THE INTERVENTIONAL EFFECT OF COMBINED REDUCING OCCUPATIONAL UPPER EXTREMITY USE AND PNEUMATIC PUMP ON BREAST CANCER RELATED LYMPHEDEMA

Abstract

Introduction: Breast cancer related lymphedema (BCRL) treatment continues to be a distressing and frequent problem. Aim of Work: To detect the relation between the level of hand use in different occupation and both the grade and stage of BCRL and to determine whether the combined effect of decreased occupational work load of the upper extremities and the use of pneumatic compression pumps could manage BCRL effectively. Materials and Methods: 68 patients with BCRL were selected. Age, body mass index (BMI), history of infection, lymphedema grade and stage, sequential circumferential arm measurements, Visual Analog Scale (VAS), handgrip strength were assessed. All patients underwent pneumatic compression pumping for 3 months combined with changing in their level of hand use. Results: Before intervention, the grades and stages of lymphedema showed statistically significant differences among the different occupational groups (p< 0.05). After applying our interventional measures, statistical significant decrease was detected regarding the VAS and significant increase in right hand grip was observed among one group while the difference of sequential circumferential measurements showed decrease in their values but not to the significant level. Conclusion: Occupations requiring more upper extremity activity had the worst lymphedema clinical grade and stage status. More researches are needed to support our findings and to assess the combined effect of decreased occupational work load of the upper extremities and the use of pneumatic compression pumps.