Effects of gradient pressure treatment on rehabilitation of the affected limb function and lymphedema in post-operation patients with breast cancer
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Abstract:
Objective
To explore the effects of gradient pressure treatment on rehabilitation of limb function and lymphedema in post-operation patients with breast cancer.
Methods
A total of 567 patients with modified radical mastectomy for breast cancer were randomly divided into experimental group (284 cases, routine nursing for breast and functional rehabilitation exercises guided by professional nurses at early stage after operationan and gradient pressure treatment) and control group (283 cases, routine nursing for breast and functional rehabilitation exercises guided by professional nurses at early stage after operation). Shoulder mobility and incidence rate of lymphedema were all observed at 5 weeks and 12 weeks after operation.
Results
The shoulder mobility in experimental group [(26.17±4.77)° for adduction, (70.13±10.55)° for outreach, (142.54±6.09)° for forward bend and upward lift, (36.47±2.86)° for extension] was superior to that in the control group (F=261.27, 31.62, 46.03, 33.37; P<0.01). 5 weeks after operation, but affected limb function was almost same in two groups 12 weeks after operation. The incidence rate of lymphedema was 7.04% in the experimental group and 16.61% in the control group 12 weeks after operation with statistically significant difference (χ2=12.447, P<0.01).
Conclusions
Gradient pressure treatment applied for post-operation patients with breast cancer can improve limb function and decrease the incidence rate and degree of lymphedema, so as to improve patients′ life quality.
Key words:
Breast neoplasms; Lymphedema; Affected limb function; Gradient pressure treatmentKeywords:
Modified Radical Mastectomy
Radical mastectomy
Objectives: Lymphedema is a communal issue in breast cancer patients. This study was designed to evaluate the effectiveness of compression therapy and exercise in the treatment of lymphedema in breast cancer patients.Materials and Methods: Thirty patients were randomly assessed in a randomized controlled study trial at the Department of Oncology, Mayo Hospital Lahore. Patients were divided into two groups. Fifteen patients were selected in Group 1 (compression therapy), and 15 patients were selected in Group 2 (compression therapy along with exercise). Both groups received eight sessions for 4 weeks followed by one session in each week. Limb circumferential measurements were used to assess the limb volume reduction and pain numeric rating scale for pain and shoulder pain and disability index scale for the pain and disability. Data were collected at baseline and after 4 weeks.Results: Statistically significant improvement was found in both groups (P > 0.05). However, no group difference was insignificant. However, clinically, the compression bandage along with exercise and skin care is more effective in reducing lymphedema in breast cancer patients.Conclusion: This study concluded that both the treatment techniques, compression bandage and compression bandage along with exercise are effective in reducing lymphedema and pain; but, clinically, compression bandage along with exercise is more effective.
Compression Bandage
Compression Therapy
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Objective: To evaluate rehabilitation after breast cancer care and rehabilitation intervention for patients with limb function.Methods: 66 patients after radical mastectomy were randomly divided into treatment group and control group,33 patients in each group;observation group after psychological intervention,and limb functional training plan based on individual counseling;the control group routine postoperative rehabilitation care.Results: The group of upper limb dysfunction in 4 cases,12 patients in the control group,there was a significant difference(χ2=6.82,P0.05);the observation group of lymph node swelling occurred in 2 cases,9 cases of the control group,there was a significant difference(χ2=5.35,P0.05);the observation group patients side of the upper extremity activity recovery adduction,abduction,flexion,extension was(33.25±3.12)°,(103.53±18.67)°,(118.38±18.55)°,(41.27±1.38)°,control group was(30.01±2.16)°,(72.71±10.24)°,(92.35±13.67)°,(25.37±1.22)°,there were significant differences(t=2.893,3.947,4.235,3.547,all P0.05).Conclusion: Rehabilitation after radical mastectomy for nursing intervention,useful limb functional recovery,helping patients to achieve physical,psychological and social overall recovery.
Modified Radical Mastectomy
Radical mastectomy
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Background and purpose: One of the most common side effects in breast cancer treatment is the same side upper extremity lymphedema. Secondary lymphedema is a chronic disease which leads to low function of the limb and loss of beauty. The purpose of the current research is to study the effect of 8 weeks of aerobic exercise on the size of lymphedema in patients suffering upper extremity secondary lymphedema after breast cancer treatments. 30 female patients affected by upper extremity secondary lymphedema after breast cancer treatments were divided into two groups of control group (15) and experimental group (15) with the introduction of the surgeon and cancer specialists based on inclusion and exclusion criteria. The experimental group participated in 8 weeks of exercise held three sessions a week, including a 10 minute warm- up and stretching, 20 minutes of cycling on a bicycle ergo meter with an intensity of 55 to 70 percent target heart beat and then cooling down by stretching. Findings of the present research showed that compared to the control group, there was a significant decrease in the size of lymph edema of experimental group (p<0.05). Results of this research revealed that using aerobic exercise can decrease the upper extremity lymphedema size.
Secondary lymphedema
Aerobic Exercise
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Objective To observe the influence of upper limb training on the functional rehabilitation in post-operation breast cancer patients.Methods Ninety-eight cases of breast cancer patients after adjuvant chemotherapy were divided into two groups:49 cases were in control group and 49 cases were in experimental group.Upper limb function was measured after 28 days of surgery and at the end of adjuvant chemotherapy respectively.Patients did upper limb training by themselves in control group and did upper limb training according to the rehabilitation gymnastics designed by our department in experimental group.The results of functional rehabilitation were evaluated after 6 cycles' adjuvant chemotherapy.Results Functional rehabilitation on shoulder abduction angles and muscle strength of patients in experimental group showed advantages over that of control group(P0.05).Conclusion The upper limb training was effective for the functional rehabilitation in post-operation breast cancer patients.
Adjuvant Chemotherapy
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Background: Lymphedema caused by breast cancer is one of the side effects of therapy. It is defined as arm edema in breast cancer patients caused by surgery or radiation therapy interrupting the flow of the axillary lymphatic system, resulting in fluid accumulation in the subcutaneous tissue of the arm, decreased tissue distensibility around the joints, and increased weight of the extremity. Objective: This study was conducted to detect the effect of combination of intermittent pneumatic compression and kinesiotape on post mastectomy lymphedema. Patients and methods: Thirty females diagnosed with post mastectomy lymphedema were assigned randomly into two equal groups. Group A (Study group)received intermittent pneumatic compression (IPC) with kinesiotape (KT) in addition to complete decongestive therapy (manual lymphatic drainage-compression bandage-medical exercises-skin care) three times per week for 4 weeks. While, Group B (Control group) received only complete decongestive therapy 3 times per week for 4 weeks. Assessment of lymphedema and shoulder range of motion (flexion-abduction-external rotation) were done by tape measurement and goniometer respectively before and after 4 weeks. Results: There was no significant difference in lymphedema size and shoulder range of motion (ROM) between groups pre-treatment (p > 0.05). Comparison between groups post treatment revealed a significant decrease in lymphedema size and a significant increase in shoulder ROM of the study group compared with that of the control group (p > 0.05). Conclusion: The results suggested that IPC in combination with KT was an effective method in post mastectomy lymphedema more than complete decongestive therapy only.
Intermittent pneumatic compression
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Objective
To explore the application effects of complex decongestion therapy (CDT) in patients with upper limb lymphedema after breast cancer treatment.
Methods
From April 2015 to December 2016, a total of 52 cases of breast cancer patients with postoperative upper limb lymphedema were selected by convenience sampling method and treated with CDT for 1 course (20 times of CDT treatment) . Limb circumference measurements and multiple-frequency bioelectrical impedance analysis were applied to evaluate the degeneration degree of edema. Fugl-Meyer and Bathel index were applied to assess the motor function and living ability before and after treatment.
Results
The differences of circumference of different parts of the affected limb (including thumb web, 5cm proximal to rasceta, 10 cm distal to cubital crease, 10 cm proximal to cubital crease and axilla) before and after intervention were statistically significant (t=20.014, 10.114, 9.190, 6.995, 3.832; P<0.01) . The differences of circumferential ratio and tissue moisture ratio before and after intervention were statistically significant (t=34.058, 22.196; P<0.01) . The score of Fugl-Meyer on patients' limb movement function and the Bathel index both, and the differences were statistically significant (t=28.446, 38.285; P<0.01) .
Conclusions
CDT is an effective and safe treatment for upper limb lymphedema after breast cancer surgery, and worthy of clinical promotion.
Key words:
Breast neoplasms; Lymphedema; Limb function; Integrated lymphatic swelling treatment
Bioelectrical Impedance Analysis
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Objective To explore the effect of postoperative progressive resistance training(PRT) on the upper limb function in breast cancer patients. Methods 66 breast cancer patients were randomly divided into intervention group(n=33) and control group(n=33). The intervention group accepted a 12-week PRT and the control group accepted the routine training since 4-6 weeks postoperative as they admitted to hospital for their first chemotherapy. All the patients received a same content of health education. Results The grip strength, range of motion of abduction and flexion of shoulder were more in the intervention group than in the control group after intervention(P0.01). Conclusion PRT can effectively improve the function of upper limbs in breast cancer patients.
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Object: Explore the application and actual effect of MET (Muscle Energy) technology after breast cancer surgery with upper limb dysfunction. Methods: Taking 40 female breast cancer patients who underwent surgical treatment in our hospital from September 2017 to June 2019 as the research objects, all of them successfully completed modified radical mastectomy for breast cancer. According to different nursing methods, the patients were randomly divided into two groups. The experiment There were 20 cases in each group and the control group. The control group was given routine functional recovery exercise intervention after the operation, and the experimental group added MET technology to the base of the control group. One month after the operation, the functional recovery of the affected limbs of the two groups of patients was effectively assessed. The upper limb dysfunction of the two groups was compared by statistical methods, and the shoulder joint range of motion (ROM) was used for performance. Results: Through early functional recovery training and MET technology, 19 cases of ROM in the experimental group showed compliance (95%), compared with only 14 cases (70%) in the control group. The difference in upper limb dysfunction between the two groups is very obvious with statistical significance (P<0.05). Conclusions: Early functional recovery training combined with muscle energy technology can promote the recovery of upper limb dysfunction after breast cancer surgery faster and better, which is conducive to the recovery of patients as soon as possible and improve the quality of life.
Functional training
Modified Radical Mastectomy
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