[KSCI] Korea Science Citation Index Service

http://dx.doi.org/10.14474/ptrs.2022.11.4.464

Effect of Cytoskeletal Manual Therapy, a Novel Soft Tissue Mobilization Technique, on Axillary Web Syndrome after Axillary Lymph Node Dissection: A Case Report

Hyun-Joong Kim (Neuromusculoskeletal Science Laboratory)
Seong-Hyeok Song (Ez Rehabiliatation Medical Center)
Seungwon Lee (Department of Physical Therapy, Sahmyook University)

Publication Information

Physical Therapy Rehabilitation Science / v.11, no.4, 2022 , pp. 464-470 More about this Journal

Abstract

Objective: Axillary web syndrome (AWS) is a condition comprising fibrous band-like cords that appear in the axilla of patients after axillary lymph node dissection (ALND) during breast cancer surgery and result in pain and reduced mobility. The cords appearing with AWS are hardened veins or lymphatic vessels. Manual therapy and stretching are recommended for pain control and mobility improvement. Therefore, this study investigated the effect of cytoskeletal manual therapy (CMT), which is a new soft tissue mobilization technique. Design: A case report Methods: A 41-year-old woman with AWS after breast cancer surgery and ALND visited a physical therapy clinic because of shoulder pain, decreased function, and decreased mobility. The cords were palpable and pain occurred 2 weeks after surgery. CMT was performed three times per week for a total of 6 weeks. Her pain intensity, range of motion (ROM), and shoulder function were measured. Results: Measurements were performed after 2 weeks and 6 weeks of CMT and evaluated using the numeric pain rating scale (NPRS). Her pain intensity largely decreased after 2 weeks (4-point score reduction) and after 6 weeks (5-point score reduction) of CMT. After CMT, her full ROM was restored and her shoulder function was improved (7-point score reduction). Conclusions: CMT is effective for pain control, mobility improvement, and functional improvement of patients with AWS.

Keywords

breast neoplasms; lymph node excision; postoperative care; musculoskeletal manipulations;

Citations & Related Records

Times Cited By KSCI : 5 (Citation Analysis)

Reference
Cited By KSCI

1	Fourie W, Robb K. Physiotherapy management of axillary web syndrome following breast cancer treatment: discussing the use of soft tissue techniques. Physiother. 2009;95:314-20. DOI
2	Reedijk M, Boerner S, Ghazarian D, McCready D. A case of axillary web syndrome with subcutaneous nodules following axillary surgery. Breast. 2006;15:410-2. DOI
3	Tilley A, Thomas-MacLean R, Kwan W. Lymphatic cording or axillary web syndrome after breast cancer surgery. Can J Surg. 2009;52:E105.
4	Koehler L, Haddad T, Hunter D, Tuttle T. Axillary web syndrome following breast cancer surgery: symptoms, complications, and management strategies. Breast Cancer. 2018:13-9.
5	Michener LA, Snyder AR, Leggin BG. Responsiveness of the numeric pain rating scale in patients with shoulder pain and the effect of surgical status. J Sport Rehabil. 2011;20.
6	Mintken PE, Glynn P, Cleland JA. Psychometric properties of the shortened disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) and Numeric Pain Rating Scale in patients with shoulder pain. J Shoulder Elbow Surg. 2009;18: 920-6. DOI
7	Norkin CC, White DJ. Measurement of joint motion: a guide to goniometry: FA Davis; 2016.
8	Mullaney MJ, McHugh MP, Johnson CP, Tyler TF. Reliability of shoulder range of motion comparing a goniometer to a digital level. Physiother Theory Pract. 2010;26:327-33. DOI
9	Veeger H, Van Der Helm F. Shoulder function: the perfect compromise between mobility and stability. J Biomech. 2007;40:2119-29. DOI
10	McDowell JM, Johnson GM, Hetherington BH. Mulligan concept manual therapy: standardizing annotation. Man Ther. 2014;19:499-503. DOI
11	Kim Y, Lee G. Immediate effects of angular joint mobilization (a new concept of joint mobilization) on pain, range of motion, and disability in a patient with shoulder adhesive capsulitis: a case report. Am J Med Case Rep. 2017;18:148.
12	George JW, Tunstall AC, Tepe RE, Skaggs CD. The effects of active release technique on hamstring flexibility: a pilot study. J Manipulative Physiol Ther. 2006;29:224-7. DOI
13	Adler SS, Beckers D, Buck M. PNF in practice: an illustrated guide: Springer; 2007.
14	Kim H, Lee S. The Efficacy of Pain Neuroscience Education on Active Rehabilitation Following Arthroscopic Rotator Cuff Repair: A CONSORT-Compliant Prospective Randomized Single-Blind Controlled Trial. Brain Sci. 2022;12:764.
15	Han J, Stegen K, Schepers R, Van den Bergh O, Van de Woestijne K. Subjective symptoms and breathing pattern at rest and following hyperventilation in anxiety and somatoform disorders. J Psychosom Res. 1998;45:519-32. DOI
16	Tweeddale P, Rowbottom I, McHardy G. Breathing retraining: Effect on anxiety and depression scores in behavioural breathlessness. J Psychosom Res. 1994;38:11-21. DOI
17	Kim H, Lee S. Effects of pain neuroscience education on kinesiophobia in patients with chronic pain: a systematic review and meta-analysis. Phys Ther Rehabil Sci. 2020;9:309-17.
18	Kim H, Song S, Lee S, Lee S. Short-term effects of joint mobilization with versus without voluntary movement in patients with chronic ankle instability: A single-blind randomized controlled trial. Phys Ther Rehabil Sci. 2021;10:1-9. DOI
19	Curtis A, Seehar G. The control of cell division by tension or diffusion. Nature. 1978;274:52-3. DOI
20	Davidson JM, Broadley KN, Quaglino D. Reversal of the wound healing deficit in diabetic rats by combined basic fibroblast growth factor and transforming growth factor-1 therapy. Wound Repair Regen. 1997;5:77-88. DOI
21	Langevin HM, Storch KN, Snapp RR, Bouffard NA, Badger GJ, Howe AK, et al. Tissue stretch induces nuclear remodeling in connective tissue fibroblasts. Histochem Cell Biol. 2010;133:405-15. DOI
22	Nekouzadeh A, Pryse KM, Elson EL, Genin GM. Stretch-activated force shedding, force recovery, and cytoskeletal remodeling in contractile fibroblasts. J Biomech. 2008;41:2964-71. DOI
23	Cho Y, Do J, Jung S, Kwon O, Jeon JY. Effects of a physical therapy program combined with manual lymphatic drainage on shoulder function, quality of life, lymphedema incidence, and pain in breast cancer patients with axillary web syndrome following axillary dissection. Support Cancer Ther. 2016;24:2047-57. DOI
24	Langevin HM, Bouffard NA, Fox JR, Palmer BM, Wu J, Iatridis JC, et al. Fibroblast cytoskeletal remodeling contributes to connective tissue tension. J Cell Physiol. 2011;226:1166-75. DOI
25	Kim S, Kim H-J. Effects of Manual Therapy on Upper Extremity Pain after Breast Cancer Surgery: A Systematic Review and Meta-analysis. Phys Ther Rehabil Sci. 2021;10:343-50.
26	De Groef A, Van Kampen M, Vervloesem N, Dieltjens E, Christiaens M-R, Neven P, et al. Effect of myofascial techniques for treatment of persistent arm pain after breast cancer treatment: randomized controlled trial. Clin Rehabil. 2018;32:451-61. DOI
27	Serra-Ano P, Ingles M, Bou-Catala C, Iraola-Lliso A, Espi-Lopez GV. Effectiveness of myofascial release after breast cancer surgery in women undergoing conservative surgery and radiotherapy: a randomized controlled trial. Support Cancer Ther. 2019;27:2633-41. DOI
28	Beurskens CH, van Uden CJ, Strobbe LJ, Oostendorp RA, Wobbes T. The efficacy of physiotherapy upon shoulder function following axillary dissection in breast cancer, a randomized controlled study. BMC Cancer. 2007;7:1-6. DOI
29	Shamley DR, Barker K, Simonite V, Beardshaw A. Delayed versus immediate exercises following surgery for breast cancer: a systematic review. Breast Cancer Res Treat. 2005;90:263-71. DOI
30	Bendz I, Olsen MF. Evaluation of immediate versus delayed shoulder exercises after breast cancer surgery including lymph node dissection-A randomised controlled trial. Breast. 2002;11:241-8. DOI
31	Risalda P, Phansopkar P, Naqvi WM. Effectiveness of active release technique verses conventional physiotherapy in management of upper cross syndrome. Indian J Forensic Med Toxicol. 2021;15:246-50.
32	Surmeli M, Cinar Ozdemir O. The effect of upper limb lymphedema in posture of patients after breast cancer surgery. J Back Musculoskelet Rehabil. 2022;35:829-37. DOI
33	McMahon PJ, Burkart A, Musahl V, Debski RE. Glenohumeral translations are increased after a type II superior labrum anterior-posterior lesion: a cadaveric study of severity of passive stabilizer injury. J Shoulder Elbow Surg. 2004;13:39-44. DOI
34	Izumi T, Aoki M, Muraki T, Hidaka E, Miyamoto S. Stretching positions for the posterior capsule of the glenohumeral joint: strain measurement using cadaver specimens. Am J Sports Med. 2008;36:2014-22. DOI
35	Cheville AL, Tchou J. Barriers to rehabilitation following surgery for primary breast cancer. J Surg Oncol. 2007;95:409-18.
36	Moskovitz AH, Anderson BO, Yeung RS, Byrd DR, Lawton TJ, Moe RE. Axillary web syndrome after axillary dissection. ANZ J Surg. 2001;181:434-9. DOI
37	Lauridsen MC, Christiansen P, Hessov I. The effect of physiotherapy on shoulder function in patients surgically treated for breast cancer: a randomized study. Acta Oncol. 2005;44:449-57. DOI
38	Dinas K, Kalder M, Zepiridis L, Mavromatidis G, Pratilas G. Axillary web syndrome: incidence, pathogenesis, and management. Curr Probl Cancer. 2019;43:100470.