Physical therapy could help restore the arm range of motion among women with breast cancer who had their lymph nodes surgically removed, according to a study presented recently during the American Society of Clinical Oncology’s 2018 Cancer Survivorship Symposium.
Lymphedema, or swelling, often can occur following lymph node removal surgery, known as lymph node dissection. Many of these lymph nodes are near or under the arm.
“Lymph node dissection, whether it is axillary or sentinel, often results in restrictions of arm movement, including range of motion. These restrictions on range of motion of the arm can be temporary or permanent,” says Electra D. Paskett, PhD, MO, the Marion N. Rowley Professor of Cancer Research and Director of the Division of Cancer Prevention and Control at The Ohio State University, in a news story from CURE.
Paskett and colleagues conducted a secondary analysis of the Lymphedema Education and Prevention (LEAP) study—a randomized-controlled trial designed to determine if a lymphedema prevention program could help patients to regain range of motion in both the affected arm as well as the unaffected arm.
The study included 568 participating women, who randomized to receive either education only or education plus exercise. The 253 women who received education only were given information about lymphedema signs and symptoms, as well as risk reduction strategies. The 315 women who received education plus exercise were given the same information as well as arm stretching and breathing exercises and a visit with a physical therapist, the news story explains.
“The physical therapist discussed lymph flow, strengthening, and breathing exercises; fitted women with an elastic compression sleeve and gauntlet and told them when to wear it; women were given two-pound hand weights; and then they were given a take home video that demonstrated all of the exercises that they were taught in this session,” Paskett says.
The participants also answered self-administered surveys to determine how well they could reach with each arm before surgery, and again at 12 and 18 months after surgery. Possible responses were: very little, about half, nearly full, overhead, and full range of motion.
Before surgery, women in the exercise group were less likely to report full range of motion for both arms compared with the education-only group, with only 58% compared with 75% in the left arm and only 57% compared with 76% in the right arm, respectively.
At 12 months postsurgery, women in the exercise group reported greater range of motion compared with the education group, with an improvement of 91% compared with 84% in the left arm and 90% compared with 83% in the right arm, respectively.
“Our take home message here is that all women receiving lymph node dissection, whether it is axillary or sentinel, should receive physical therapy to regain range of motion more quickly after surgery, and thus, help maintain physical functioning,” Paskett concludes, in the news story.