Addition of scapulothoracic exercise to the Combined Decongestive Therapy in breast cancer survivors after mastectomy

Background and Objective: In the process of the Combined Decongestive Therapy for breast cancer survivors we usually give upper limb mobility exercises but scapular orientation on thoracic is ignored. The aim of this study was to evaluate the effect of addition scapulothoracic exercises to combined Decongestive Therapy on reducing lymphedema and pain and increasing the mobility of the shoulder joint of the affected limb of these women after mastectomy.Methods: The study was performed on 60 breast cancer survivor women who referred to physical therapy clinic for consultation and treatment of lymphedema. Control group just received Combined Decongestive Therapy but in the other group after massage, the survivors performed scapulothoracic exercises and correct scapular orientation then we bandaged their limbs. Data were collected by using volumeter, goniometer and VAS.Results: Pain, edema volume and range of motion (ROM) were not significantly different between the two groups before the study. According to the Wilcoxon test on the tenth day the mean ROM of the intervention and control groups were significantly different between the two groups (p< 0.05). Also on the tenth day the average of edema of intervention and control groups were (P =0. 273) and pain score, (P =0.696) had no significant differences. On the tenth day, in both groups, the edema volume, shoulder ROM and pain scores were improved significantly in comparison of baseline.Discussion and conclusion: The results of this study suggested that Combined Decongestive Therapy is effective in decreasing lymphedema and pain and increasing the range of motion of affected limb. While addition scapular exercise can increase these effects and improve the achieved outcomes.

Keywords:

CDT , lymphedema , pain , range of motion , quality of life , breast cancer