Effect of Myofascial Release Technique for Postoperative Treatment of Stage Ⅲ Upper Limb Lymphedema in Patients with Breast Cancer

  Objective  To explore the effect of myofascial release technique in the treatment of stage Ⅲ lymphedema after breast cancer surgery.

  Methods  The clinical data of breast cancer-related stage Ⅲ lymphedema patients treated in the Department of Rehabilitation Medicine of Peking Union Medical College Hospital from January 2016 to December 2021 were retrospectively collected. According to different treatment methods, the patients were divided into manual therapy group and conventional therapy group. The conventional therapy group was treated with conventional bandage compression combined with exercise training, while the manual therapy group was treated with myofascial release technique before bandage compression and exercise training. Both groups were treated 2-3 times a week, 25-30 times in total. Limb volume, pain, range of motion (ROM), and limb function were evaluated before treatment, at the end of treatment, and 3 months after treatment, with limb volume as the primary outcome index.

  Results  A total of 79 breast cancer patients with stage Ⅲ lymphedema who met the inclusion and exclusion criteria were enrolled, including 39 in the conventional therapy group and 40 in the manual therapy group. There was no significant difference in limb volume, visual analogue scale (VAS) score, flexion and abduction ROM, and disability arm shoulder hand (DASH) score between the two groups before treatment (all P > 0.05). Compared with the conventional therapy group, the affected limb volume in the manual therapy group was reduced at the end of treatment(2511.70±437.08)cm³ vs. (2823.58±537.60)cm³, P=0.006 and 3 months after treatment(2492.91±446.52)cm³ vs. (2813.90±533.87)cm³, P=0.005, and VAS and DASH scores were decreased (all P < 0.05), while the anteriorflexion and abduction ROM of the affected limb were increased 3 months after treatment (all P < 0.05). Linear regression analysis showed that in the manual therapy group the mean reduction of limb volume after treatment was 156.260 cm³(95% CI: 124.264-188.255, P < 0.001) more than that in the conventional therapy group; the mean reduction of VAS score was 0.557(95% CI: 0.163-0.951, P=0.006) more than that in the conventional therapy group; and the mean reduction of DASH score was 16.590(95% CI: 12.270-20.911, P < 0.001) more than that in the conventional therapy group; the average increase of anteriorflexion ROM was 7.390(95% CI: 2.016-12.763, P=0.007) more than that in the conventional therapy group, and the average increase of abduction ROM was 12.737(95% CI: 6.320-19.153, P < 0.001) more than that in the conventional therapy group.

  Conclusions  Myofascial relaxation may be associated with the reduction of the volume of stage Ⅲ lymphedema in patients with breast cancer. It can relieve pain and restore joint function to a certain extent.