Response of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy

Mahmoud El-Shazly; Wafaa Hussien Borhan; Wael Naeem Thabet; Ashraaf Hassan

doi:doi:10.11648/j.js.s.2016040301.13

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Response of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy

Mahmoud El-Shazly, Wafaa Hussien Borhan, Wael Naeem Thabet, Ashraaf Hassan

Published in Journal of Surgery (Volume 4, Issue 3-1)

Received: 31 January 2016 Accepted: 31 January 2016 Published: 23 March 2016

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Abstract

Introduction: Post-mastectomy lymphedema is a chronic, debilitating disorder that is frequently misdiagnosed, treated too late or not treated at all, Lymphedema (LE) is an abnormal accumulation of protein-rich fluid in the interstitium leading to limb swelling, chronic inflammation and reactive fibrosis of the affected tissues resulting from damage to lymphatic circulation following surgery, chemotherapy and/or radiation therapy. The aim was to investigate the effect of shockwave therapy on the post-mastectomy lymphedema. Subjects and methods: Sixty female patients underwent modified radical mastectomy surgery or lumpectomy, chemotherapy and radiotherapy associated with unilateral lymphedema (stage 2, 3), into two equal groups; their ages ranged from 30-50 years. The study group received shockwave therapy 2 times/week for 6 weeks plus traditional physical therapy program (manual lymphatic drainage, circulatory exercises with elevation, shoulder ROM exercises and pneumatic compression therapy) 3times /week /6weeks. Control group received traditional physical therapy program (manual lymphatic drainage, circulatory exercises with elevation, shoulder ROM exercises and pneumatic compression therapy) 3times /week /6weeks. Evaluation procedures were carried out to measure the upper limb volume measurement, ROM of shoulder flexion, abduction and external rotation. Results: Post treatment results showed that there was a significant improvement difference in shoulder ROM and upper limb volume in both groups in favor of the study group. Percentage of improvement of shoulder abduction, flexion, and external rotation in the study group was 38.92%, 26.61%, 36.24% respectively, while it was 20.86%, 14.93%, 16.17%in the control group. Percentage of improvement of upper limb volume in the study group was 24.21%, while it was 15.5% in the control group. Conclusion: extracorporeal shockwave therapy was considered to be an effective modality for treatment of the post-mastectomy lymphedema.

Published in	Journal of Surgery (Volume 4, Issue 3-1) This article belongs to the Special Issue Surgical Infections and Sepsis
DOI	10.11648/j.js.s.2016040301.13
Page(s)	14-20
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2016. Published by Science Publishing Group

Keywords

Lymphedema, Mastectomy, Shockwave Therapy

References

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APA Style

Mahmoud El-Shazly, Wafaa Hussien Borhan, Wael Naeem Thabet, Ashraaf Hassan. (2016). Response of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy. Journal of Surgery, 4(3-1), 14-20. https://doi.org/10.11648/j.js.s.2016040301.13

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ACS Style

Mahmoud El-Shazly; Wafaa Hussien Borhan; Wael Naeem Thabet; Ashraaf Hassan. Response of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy. J. Surg. 2016, 4(3-1), 14-20. doi: 10.11648/j.js.s.2016040301.13

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AMA Style

Mahmoud El-Shazly, Wafaa Hussien Borhan, Wael Naeem Thabet, Ashraaf Hassan. Response of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy. J Surg. 2016;4(3-1):14-20. doi: 10.11648/j.js.s.2016040301.13

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@article{10.11648/j.js.s.2016040301.13,
  author = {Mahmoud El-Shazly and Wafaa Hussien Borhan and Wael Naeem Thabet and Ashraaf Hassan},
  title = {Response of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy},
  journal = {Journal of Surgery},
  volume = {4},
  number = {3-1},
  pages = {14-20},
  doi = {10.11648/j.js.s.2016040301.13},
  url = {https://doi.org/10.11648/j.js.s.2016040301.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.s.2016040301.13},
  abstract = {Introduction: Post-mastectomy lymphedema is a chronic, debilitating disorder that is frequently misdiagnosed, treated too late or not treated at all, Lymphedema (LE) is an abnormal accumulation of protein-rich fluid in the interstitium leading to limb swelling, chronic inflammation and reactive fibrosis of the affected tissues resulting from damage to lymphatic circulation following surgery, chemotherapy and/or radiation therapy. The aim was to investigate the effect of shockwave therapy on the post-mastectomy lymphedema. Subjects and methods: Sixty female patients underwent modified radical mastectomy surgery or lumpectomy, chemotherapy and radiotherapy associated with unilateral lymphedema (stage 2, 3), into two equal groups; their ages ranged from 30-50 years. The study group received shockwave therapy 2 times/week for 6 weeks plus traditional physical therapy program (manual lymphatic drainage, circulatory exercises with elevation, shoulder ROM exercises and pneumatic compression therapy) 3times /week /6weeks. Control group received traditional physical therapy program (manual lymphatic drainage, circulatory exercises with elevation, shoulder ROM exercises and pneumatic compression therapy) 3times /week /6weeks. Evaluation procedures were carried out to measure the upper limb volume measurement, ROM of shoulder flexion, abduction and external rotation. Results: Post treatment results showed that there was a significant improvement difference in shoulder ROM and upper limb volume in both groups in favor of the study group. Percentage of improvement of shoulder abduction, flexion, and external rotation in the study group was 38.92%, 26.61%, 36.24% respectively, while it was 20.86%, 14.93%, 16.17%in the control group. Percentage of improvement of upper limb volume in the study group was 24.21%, while it was 15.5% in the control group. Conclusion: extracorporeal shockwave therapy was considered to be an effective modality for treatment of the post-mastectomy lymphedema.},
 year = {2016}
}

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TY  - JOUR
T1  - Response of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy
AU  - Mahmoud El-Shazly
AU  - Wafaa Hussien Borhan
AU  - Wael Naeem Thabet
AU  - Ashraaf Hassan
Y1  - 2016/03/23
PY  - 2016
N1  - https://doi.org/10.11648/j.js.s.2016040301.13
DO  - 10.11648/j.js.s.2016040301.13
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 14
EP  - 20
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.s.2016040301.13
AB  - Introduction: Post-mastectomy lymphedema is a chronic, debilitating disorder that is frequently misdiagnosed, treated too late or not treated at all, Lymphedema (LE) is an abnormal accumulation of protein-rich fluid in the interstitium leading to limb swelling, chronic inflammation and reactive fibrosis of the affected tissues resulting from damage to lymphatic circulation following surgery, chemotherapy and/or radiation therapy. The aim was to investigate the effect of shockwave therapy on the post-mastectomy lymphedema. Subjects and methods: Sixty female patients underwent modified radical mastectomy surgery or lumpectomy, chemotherapy and radiotherapy associated with unilateral lymphedema (stage 2, 3), into two equal groups; their ages ranged from 30-50 years. The study group received shockwave therapy 2 times/week for 6 weeks plus traditional physical therapy program (manual lymphatic drainage, circulatory exercises with elevation, shoulder ROM exercises and pneumatic compression therapy) 3times /week /6weeks. Control group received traditional physical therapy program (manual lymphatic drainage, circulatory exercises with elevation, shoulder ROM exercises and pneumatic compression therapy) 3times /week /6weeks. Evaluation procedures were carried out to measure the upper limb volume measurement, ROM of shoulder flexion, abduction and external rotation. Results: Post treatment results showed that there was a significant improvement difference in shoulder ROM and upper limb volume in both groups in favor of the study group. Percentage of improvement of shoulder abduction, flexion, and external rotation in the study group was 38.92%, 26.61%, 36.24% respectively, while it was 20.86%, 14.93%, 16.17%in the control group. Percentage of improvement of upper limb volume in the study group was 24.21%, while it was 15.5% in the control group. Conclusion: extracorporeal shockwave therapy was considered to be an effective modality for treatment of the post-mastectomy lymphedema.
VL  - 4
IS  - 3-1
ER  -

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Author Information

Mahmoud El-Shazly

Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
Wafaa Hussien Borhan

Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
Wael Naeem Thabet

Department of General Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
Ashraaf Hassan

Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt

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APA Style

Mahmoud El-Shazly, Wafaa Hussien Borhan, Wael Naeem Thabet, Ashraaf Hassan. (2016). Response of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy. Journal of Surgery, 4(3-1), 14-20. https://doi.org/10.11648/j.js.s.2016040301.13

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ACS Style

Mahmoud El-Shazly; Wafaa Hussien Borhan; Wael Naeem Thabet; Ashraaf Hassan. Response of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy. J. Surg. 2016, 4(3-1), 14-20. doi: 10.11648/j.js.s.2016040301.13

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AMA Style

Mahmoud El-Shazly, Wafaa Hussien Borhan, Wael Naeem Thabet, Ashraaf Hassan. Response of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy. J Surg. 2016;4(3-1):14-20. doi: 10.11648/j.js.s.2016040301.13

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@article{10.11648/j.js.s.2016040301.13,
  author = {Mahmoud El-Shazly and Wafaa Hussien Borhan and Wael Naeem Thabet and Ashraaf Hassan},
  title = {Response of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy},
  journal = {Journal of Surgery},
  volume = {4},
  number = {3-1},
  pages = {14-20},
  doi = {10.11648/j.js.s.2016040301.13},
  url = {https://doi.org/10.11648/j.js.s.2016040301.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.s.2016040301.13},
  abstract = {Introduction: Post-mastectomy lymphedema is a chronic, debilitating disorder that is frequently misdiagnosed, treated too late or not treated at all, Lymphedema (LE) is an abnormal accumulation of protein-rich fluid in the interstitium leading to limb swelling, chronic inflammation and reactive fibrosis of the affected tissues resulting from damage to lymphatic circulation following surgery, chemotherapy and/or radiation therapy. The aim was to investigate the effect of shockwave therapy on the post-mastectomy lymphedema. Subjects and methods: Sixty female patients underwent modified radical mastectomy surgery or lumpectomy, chemotherapy and radiotherapy associated with unilateral lymphedema (stage 2, 3), into two equal groups; their ages ranged from 30-50 years. The study group received shockwave therapy 2 times/week for 6 weeks plus traditional physical therapy program (manual lymphatic drainage, circulatory exercises with elevation, shoulder ROM exercises and pneumatic compression therapy) 3times /week /6weeks. Control group received traditional physical therapy program (manual lymphatic drainage, circulatory exercises with elevation, shoulder ROM exercises and pneumatic compression therapy) 3times /week /6weeks. Evaluation procedures were carried out to measure the upper limb volume measurement, ROM of shoulder flexion, abduction and external rotation. Results: Post treatment results showed that there was a significant improvement difference in shoulder ROM and upper limb volume in both groups in favor of the study group. Percentage of improvement of shoulder abduction, flexion, and external rotation in the study group was 38.92%, 26.61%, 36.24% respectively, while it was 20.86%, 14.93%, 16.17%in the control group. Percentage of improvement of upper limb volume in the study group was 24.21%, while it was 15.5% in the control group. Conclusion: extracorporeal shockwave therapy was considered to be an effective modality for treatment of the post-mastectomy lymphedema.},
 year = {2016}
}

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TY  - JOUR
T1  - Response of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy
AU  - Mahmoud El-Shazly
AU  - Wafaa Hussien Borhan
AU  - Wael Naeem Thabet
AU  - Ashraaf Hassan
Y1  - 2016/03/23
PY  - 2016
N1  - https://doi.org/10.11648/j.js.s.2016040301.13
DO  - 10.11648/j.js.s.2016040301.13
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 14
EP  - 20
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.s.2016040301.13
AB  - Introduction: Post-mastectomy lymphedema is a chronic, debilitating disorder that is frequently misdiagnosed, treated too late or not treated at all, Lymphedema (LE) is an abnormal accumulation of protein-rich fluid in the interstitium leading to limb swelling, chronic inflammation and reactive fibrosis of the affected tissues resulting from damage to lymphatic circulation following surgery, chemotherapy and/or radiation therapy. The aim was to investigate the effect of shockwave therapy on the post-mastectomy lymphedema. Subjects and methods: Sixty female patients underwent modified radical mastectomy surgery or lumpectomy, chemotherapy and radiotherapy associated with unilateral lymphedema (stage 2, 3), into two equal groups; their ages ranged from 30-50 years. The study group received shockwave therapy 2 times/week for 6 weeks plus traditional physical therapy program (manual lymphatic drainage, circulatory exercises with elevation, shoulder ROM exercises and pneumatic compression therapy) 3times /week /6weeks. Control group received traditional physical therapy program (manual lymphatic drainage, circulatory exercises with elevation, shoulder ROM exercises and pneumatic compression therapy) 3times /week /6weeks. Evaluation procedures were carried out to measure the upper limb volume measurement, ROM of shoulder flexion, abduction and external rotation. Results: Post treatment results showed that there was a significant improvement difference in shoulder ROM and upper limb volume in both groups in favor of the study group. Percentage of improvement of shoulder abduction, flexion, and external rotation in the study group was 38.92%, 26.61%, 36.24% respectively, while it was 20.86%, 14.93%, 16.17%in the control group. Percentage of improvement of upper limb volume in the study group was 24.21%, while it was 15.5% in the control group. Conclusion: extracorporeal shockwave therapy was considered to be an effective modality for treatment of the post-mastectomy lymphedema.
VL  - 4
IS  - 3-1
ER  -

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