Sui Yan-Fang, Tong Lang-Qian, Lin Xia-Fei, Wu Hai-Xia, Shi Jing-Qin, Wang Shan-Shan, Tang Bu-He, Song Zhen-Hua
Department of Rehabilitation Medicine, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China.
Department of Nuclear Medicine, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China.
Front Oncol. 2023 Jun 16;13:1046003. doi: 10.3389/fonc.2023.1046003. eCollection 2023.
To underscore the paramount significance of incorporating comprehensive rehabilitation therapy as a crucial aspect of managing lymphedema caused by breast cancer surgery, and to illuminate our first-hand experience and insights gained in utilizing this approach.
We present a case report of a breast cancer survivor who had been suffering from persistent left upper-limb edema for over 15 years, who was effectively treated with a combination of conventional rehabilitation (seven-step decongestion therapy) and a comprehensive rehabilitation program (seven-step decongestion therapy, along with core and respiratory function training, as well as functional brace wearing). The efficacy of the rehabilitation therapy was evaluated through a comprehensive assessment.
Although the patient underwent the conventional rehabilitation program for one month, only limited improvement was observed. However, after an additional month of comprehensive rehabilitation treatment, the patient exhibited significant improvement in both lymphedema and the overall function of the left upper limb. The patient's progress was quantified by measuring the reduction in arm circumference, which demonstrated a notable decrease. Furthermore, improvements in joint range of motion were observed, with forward flexion of the shoulder enhancing by 10°, forward flexion improving by 15°, and elbow flexion increasing by 10°. In addition, manual muscular strength tests revealed an increase in strength from Grade 4 to Grade 5. The patient's quality of life was also significantly improved, as evidenced by the increase in the Activities of Daily Living score from 95 to 100 points, the increase in the the Functional Assessment of Cancer Therapy: Breast score from 53 to 79 points, and the decrease in the Kessler Psychological Distress Scale score from 24 to 17 points.
While seven-step decongestion therapy has been shown to be effective in reducing upper-limb lymphedema caused by breast cancer surgery, it has limitations in treating more chronic cases of the condition. However, when combined with core and respiratory function training and functional brace wearing, seven-step decongestion therapy has been shown to be even more effective in reducing lymphedema and improving limb function, ultimately leading to significant improvements in quality of life.
强调将综合康复治疗作为乳腺癌手术所致淋巴水肿管理的关键环节的至关重要性,并阐述我们在运用该方法过程中获得的第一手经验和见解。
我们呈现了一例乳腺癌幸存者的病例报告,该患者左上肢持续性水肿已超过15年,通过传统康复(七步消肿疗法)与综合康复方案(七步消肿疗法,同时进行核心及呼吸功能训练以及佩戴功能性支具)相结合的方式得到了有效治疗。通过全面评估来评价康复治疗的疗效。
尽管患者接受了为期一个月的传统康复方案,但仅观察到有限的改善。然而,在额外进行了一个月的综合康复治疗后,患者的淋巴水肿及左上肢整体功能均有显著改善。通过测量上臂围减小情况对患者的进展进行量化,结果显示有明显下降。此外,观察到关节活动范围有所改善,肩部前屈增加了10°,前伸增加了15°,肘部屈曲增加了10°。另外,徒手肌力测试显示肌力从4级增加到了5级。患者的生活质量也有显著提高,日常生活活动评分从95分提高到100分,癌症治疗功能评估:乳腺评分从53分提高到79分,凯斯勒心理困扰量表评分从24分降至17分,这些均证明了这一点。
虽然七步消肿疗法已被证明对减轻乳腺癌手术所致上肢淋巴水肿有效,但在治疗该病症的更慢性病例时存在局限性。然而,当与核心及呼吸功能训练以及佩戴功能性支具相结合时,七步消肿疗法在减轻淋巴水肿和改善肢体功能方面显示出更显著的效果,最终使生活质量得到显著提高。