Reach the best result for increase upper extremity range of motion in breast cancer related lymphedema: A review article

Back ground and Aim:Breast cancer BC is the most common cancer among women, worldwide. Lymphedema is one of the most common postoperative complications, especially after BC surgery that occurs in one out of four women 25% . It is defined as the abnormal accumulation of protein-rich fluid in an interstitial space that results from impaired lymphatic function due to axillary lymph node dissection, radiotherapy, fibrosis, or inflammation. In 33% of breast cancer survivors, lymphedema will develop within the first 6-18 months after treatment and can cause dysfunction, pain, heaviness, tension, a sense of numbness and difficulty performing activities of daily living ADL . Even, untreated lymphedema can cause infection and be limb threatening.In the case of lymphedema patients, pain can be the reason for loss of functions and decrease in upper extremity Range of Motion ROM . Search Method: In this study we searched electronic data bases include PubMed, science direct and Scopus to find RCTs in field of increase upper extremity ROM in breast cancer-related lymphedema.Results :Based on available evidences, best results can reach in postoperative breast cancer patients, that pain decreased significantly after exercising for 30 min a day, four times a week for at least 1 month of exercise after surgery. Complex exercise significantly increases the ROM compared to the conventional decongestive therapy. Resistance and aerobic exercise in home or gym help joint range movement’s ROM, and venous drainage exercise and upper extremity exercise can increase the joint range of motion in flexion, unbending, abduction, gathering closely, external rotation, and inward rotation.Conclusion: Physiologically, exercise increases venous and lymphatic rotation in the affected extremities, by activating the skeletal muscles, which can reduce inflammation and it’s resulting in reduced pain and ultimately increased ROM. Studies showed that complex exercise significantly reduced the pain scale. But the conventional decongestive therapy group did not have change in the pain scale.

Keywords:

Breast cancer , lymphedema , range of motion , rehabilitation