Decongestive Exercise and Compression for Breast Cancer Related Lymphedema Management

Titre officiel

Decongestive Progressive Resistance Exercise With Advanced Compression for Breast Cancer Related Lymphedema Management (DREAM): A Pilot Randomized Control Trial

Sommaire:

Après une chirurgie pour un cancer du sein, il peut y avoir formation d’un œdème dans le bras du côté du cancer. Lorsque l’œdème devient chronique, on parle alors de lymphœdème. Dans le cadre de cette étude, nous examinerons les effets d’un programme d’exercices décongestifs contre résistance d’intensité progressive d’une durée de 12 semaines, combiné à une compression du lymphœdème consécutif au cancer du sein. Notre objectif est de déterminer si les survivantes du cancer du sein acceptent et sont capables de porter un dispositif perfectionné de compression durant la pratique d’exercices et si cette association aide à réduire leur lymphœdème. Vingt-quatre survivantes du cancer d’Edmonton, en Alberta, participeront à cette étude d’un an.

Description de l'essai

Primary Outcome:

• Arm Lymphedema Volume

Secondary Outcome:

• Bioimpedance Analysis
• Upper body strength
• Lower body strength
• Shoulder range of motion
• Lymphedema International Classification of Functioning (LYMPH-ICF)
• Rand Short-form (SF): 36
• Godin Leisure-time Questionnaire
• Body composition
• Body Image
• Tissue Composition

Lymphedema is a swelling in the arm, chest wall and breast on the side of the breast cancer. Arm lymphedema develops as a result of breast cancer surgery and/ or radiation therapy. Compression therapy and exercise are commonly prescribed treatment to help reduce the arm swelling and to maintain the result. The exercise that is usually prescribed for lymphedema is called decongestive remedial exercise. It involves active, non-resisted movements that follow a specific order from proximal to distal and back proximally. The exercises start at the neck, move to the chest wall and then down the arm, and back. Two different types of compression garments have been proposed to help reduce swelling when women are exercising. One compression garment is made with a stiffer, less elastic type of material and is called a "flat-knit" garment. The other garment, the "Adjustable Compression Wrap" is a garment with an adjustable elastic strapping system that helps to reinforce the compression on the arm. Recent research suggests that these specialized garments enhance the muscle pump effect on lymph flow; however, no research has been conducted to test whether this actually results in improvements in arm lymphedema volume. Resistance exercise training helps to improve arm flexibility, strength, function, and quality of life in breast cancer survivors. Recent evidence has shown that breast cancer survivors with lymphedema, can safely perform resistance training (strength training), however, there is no impact (better or worse) on arm lymphedema volume. To date, no studies have been performed combining all potential therapeutic approaches for lymphedema management: resistance exercise, a therapeutic decongestive exercise sequence, and compression therapy. Women in the experimental arms of this study will wear a compression garment when performing progressive resistance exercise that follows the decongestive sequence. We will examine the effect of the combined intervention on arm lymphedema volume, function and quality of life.

Voir cet essai sur ClinicalTrials.gov