapia Polska 2019; 19(4); 28-40

Abstract
Introduction. Breast cancer is one of the most dangerous malignancies tumor, and the incidence of this disease is still growing. As a result of treatment and related removal or impairment of lymph node structure, a frequent complication is lymphoedema. There are many methods of treatment, however, the most recommended and currently the most effective is a complex decongestive therapy.
Purpose of this study. The aim of the study was to evaluate the effectiveness of complex decongestive therapy, its influence on the reduction of lymphoedema and the improvement of mobility and strength of the upper limb.
Materials and methods. The study was conducted on a group of 60 women after unilateral mastectomy at the Świętokrzyski Oncology Center in Kielce. The examined patients were divided into two groups: research and control. In the study group consisting of 30 women, KFTU treatments were performed, while other rehabilitation procedures were performed. The therapeutic cycle lasted 10 days. At the beginning and at the end of the treatment, the change in pain severity was assessed on the VAS scale and the range of motion was measured using the goniometric method, the limb circumferences were measured with a centimeter tape and SUR was measured using a dynamometer.
Results. In both groups, after the end of the therapy, all parameters were improved, but in the research group where a complex decongestive therapy was used, the effect was more noticeable. In the study group there was a significant decrease in pain sensation, decreased limb circumference and visible improvement in strength and range of motion.
Conclusions.The use of both methods of treatment brings effects in the form of reduction of lymphatic edema, however, a complex decongestive therapy is a more effective method of improvement.

Key words:
mastectomy, comprehensive draining therapy, lymphoderma

 

 

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Comparison of circumference of women’s upper limbs after radical breast amputation subjected and not subjected to early professional rehabilitation

Elżbieta Niedbała, Leszek Kołodziejski

E. Niedbała, L. Kołodziejski – Porównanie obwodów kończyn górnych u kobiet po radykalnym leczeniu raka piersi korzystających i nie korzystających z wczesnej profesjonalnej rehabilitacji. FP 2013; 13(4); 37-43

Abstract

Removing the lymphatic system of the armpit during the radical mastectomy hinders the outflow of lymph from the upper limb. Aim of the work. The aim of this report is to compare the circumference of women’s upper limbs post-surgical breast cancer undergone to early professional and unprofessional rehabilitation. Material and methods. A group of 146 members of Amazon Club subjected to radical breast amputation by Maddens methods between 2002-2009, have been evaluated. 71 patients from Malopolska (M group) were operated on in the Oncological Centre of Krakow (OCK) and 75 from Świętokrzyskie (Ś group) were operated on in the Świętokrzyskie Oncological Centre in Kielce (SCO). For all the patients the same, standard oncological procedures were used. The only significant difference between the medical centres was the method of conducting early post operative rehabilitation. In the M group it was conducted by trained nurses and volunteers of Amazon Club and the patients continued their exercises on their own at home. In Ś group a complex rehabilitation in the stationary conditions was conducted by professional physiotherapists. Data of all the women have been obtained including the patients’ age, past treatment and rehabilitation or the circumference of upper limbs were done. Women from both groups (M i S) were compared regarding antropometric features, past treatment and circumference of upper limbs and development of lymphedema. Results. In spite of the considerable difference in the method of early postoperative rehabilitation the patients from M i S did not differ significantly as regards circumference of their upper limbs, occurrence and volume lymphedema on the operated side.
Conclusions:
1. At women after radical mastectomy subjected to the early professional and unprofessional rehabilitation, in the late period of observation, the circumference of their upper limbs were the similar.
2. In both groups M i S the percentage of women with lymphedema was low.

Key words:
mastectomy, circumference upper limbs, lymphedema

Physiotherapy in the treatment of lymphoedema

Jacek Kultys, Teresa Pop, Ryszard Bielak

J. Kultys, T. Pop, R. Bielak: Physiotherapy in the treatment of lymphoedema. Fizjoterapia Polska 2015;15(3);64-77

Abstract

Lymphoedema is a chronic disease caused by the malfunction of the lymphatic system, leading to the accumulation of lymph in the interstitial space. The consequence of a primary or secondary lymphoedema is an unesthetical appearance of the limb, limited activity, and sometimes a significant distortion with a deformation of osteoarticular structures and muscle atrophy. Emotional problems often appear, affecting interpersonal relationships and the quality of life of the patients. A complete decongestive physiotherapy is still considered to be the most effective method of conservative treatment of lymphoedema, where a corresponding plan and implementation of the treatment throughout different degrees of severity of the disease brings good therapeutic results.
Key words:
lymphoedema, treatment, complex decongestive physiotherapy

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Possible applications of dynamic taping in women after the removal of lymph nodes because of breast cancer

Anna Lipińska, Magdalena Lipińska-Stańczak, Paweł Macek, Renata Szczepaniak, Sławomir Jandziś, Zbigniew Śliwiński

A. Lipińska, M. Lipińska-Stańczak, P. Macek, R. Szczepaniak, S. Jandziś, Z. Śliwiński: Possible applications of dynamic taping in women after the removal of lymph nodes because of breast cancer. FP 2015;15(4);16-31

Abstract
Introduction. In Poland and in the world breast cancer is the most frequent malignancy among women. Complications occurring after the applied therapy lower the quality of patients’ life. One of the many adverse effects of breast cancer treatment is lymphedema. Removal of lymph nodes and damage to lymphatic vessels make the transport of high-molecular proteins difficult, and at the same time, they have an influence on an increase in the colloid-osmotic pressure, water retention in the inter-tissue space, the loss of lymphatic vascular tone and reduction of the hydrostatic pressure. If not treated, lymphedema causes ailments in the form of recurrent inflammatory conditions of the skin, lymphatic vessels, which greatly reduces the patients’ psychophysical efficiency and promotes the development of lymphosarcoma of the upper limb on the side of mastectomy. One of the methods of lymphedema treatment is Kinesiology Taping. In Poland, the term dynamic taping is more and more frequently used. Application of this method causes that healing processes occur in the patient in a painless and natural way.
Aim. To present the possibilities of using lymphatic techniques of dynamic taping in women after mastectomy and to assess the impact of the applications on the secondary lymphedema.  The author decided to verify the main objective through the following research hypotheses:
1.Applications of dynamic taping reduce lymphedema in women after mastectomy.
2.Techniques of the Kinesiology Taping method influence the change of motion ranges in the joints of the upper limb.
Material and research methods. The study was performed in the Department of Rehabilitation of Holycross Cancer Centre in Kielce. The study group consisted of 73 patients after mastectomy diagnosed with secondary lymphedema of the upper limb. The volume of upper limbs was measured with the use of a measuring cylinder filled with water. Measurements of motion ranges in the joints of upper limbs were performed with the use of a goniometer.
Results and conclusions. Analysis of the results shows that the employed lymphatic applications reduce lymphedema, increase the range of motion in the joints of the upper limb on the operated side and promote healing processes, contributing to the improvement of physical efficiency and the quality of life.

Key words:
breast cancer, lymphedema, dynamic taping, Kinesiology Taping

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