Post Mastectomy Lymphedema
Conditions
Brief summary
The purpose of the study is to determine the effect of Thera-band exercises versus Swiss ball exercises on postural stability in unilateral post mastectomy lymphedema.
Detailed description
The need for this study develops from the lack of information in the published studies about the effectiveness of Thera-band exercises and Swiss ball exercise on balance in unilateral post mastectomy lymphedema. Lymphedema is a chronic and progressive condition associated with functional impairment of the body segment. The asymmetry between hemi Corp related to the range of motion, muscle strength, sensory stimuli and volume, reduce the ability to perceive and integrate information on the maintenance of the center of gravity and postural balance. The damage in the balance of patients with breast cancer is pointed out in the literature and is related to factors related to surgical intervention, adjuvant treatment, or even unilateral asymmetry caused by upper limb lymphedema. Core stability exercises improve neuromuscular system performance that causes the optimal lumbar-pelvic -hip chain mobility and good acceleration and deceleration, appropriate muscular balance, proximal stability and good function. Progressive resistance training interventions designed to increase strength and reduce the falls in elderly were effective in reducing both rate of falls and risk of falling, especially when some form of balance exercise was an integral part of the program. The present study is designed to investigate the effect of Thera-band exercises versus Swiss ball exercises on balance in unilateral post mastectomy lymphedema.
Interventions
OTHERThera-Band exercises
Participants in the first experimental group performed a Thera-Band exercise program 3 sessions weekly, for 8 weeks with progressive resistance, divided into four 2-week phases. Each 60-minute session included a 10-min warm-up (walking, jogging, and calisthenics), 45-min Thera-Band exercises, and 5-min cool-down. Phase 1 focused on major muscle groups (e.g., shoulder press, biceps curl). Phase 2 included trunk and leg-focused moves (e.g., reverse flies, lunge). Phase 3 added advanced resistance (e.g., chest press, deadlift). Phase 4 targeted core and lower body (e.g., diagonal chop, squat). Exercises changed every phase to progressively strengthen different muscle groups.
OTHERSwiss ball exercises
Participants in the second experimental group performed Swiss ball exercises 3 sessions weekly, for 8 weeks. Exercises included warm-up (15-5 mins), core Swiss ball training (progressing from 1 to 4 sets), and cool-down. Each session focused on abdominal, back, leg, trunk, and balance training using varied exercises performed for 30 seconds with rest. Exercise intensity ranged from 80-95% of max effort, increasing weekly. The Swiss ball size was selected based on patient height to ensure proper posture. Sessions gradually increased in duration and difficulty, ending with breathing and stretching for recovery.
OTHERTraditional physical therapy program
Participants in both experimental groups performed a traditional physical therapy program in the form of complex decongestive physical therapy(CDPT), including (manual lymphatic drainage, compression, exercise and skin care) and balance training, 3 sessions weekly, for 8 weeks.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
30 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* Patients are females. * Patient with post mastectomy unilateral lymphedema. * Their age will range from (30-50) years. * Patients will be given their informed consent.
Exclusion criteria
* Musculoskeletal disorders that will impair performance during training and tests. * Uncontrolled cardiovascular or pulmonary diseases. * Neurological and renal disorders. * Metabolic or vascular disease with a neurological component such as diabetes. * Malignant conditions. * Primary lymphedema. * Psychiatric illness, severe behavior or cognitive disorders. * Uncooperative patients. * Pregnancy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Center of Pressure (COP) | 8 weeks | The Wii Balance Board (WBB) will be used to measure the Center of Pressure (COP), which represents the point location of the vertical ground reaction force vector. This outcome reflects the user's weight distribution and is a key indicator of balance and postural control. COP will be assessed in both the mediolateral (X-axis: left-right) and anteroposterior (Y-axis: front-back) directions, allowing evaluation of postural sway and dynamic weight shifting during balance tasks. |
| Total Force (Weight) | 8 weeks | Total vertical ground reaction force will be calculated by summing the readings from all four pressure sensors on the WBB. This measure provides an estimate of the user's body weight and enables monitoring of force fluctuations during dynamic or static postural tasks, serving as an indirect marker of load-bearing and movement initiation or compensation patterns. |
| Load Distribution | 8 weeks | The WBB will quantify the distribution of body weight across the left vs. right and front vs. back regions of the platform. This load distribution outcome helps identify asymmetries in stance or postural alignment, which can be critical in populations with balance deficits or musculoskeletal impairments. The measure allows for detailed analysis of postural strategy and weight-bearing preference. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Limb volume measurement | 8 weeks | Limb volume will be measured using the truncated cone method with circumferential measurements taken at 10-cm intervals (at 0, 10, 20, 30, and 40 cm from the ulnar styloid). The patient will be seated with the limb supported horizontally on a bedside table. A 1-cm retractable fiberglass tape will be used, and an adhesive measuring strip from axilla to wrist will ensure consistency. Segment volume will be calculated using the formula: V = h × (C1² + C1×C2 + C2²) / (12π), where C1 and C2 are the circumferences and h is the 10 cm distance between them. |
Countries
Egypt
Contacts
Primary ContactAfkar Zaki Abdallah Elbabouby, M.Sc
Backup ContactKhadra Mohamed Ali, PhD
Outcome results
None listed