ORIGINAL ARTICLE   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2018 May;177(5):204-11

DOI: 10.23736/S0393-3660.17.03591-4

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Effects of a specific adapted upper limb exercise on lymphedema in breast cancer survivors: a pilot study

Daniela MIRANDOLA ¹, Marco MONACI ², Guido MICCINESI ³, Maria G. MURACA ⁴, Francesca PAPI ¹, Mirko MANETTI ², Eleonora SGAMBATI ⁵, Mirca MARINI ² ✉

¹ Cancer Rehabilitation Center (CeRiOn), Italian League Against Tumors (LILT), Florence, Italy; ² Section of Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; ³ Unit of Clinical Epidemiology, Cancer Prevention and Research Institute (ISPO), Florence, Italy; ⁴ Cancer Prevention and Research Institute (ISPO), Cancer Rehabilitation Center (CeRiOn), Florence, Italy; ⁵ Department of Biosciences and Territory, University of Molise, Pesche, Isernia, Italy

BACKGROUND: Upper limb lymphedema (LE), due to axillary lymphatic drainage interruption because of axillary lymph node dissection and/or radiation, is a dreaded chronic complication in breast cancer survivors. Upper limb swelling can cause pain, discomfort, heaviness, distortion, and further loss of movement, thereby affecting quality of life (QoL). Many treatment options for LE are available, but none offers a permanent reduction or resolution of swelling. Recent research supports the positive effects deriving from the regular participation in structured adapted physical activity programs in attenuating cancer treatment-related impairments with QoL improvement. In this context, the objective of our study was to investigate the effects of a specific adapted exercise on reducing LE and improving upper limb strength and mobility, as well as QoL in breast cancer survivors.
METHODS: Fourteen breast cancer survivors with chronic upper limb LE were recruited at the CeRiOn Center of Florence. Upper limb circumference, ROM of shoulder and hand-wrist, strength (handgrip test) and QoL (ULL27 questionnaire) were assessed at baseline and at 1, 2 and 3 months after beginning of adapted exercise execution.
RESULTS: Our results suggest that a structured exercise, specifically tailored to issues of the LE-affected upper limb, may improve upper limb function, reduce edema and increase overall QoL in breast cancer survivors.
CONCLUSIONS: This pilot study suggests that a specific adapted exercise targeting upper limb LE related to breast cancer treatment may be effective either in reducing and managing swelling or in improving function of the upper limb, thus helping in recovering QoL.

KEY WORDS: Exercise - Lymphedema - Breast neoplasms - Survivors - Quality of life