Effects of a multimodal physical therapy approach on breast cancer-related lymphedema : a retrospective pre-post study

Abstract

Despite the availability of numerous lymphedema treatments, integrating physical therapy for breast cancer-related lymphedema (BCRL) management has limited evidence. The objective is to evaluate the effect of a multimodal physical therapy approach in reducing upper limb (UL) lymphedema and improving shoulder range of motion (ROM) in women with BCRL. A retrospective study was conducted with 19 women diagnosed with BCRL. UL circumference and shoulder ROM were assessed before and after four weeks of therapy and showed significant improvement (p < 0.05). The mean difference between baseline and 4-week intervention was 2.11 cm for UL circumference (95% CI: 1.54, 2.68; Cohen’s d = 1.35), 46.31o for shoulder flexion (95% CI -57.5, -35.1; Cohen’s d = 1.68), 10o for shoulder extension (95% CI -13.4, -6.59; Cohen’s d = 1.74), 47.36o for shoulder abduction (95% CI -60.35, -34.38; Cohen’s d = 1.67), 18.94o for shoulder internal rotation (95% CI -24.4, -13.4; Cohen’s d = 1.37) and 16.05o for shoulder external rotation (95% CI -20.03, -12.07; Cohen’s d = 1.51). Women with BCRL showed significant improvements in lymphedema and shoulder mobility following four weeks of therapy. Further, robust randomised clinical trials are required to substantiate these findings in Indian women.