Quality of life improvement in breast cancer survivors affected by upper limb lymphedema through a novel multiperspective physical activity methodology: a monocentric pilot study

Breast Cancer. 2022 May;29(3):437-449. doi: 10.1007/s12282-021-01322-0. Epub 2022 Jan 13.

Abstract

Purpose: Chronic lymphedema causes psychophysical sequelae jeopardizing quality of life (QoL) of breast cancer (BC) survivors, and lack of effective therapies represents a major challenge for healthcare professionals. Structured adapted physical activity (APA) may represent an effective strategy to attenuate cancer treatment-related impairments and improve QoL. Here, we describe the effects of a specific APA intervention based on a novel multiperspective methodology in counteracting lymphedema-related morphofunctional alterations and improving QoL of BC survivors.

Methods: BC survivors with chronic moderate/severe lymphedema attending the Cancer Rehabilitation Center in Florence were assessed before and after 8-week APA. The protocol consisted of both APA specialist-supervised and self-leaded sessions using a tailor-designed proprioceptive board. Body mass index, bioimpedance parameters, indirect upper limb volume measurement, and ultrasonography were performed. Wrist flexion/extension and hand strength functional tests were also executed. QoL, depression/anxiety and pain intensity were evaluated by ULL27, HADS, distress thermometer and NRS questionnaires, respectively.

Results: Although bioimpedance, ultrasound and volumetric measures remained mostly unchanged, wrist mobility, pain perception, depression, and QoL were all significantly ameliorated after APA.

Conclusions: Our findings suggest that a multidisciplinary treatment approach involving APA professionals should be employed in the management of BC-related lymphedema to improve patient psychophysical outcomes and QoL.

Keywords: Adapted physical activity; Breast cancer survivors; Cancer-related symptoms; Lymphedema; Patient-reported outcomes; Quality of life.

MeSH terms

  • Breast Neoplasms* / complications
  • Breast Neoplasms* / therapy
  • Cancer Survivors*
  • Exercise
  • Female
  • Humans
  • Lymphedema* / etiology
  • Lymphedema* / therapy
  • Pilot Projects
  • Quality of Life
  • Surveys and Questionnaires
  • Survivors
  • Upper Extremity