Acute effects of remedial exercises and compression in unilateralupper extremity lymphedema associated with brest cancer

The aim of this study is to investigate the acute effect of remedial exercises with and without compression on the severity and symptoms of lymphedema in women with unilateral breast-cancer related lymphedema (BCRL). 34 women with BCRL were included in the study. Demographic and physical characteristics of the individuals were recorded. Kinesiophobia was evaluated with Tampa Kinesiophobia Scale and quality of life was evaluated with Lymphedema Life Impact Scale. The severity of lymphedema, extracellular water ratio and tissue thicknesses were evaluated by the bilateral circumferential measurements, the bioimpedance spectroscopy and ultrasonographic evaluations, respectively. The severity of self-reported symptoms (swelling, heaviness, tightness, and pain) were assessed using a visual analog scale. Perceptions of satisfaction and perceptions of improvement regarding exercise interventions with/without compression were evaluated by likert scale and Patient Global Impression of Severity, respectively. All the evaluations were performed before and 24 hours post-exercise. Participants were completed 3 sets of remedial exercises (within 24 hours) with and without compression bandage separated by a 3-day washout period. There was no difference in the severity of lymphedema (arm volume, LDex score and ultrasonographic measurements) and changes in symptom severity scores (except pain) 24 hour post-remedial exercise without compression (p >.05). At 24 hours after the remedial exercise with compression, all outcomes decreased significantly compared to baseline (p<0.001). While the average quality of life of the individuals was 27.38±12.22, the average kinesiophobia level was determined as 33±6.02. It was determined that the perception of recovery was higher after remedial exercises with compression (85.28%) than after remedial exercises without compression (49.99%). It reveals that remedial exercises can be performed safely without compression within a day without acutely increasing the severity of lymphedema in breast cancer-related lymphedema. These are important preliminary findings, which can be used to inform future prospective evaluation of the long-term effects of remedial exercise performed without compression therapy. Key Words: Complex decongestive therapy, physiotherapy, bioimpedance spectroscopy, ultrasound, exercise