• Journal of the Korean Society of Physical Medicine
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• v.6 no.1
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• pp.31-38
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• 2011

Purpose : The purpose of this study was to examine the effect of upper extremity exercise and Bandage on the edema and range of motion. Complex decongestive physiotherapy was one of the latest methods to deal with the limitation of range of motion and the edema that were the prime problems of patients with lymphedema. Methods : Twenty patients undergone mastectomy were participated in this study voluntarily. They had lymphedema on upper extremity and partial limitation of range of motion. The subjects had been treated with upper extremity home exercise and complex decongestive physiotherapy with Bandage for 4 weeks. The measure of these patients with upper extremity edema was included: the volume, arm circumfenence and range of motion. These were measured two times: before the treatment, after 4 weeks of the treatment. Results : The upper extremity edema of patients treated home exercise group and complex decongestive physiotherapy group with Bandage was definitely decreased (p<0.05). Moreover, the upper volume of those who were the same condition also significantly shrank and patients' arm circumferences of upper arm breathtakingly diminished as well (p<0.05). But home exercise group patients' arm circumferences of forearm was not remarkable(p>0.05). However, patients' range of motion who were treated with upper extremity exercise were evidently increased when compared to that of the before treatment (p<0.05). Conclusion : Complex decongestive physiotherapy and bandage performed by physical therapist increased the ROM of upper arm and reduced the edema in patients with lymphedema.

• The Korean Journal of Pain
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• v.35 no.3
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• pp.280-290
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• 2022

Background: This study aimed to determine the impact of complex decongestive therapy applications on upper extremity function in breast cancer patients who developed adhesive capsulitis after lymphedema. Methods: Thirty patients who developed adhesive capsulitis due to lymphedema were divided into two groups as study (n = 15) and control (n = 15) groups. Both groups received 20 minutes of exercise five days a week for three weeks using a Biodex isokinetic dynamometer, as well as a hot pack and TENS (Transcutaneous Electrical Nerve Stimulation) treatment to the shoulder joint. The study group received 45 minutes of intensive decongestive therapy along with the adhesive capsulitis treatment. The visual analogue scale was used to assess pain, circumference, and volumetric measurements were used to assess edema, and the Arm, Shoulder, and Hand Problems Questionnaire (DASH: Disabilities of the Arm, Shoulder, and Hand) was used to assess upper extremity functionality. The shoulder range of motion was evaluated. Results: Both groups had improvements in pain (P < 0.001), shoulder joint range of motion (P < 0.001), and upper extremity functionality (P < 0.001) after the treatment. There was a significant decrease in circumference and volumetric measurements in the study group (P < 0.001). However, no differences were seen in measurements in the control group. Conclusions: The results showed that complex decongestive therapy was beneficial in reducing lymphedema in breast cancer patients who acquired adhesive capsulitis due to lymphedema. Consequently, the authors believe that supplementing conventional physiotherapy with complex decongestive therapy will benefit patients.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.2
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• pp.153-161
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• 2013

PURPOSE: This study aimed to investigate the effect of complex theraputic exercise on visual analog scale of pain, shoulder' range of motion for middle-aged women with breast cancer related lymphedema. METHODS: The 14 middle-aged women involved voluntary in this study and then they were divided into two groups(n =7 per group). The complex exercise program was implemented over 4 weeks, 60 minutes per day, with 3 types of exercise for stimulation whereas the control group was performed a classical decongestive physiotherapy in a same day. For data analysis, the mean and standard deviation were estimated; 2 way repeated measures ANOVA was carried out. RESULTS: First, The level of VAS was significantly reduced on time, interaction effect in the group. Second, most factors of ROM were significantly increased on time, interaction effect whereas extension was not significantly increased. CONCLUSION: In conclusion, Our results showed that complex therapeutic exercise could improve or maintain VAS and ROM of shoulder joint for middle-aged women with breast cancer related lymphedema.

• Physical Therapy Korea
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• v.6 no.3
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• pp.110-120
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• 1999

Lymphedema, regardless of etiology, is essentially incurable but different treatment approaches which serve to contain swelling exist. The objectives of treatment are to reduce swelling, restore shape, educate about the self-maintenance methods, and prevent inflammatory episodes, eg, recurrent cellulitis. The purpose of this report is to provide therapists and other medical staff with a general guideline through the example treatment procedure of two patients with lymphedema admitted to Samsung Medical Center. This study demonstrates the effects of the various treatments used and how they helped to achieve improvement in mobility and reduction in swelling of the lower limbs. The basic conservative treatments were sequential intermittent pneumatic pumps, elevation, and CDP (complex decongestive physiotherapy). The surgical procedures (Homan's operation) were carried out after maximal volume reduction through conservative programs. In these cases, we can see greater than 50% reduction in the lymphedema in those treated by conservative and surgical procedures. This presents a simple, reliable, variable method yielding satisfactory cosmetic and functional results for patients suffering from chronic both-leg lymphedema. Futhermore, I suggest that the outcomes are best when treatment is administered by a multidisciplinary team including a physiotherapist, surgeon, nurse, et al.

• Physical Therapy Korea
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• v.14 no.3
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• pp.1-8
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• 2007

The purpose of this study was to determine whether aromatherapy massages with manual lymph drainage (MLD) are significantly more effective than sham massages with MLD in reducing edematous limb volume in lymphedema. This study was performed on 46 patients who had developed unilateral upper or lower lymphedema. Twenty-three patients served as the experimental group and were treated with complex decongestive physiotherapy (CDP) applications including aroma massages with MLD, multi layered compression bandages, remedial exercises and skin care. Twenty-three patients in the control group were treated with CDP applications including sham massages with MLD, bandages, exercises and skin care. Patients undergo a therapy program once a day; 5 days a week for 2 weeks. Percentage excess volume (PEV) and body mass index (BMI) were recorded before and after treatment. PEV and BMI were significantly decreased before and after treatment in the experimental as well as in the control groups (p<.05). However, the percentage excess volume and BMI were not significantly improved after treatment between the two groups (p>.05). This study there suggests that aroma massages is not effective in the edema of patients with lymphedema.

• PNF and Movement
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• v.19 no.1
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• pp.19-29
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• 2021

Purpose: This study aimed to compare the effects of a four-week scapular stabilization exercise program using the PNF technique on scapular symmetry and range of flexion motion (ROM), pain, function, and quality of life (QOL) in post-mastectomy women with breast cancer. Methods: This study included 20 women divided into an experimental group (n = 10) and a control group (n = 10). All patients performed complex decongestive physiotherapy for 40 min daily, five times per week for four weeks. The experimental group performed the extra scapular stabilizing exercise program using the PNF technique for 50 min daily, five times per week for four weeks. Scapular symmetry, shoulder flexion ROM, pain and function, and QOL were subsequently assessed. For ROM measurement, the range of shoulder flexion was measured using a clinometer smart phone application; the pain of the shoulder was measured using the visual analogue scale (VAS); the scapular position was measured using a lateral scapular slide test (LSST); the level of pain and functional activity was measured using the Shoulder Pain and Disability Index (SPADI); and the QOL was measured using Functional Assessment of Cancer Therapy-Breast. Results: There were significant differences in shoulder flexion ROM, VAS, SPADI, and LSST 0˚ and 45˚ when the experimental group was compared with the control group (p < 0.05). After the intervention, there was an improved within-group change in the ROM, SPADI, LSST, and QOL in both the experimental and control groups. Conclusion: These findings suggest that a scapular stabilization exercise program using the PNF technique may be used as a possible treatment option for post-mastectomy women with breast cancer that aims to improve scapular position, shoulder ROM and function, and QOL.