The effect of exercise and complete decongestive therapy on edema volume and shoulder range of motion in patients with breast cancer related lymphedema: A randomized clinical trial

Abstract

Objective (s): Secondary lymphedema is known as a common complication after breast cancer treatment. Exercise is considered as a valuable intervention in these patients. The aim of this study was to investigate the effect of exercise on reducing edema volume and improving shoulder range of motion in breast cancer patients with lymphedema. Methods: Thirty patients with lymphedema were included in this randomized double-blind study. Fifteen patients were randomly assigned to the exercise plus complete decongestive therapy (exercise + CDT) group and the rest was allocated to the control group (CDT only). In exercise group, patients received a Pilates exercise program with a routine CDT. Variables of edema volume and shoulder range of motion were measured in five different times including before treatment, on 7, 14,21, and 42-day of the treatment. Repeated measures analysis of variance was used. Results: The mean age (SD) of patients in the study was 56.3 (6.1) years. Before treatment, there was no significant difference between the two groups in terms of clinical and demographic variables. Although there was no statistically significant difference between the two groups, an improvement in shoulder range of motion and edema volume were observed in two groups over time. Based on the results, the effect of complete decongestive therapy alone and in combination with exercise (Pilates) on edema volume and shoulder range of motion were statistically significant as indicated by within group comparison during the study period (p<0.05). Conclusion: The exercise can improve the shoulder range of motion and also can lead to less pain and volume in patients suffering from breast cancer related lymphedema. Although there was no significant difference between the two groups in terms of improvement in shoulder range of motion or edema volume, no adverse effect of Pilates was noticed.