Roberta PC Luz, Cinira AS Haddad, Patricia S Giron, Patrícia VG Figueira, Samantha KLA Rizzi, Thais L Pinheiro, Afonso CP Nazário, Gil Facina
Institution: Federal University of Sao Paulo
“OBJETIVE: This study aimed to show if strength training can be associated with complex physical therapy.METHODS: Clinical trial conducted at Department of Gynecology, Federal University of São Paulo. Women older than 18 years, with lymphedema due to unilateral breast cancer, were included. Women with bilateral breast cancer, malignant lymphedema, renal dysfunction, deep vein thrombosis, skin disease or heart disease were excluded. Patients were randomized into two groups, with 18 patients in each. Group 1 was treated with complex physical therapy (CPT): lymphatic drainage, skin care, compressive bandaging and decongestive exercises. Group 2 was treated with CPT associated to a muscle strengthening protocol. Patients performed exercises with 40% of maximum muscle load during one repetition. Exercises were conducted twice a week, with two sets of 10 repetitions at the first week, three sets of 10 repetitions at the second week and three sets of 15 repetitions from third to eighth weeks. RESULTS: There was no difference between groups about shoulder flexion, extension, adduction, abduction and external rotation range of motion (ROM) change over time. Regarding shoulder internal rotation, Group 1 had a statistically significant increase (p=0,0219), which did not happen with Group 2 (p=0,9927). Concerning muscle strength change over time, there was also no difference among groups. With espect to upper limb volumetry over time, both groups showed the same pattern of change (p=0,024). However, since first evaluation volumetric measure was higher in Group 1 than in Group 2 (p<0,001).CONCLUSION: There is no difference between CPT alone or associated to a strengthening protocol for the treatment of lymphedema. However, strength exercises can be performed by patients with lymphedema, without risk of arm volume increase.
Keywords: breast cancer, lymphedema, strength training”