ORIGINAL PAPER
Radial shock wave and a tailored exercise program on axillary web syndrome after breast cancer surgery with axillary dissection: a controlled clinical trial
1
Physical Therapy Department, Faculty of Applied Medical Sciences, Jerash University, Jerash, Jordan
2
Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
3
Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Delta University for Science and Technology, Gamasa, Egypt
4
Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Delta University for Science and Technology, Gamasa, Egypt
These authors had equal contribution to this work
Submission date: 2024-01-07
Acceptance date: 2024-05-27
Publication date: 2025-06-18
Corresponding author
Hany Mohamed Elgohary
Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, El-Tahrir St. Dokki, Giza, P.O. Box 11432, Egypt
Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, El-Tahrir St. Dokki, Giza, P.O. Box 11432, Egypt
Physiother Quart. 2025;33(2):54-60
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The study evaluated the effectiveness of combining radial shock wave therapy and a tailored exercise program for treating axillary web syndrome after breast cancer surgery.
Methods:
Ninety-three eligible patients were randomly divided into three groups who received radial shock waves and a tailored exercise program (group A), shock wave therapy (group B), or a tailored exercise program (group C). All three groups underwent treatment over 4 weeks and were assessed for shoulder flexion and abduction, pain, thickness, echogenicity, cord disorganisation, and abbreviated disabilities of the arm, shoulder and hand (Quick DASH) assessment at the beginning and end of the interventions. The statistical analysis included descriptive statistics, tests for homogeneity, chi-squared tests, interquartile range, Kruskal–Wallis tests, and one-way analysis of variance (ANOVA) with post hoc Tukey.
Results:
After the 4-week interventions, the mean differences in outcome measures indicated significant variations among the groups. Specifically, group A exhibited mean differences of –7.9 and –6.87 for shoulder flexion compared to groups B and C, respectively. For shoulder abduction, group A had mean differences of –20.17 and –10.28 compared to groups B and C, while group B exhibited a mean difference of 9.89 compared to group C. Additionally, distinct mean differences were observed for visual analogue scale (VAS), cord thickness, and Quick DASH across the groups.
Conclusions:
The results suggest that combining radial shock wave therapy with a tailored exercise program provides greater benefits compared to the exercise program or radial shock wave therapy alone for patients who have undergone breast cancer surgery with axillary dissection.
The study evaluated the effectiveness of combining radial shock wave therapy and a tailored exercise program for treating axillary web syndrome after breast cancer surgery.
Methods:
Ninety-three eligible patients were randomly divided into three groups who received radial shock waves and a tailored exercise program (group A), shock wave therapy (group B), or a tailored exercise program (group C). All three groups underwent treatment over 4 weeks and were assessed for shoulder flexion and abduction, pain, thickness, echogenicity, cord disorganisation, and abbreviated disabilities of the arm, shoulder and hand (Quick DASH) assessment at the beginning and end of the interventions. The statistical analysis included descriptive statistics, tests for homogeneity, chi-squared tests, interquartile range, Kruskal–Wallis tests, and one-way analysis of variance (ANOVA) with post hoc Tukey.
Results:
After the 4-week interventions, the mean differences in outcome measures indicated significant variations among the groups. Specifically, group A exhibited mean differences of –7.9 and –6.87 for shoulder flexion compared to groups B and C, respectively. For shoulder abduction, group A had mean differences of –20.17 and –10.28 compared to groups B and C, while group B exhibited a mean difference of 9.89 compared to group C. Additionally, distinct mean differences were observed for visual analogue scale (VAS), cord thickness, and Quick DASH across the groups.
Conclusions:
The results suggest that combining radial shock wave therapy with a tailored exercise program provides greater benefits compared to the exercise program or radial shock wave therapy alone for patients who have undergone breast cancer surgery with axillary dissection.
REFERENCES (23)
1.
Johansson K, Chong H, Ciornei C-D, Brorson H, Mortimer PS. Axillary web syndrome: evidence for lymphatic origin with thrombosis. Lymphat Res Biol. 2020;18(4):329–32; doi: 10.1089/lrb.2019.0074.
2.
Koehler LA, Hunter DW, Blaes AH, Haddad TC. Function, shoulder motion, pain, and lymphedema in breast cancer with and without axillary web syndrome: an 18-month follow-up. Phys Ther. 2018;98(6):518–27; doi: 10.1093/ptj/pzy010.
3.
Maksymets TO. Risk factors for thromboembolic complications in patients with elevated body mass index during the perioperative period of laparoscopic myomectomy. Emerg Med. 2021;17:89–95; doi: 10.22141/2224-0586.17.5.2021.240714.
4.
Wang K, Kopsini A. Design of an innovative medical device to improve quality of life in lymphedema patients. In: Proceedings of the 13th International Joint Conference on Biomedical Engineering Systems and Technologies. Vol. 1 ClinMed. SciTePress – Science and Technology Publications: Valetta; 2020, pp. 323–8; doi: 10.5220/0009369703230328.
5.
Dewi R, Ramayati R, Rosdiana N, Ramayani OR, Siregar R, Siregar B. Waist circumference, body mass index, and skinfold thickness as potential risk factors for high blood pressure in adolescents. Paediatr Indones. 2019;59(2):79–86; doi: 10.14238/pi59.2.2019.79-86.
6.
Crane P, Ladden J, Monica D. Treatment of axillary web syndrome using instrument assisted soft tissue mobilization and thoracic manipulation for associated thoracic rotation dysfunction. Physiother Theory Pract. 2018;34(1):74–8; doi: 10.1080/09593985.2017.1368755.
7.
Ahmad S, Komal S, Shafique S, Altaim T. Comparison of effectiveness of myofascial trigger point release with manual therapy and myofascial release in combination with self-stretching in upper cross syndrome. J Riphah Coll Rehabil Sci. 2019;7(1):3–6; doi: 10.5455/JRCRS.2019070102.
8.
González-Rubino JB, Vinolo-Gil MJ, Martín-Valero R. Effectiveness of physical therapy in axillary web syndrome after breast cancer: a systematic review and meta-analysis. Support Care Cancer. 2023;31(5):257; doi: 10.1007/s00520-023-07666-x.
9.
Tsai YLI, I TY, Chuang YC, Cheng YY, Lee YC. Extracorporeal shock wave therapy combined with complex decongestive therapy in patients with breast cancer-related lymphedema: a systemic review and meta-analysis. J Clin Med. 2021;10(24):5970; doi: 10.3390/jcm10245970.
10.
Kolber JM, Fuller C, Marshall J, Wright A, Hanney WJ. The reliability and concurrent validity of scapular plane shoulder elevation measurements using a digital inclinometer and goniometer. Physiother Theory Pract. 2012;28(2):161–8; doi: 10.3109/09593985.2011.574203.
11.
British Pain Society Publications. Pain scales in multiple languages. London; 2006. Available from: https://www.britishpainsociety... (accessed 10.06.2022).
12.
Abd El-Majied SF, Mohammed MM. Validity and reliability of the Arabic version of the Quick-DASH Questionnaire for upper extremity disorders. Med J Cairo Univ. 2020;12:2037–43; doi: 10.21608/mjcu.2020.146776.1153.
13.
Deo SVS, Ray S, Rath GK, Shukla NK, Kar M, Asthana S, Raina V. Prevalence and risk factors for development of lymphedema following breast cancer treatment. Indian J Cancer. 2004;41(1):8–12.
14.
Bae H, Kim HJ. Clinical outcomes of extracorporeal shock wave therapy in patients with secondary lymphedema: a pilot study. Ann Rehabil Med. 2013;37(2):229–35; doi: 10.5535/arm.2013.37.2.229.
15.
Hemmati M, Rojhani-Shirazi Z, Zakeri ZS, Akrami M, Dehno NS. The effect of the combined use of complex decongestive therapy with electrotherapy modalities for the treatment of breast cancer-related lymphedema: a randomized clinical trial. BMC Musculoskelet Disord. 2022;23(1):837; doi: 10.1186/s12891-022-05780-1.
16.
Moskovitz AH, Anderson BO, Yeung RS, Byrd DR, Lawton TJ, Moe RE. Axillary web syndrome after axillary dissection. Am J Surg. 2001;181(5):434–9; doi: 10.1016/s0002-9610(01)00602-x.
17.
Donahue PMC, MacKenzie A, Filipovic A, Koelmeyer L. Advances in the prevention and treatment of breast cancer-related lymphedema. Breast Cancer Res Treat. 2023;200(1):1–14; doi: 10.1007/s10549-023-06947-7.
18.
Jingyi L, Chen D, Yin X. Effect of manual lymphatic drainage combined with vacuum sealing drainage on axillary web syndrome caused by breast cancer surgery. Int Wound J. 2023;20:183–90; doi.org/10.1111/iwj.13862.
19.
Metzner G, Dohnalek C, Aigner E. High-energy extracorporeal shockwave therapy (ESWT) for the treatment of chronic plantar fasciitis. Foot Ankle Int. 2010;31(9):790–6; doi: 10.3113/FAI.2010.0790.
20.
Sugawara AT, Lima MDC, Dias CB, Oliveira MSC. Extracorporeal shockwave therapy for pain reduction of musculoskeletal diseases: predictors and responders. Ann Phys Rehabil Med. 2018;61(Suppl):e171; doi: 10.1016/j.rehab.2018.05.390.
21.
Yehia RM, ElMeligie MM. Effectiveness of extracorporeal shockwave therapy for frozen shoulder in perimenopausal diabetic women. Biomed Hum Kinet. 2022;14(1):109–16; doi: 10.2478/bhk-2022-0014.
22.
Simplicio CL, Purita J, Murrell W, Santos GS, Dos Santos RG, Lana JFSD. Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine. J Clin Orthop Trauma. 2020;11(Suppl 3):309–18; doi: 10.1016/j.jcot.2020.02.004.
23.
Wang L, Qin L, Lu H-B, Cheung W-H, Yang H, Wong W-N, Chan K-M, Leung K-S. Extracorporeal shock wave therapy in treatment of delayed bone-tendon healing. Am J Sports Med. 2008;36(2):340–7; doi: 10.1177/0363546507307402.
Share
RELATED ARTICLE
| eISSN: | 2544-4395 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
