Korean J Pain.  2022 Jul;35(3):280-290. 10.3344/kjp.2022.35.3.280.

The effects of complex decongestive therapy on pain and functionality in individuals with breast cancer who developed adhesive capsulitis due to lymphedema: an evaluation by an isokinetic computerized system

• Tatar KK
• Turhan B

• KMID: 2530983
• DOI: http://doi.org/10.3344/kjp.2022.35.3.280

Abstract

Background
This study aimed to determine the impact of complex decongestive therapy applications on upper extremity function in breast cancer patients who developed adhesive capsulitis after lymphedema.
Methods
Thirty patients who developed adhesive capsulitis due to lymphedema were divided into two groups as study (n = 15) and control (n = 15) groups. Both groups received 20 minutes of exercise five days a week for three weeks using a Biodex isokinetic dynamometer, as well as a hot pack and TENS (Transcutaneous Electrical Nerve Stimulation) treatment to the shoulder joint. The study group received 45 minutes of intensive decongestive therapy along with the adhesive capsulitis treatment. The visual analogue scale was used to assess pain, circumference, and volumetric measurements were used to assess edema, and the Arm, Shoulder, and Hand Problems Questionnaire (DASH: Disabilities of the Arm, Shoulder, and Hand) was used to assess upper extremity functionality. The shoulder range of motion was evaluated.
Results
Both groups had improvements in pain (P < 0.001), shoulder joint range of motion (P < 0.001), and upper extremity functionality (P < 0.001) after the treatment. There was a significant decrease in circumference and volumetric measurements in the study group (P < 0.001). However, no differences were seen in measurements in the control group.
Conclusions
The results showed that complex decongestive therapy was beneficial in reducing lymphedema in breast cancer patients who acquired adhesive capsulitis due to lymphedema. Consequently, the authors believe that supplementing conventional physiotherapy with complex decongestive therapy will benefit patients.

Keyword

Breast Neoplasms; Bursitis; Decongestive Therapy; Lymphedema; Pain; Physical Therapy Modalities; Shoulder Joint; Transcutaneous Electric Nerve Stimulation; Upper Extremity

Figure

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  Fig. 1 Flow chart diagram.

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  Fig. 2 Combined shoulder isometric exercises.

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  Fig. 3 Healing in pain scores of groups. VAS: visual analogue scale, CG: control group, SG: study group, BT: before treatment, AT: after treatment.

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  Fig. 4 Range of motion. DASH: Disability of the Arm, Shoulder and Hand Questionnaire.

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