Limb circumference, muscle strength and quality of life after Complete Decongestive Therapy with structured exercise among Breast cancer-related lymphedema patient

a. A brief description of CDT component: Manual lymphatic Drainage (MLD) - Non-invasive massage technique that uses light, superficial and gentle strokes to mobilize oedema fluid with pumping, scooping, and rotary movement according to Vodder Technique Multilayer Compression bandaging - Multi-layered padding and short-stretch bandages are applied to the affected limb. Remedial exercise: includes active, rhythmic, repetitive, non-resistance exercises combined with breathing. These exercises consisted of diaphragmatic breathing exercise, active free exercise for shoulder movement, elbow movement, wrist and fingers. Skin Care and education 1. Understanding of breast cancer-related lymphedema - sign and symptom 2. Overview of CDT 3. Compression bandaging - how to wear, important of bandaging and care tips 4. Skin care and infection prevention 5. Self-management technique 6. Precaution measure in daily life The structured exercise is according to a study done by Corum et. al (2021), Omar et al (2019) and Kim et al (2010). Strengthening exercise while wearing a multilayer bandage. Repetition Intensity: 60% of their estimated one repetition maximum (1RM) with 3 set per day for each exercise Resistance exercise includes: • Triceps extension • Biceps curl up • Dumbbell floor fly • Dumbbell side raise • Lifting the arm forward • Wrist curl • Reverse wrist curl b) Intervention will be deliver by physiotherapist at the hospital involved c) Frequency and total duration of intervention: - weekly for 8 weeks, 60-90 minutes per participants d) mode of delivery: one to one e) strategies to assess adherence to the intervention: session attendance and log book