Objective
To evaluate the effects of extracorporeal shockwave therapy (ESWT) on improving lymphedema, quality of life, and fibrous tissue in patients with stage 2 lymphedema.
Methods
Breast cancer-related lymphedema patients referred to the rehabilitation center were recruited. We enrolled stage 2 lymphedema patients who had firmness of the skin at their forearm, a circumference difference of more than 2 cm between each arm, or a volume difference between upper extremities greater than 200 mL, confirmed by lymphoscintigraphy. The patients were randomly divided into the ESWT group and the control group. ESWT was performed for 3 weeks (two sessions per week); both groups received complex decongestive physical therapy. All patients were evaluated at baseline and at 3 weeks after treatment. The measurements performed included visual analog scale score, volume, circumference, QuickDASH (Quick Disabilities of the Arm, Shoulder and Hand) score, bioelectrical impedance, and skin thickness.
Results
The patients in both groups (n=15 in each group) completed the 3-week therapy experiment. No significant differences were observed in demographic characteristics between groups. After the 3-week treatment period, improvement was noted in the circumference difference below the elbow, volume, ratio of extracellular water to total body water, and skin thickness in the ESWT group. A significant difference was found in all the above-mentioned areas except in circumference below the elbow in the ESWT group.
Conclusion
ESWT reduced edema and skin fibrosis without significant complications. Therefore, ESWT can be used together with complex decongestive physical therapy for treating lymphedema.

Citations

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  Chuyu Deng, Zhiguo Wu, Zijie Cai, Xiaoyan Zheng, Chunzhi Tang
  Frontiers in Oncology.2024;[Epub]     CrossRef
• Shock wave therapy in oncology: in vitro, in vivo, rehabilitation
  T.I. Grushina, I.I. Orlov
  Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul'tury.2022; 99(3): 58.     CrossRef
• Surgical Treatment and Rehabilitation Strategies for Upper and Lower Extremity Lymphedema: A Comprehensive Review
  Alessandro de Sire, Luigi Losco, Lorenzo Lippi, Davide Spadoni, Juste Kaciulyte, Gokhan Sert, Paola Ciamarra, Marco Marcasciano, Roberto Cuomo, Alberto Bolletta, Marco Invernizzi, Emanuele Cigna
  Medicina.2022; 58(7): 954.     CrossRef
• The effect of the combined use of complex decongestive therapy with electrotherapy modalities for the treatment of breast cancer-related lymphedema: a randomized clinical trial
  Mahboobeh Hemmati, Zahra Rojhani-Shirazi, Zeinab Sadat Zakeri, Majid Akrami, Nasrin Salehi Dehno
  BMC Musculoskeletal Disorders.2022;[Epub]     CrossRef
• Long-Term Effects of Extracorporeal Shock Wave Therapy on Breast Cancer-Related Lymphedema
  Jong-Hwa Lee, Sang-Beom Kim, Kyeong-Woo Lee, Won-Wook Ha
  Journal of Clinical Medicine.2022; 11(22): 6747.     CrossRef
• Pilot study of oncological safety of extracorporeal shock wave therapy for post-mastectomy lymphedema in patients with breast cancer
  T.I. Grushina, I.I. Orlov
  Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul'tury.2022; 99(6): 30.     CrossRef
• Effect of extracorporeal shock wave therapy on keratinocytes derived from human hypertrophic scars
  Hui Song Cui, So Young Joo, Yoon Soo Cho, Ji Heon Park, Yu Mi Ro, June-Bum Kim, Cheong Hoon Seo
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• A Risk Factor Analysis of Axillary Web Syndrome in Patients After Breast Cancer Surgery: A Single Center Study in Korea
  Sangah Jeong, Byung Joo Song, Jiyoung Rhu, Cheolki Kim, Sun Im, Geun-Young Park
  Annals of Rehabilitation Medicine.2021; 45(5): 401.     CrossRef
• Extracorporeal Shock Wave Therapy Combined with Complex Decongestive Therapy in Patients with Breast Cancer-Related Lymphedema: A Systemic Review and Meta-Analysis
  Yu Lin Tsai, Ting Jie I, Ya Chi Chuang, Yuan Yang Cheng, Yu Chun Lee
  Journal of Clinical Medicine.2021; 10(24): 5970.     CrossRef

Objective
To compare the treatment effects, satisfaction with the treatment, and performance improvement following bandage treatment using the spiral method and spica method for breast cancer-related lymphedema (BCRL).
Methods
A prospective study with 46 patients with BCRL was conducted. All patients were divided into either the spiral or spica group for non-elastic bandage therapy and received the same treatment for 2 weeks, apart from the group-specific bandaging method used. For both groups, the Quality of Life Instrument score before treatment, changes in the volume of lymphedema limb and the Disability of the Arm, Shoulder, and Hand (DASH) score before and after treatment, and treatment satisfaction after treatment were compared. The Student t-test was used to compare the parameters between the two different bandage methods.
Results
With respect to the treatment outcomes, total volume reduction and proximal part volume reduction after treatment were 98.0±158.3 mL and 56.0±65.4 mL in the spiral method group and 199.0±125.1 mL and 106.1±82.2 mL in the spica method group, respectively. Therefore, the spica method group showed a significantly better improvement (p<0.05). The DASH score changes after treatment showed that the spiral group score increased by 3.8±5.4 and the spica group score increased by 7.7±6.1; thus, a significantly better improvement was noted in the spica group (p<0.05).
Conclusion
The spica method indicated better volume reduction and DASH score improvement than the spiral method. Therefore, the spica method may be more effective for treating patients with BCRL.

Citations

• Wrapping up the evidence: bandaging in breast cancer-related lymphedema—a systematic review and meta-analysis
  Celia García-Chico, Susana López-Ortiz, Carmen Lorenzo-Crespo, José Pinto-Fraga, Alejandro Santos-Lozano, Ana Domínguez-García
  Breast Cancer.2025;[Epub]     CrossRef
• Effects of Forearm Bandaging Technique, Muscle Contraction, and Additional Compression Pad Use on Sub-Bandage Pressure
  Elif Sakizli Erdal, Miray Haspolat, Burak Erturk, Ilke Keser
  Lymphatic Research and Biology.2025;[Epub]     CrossRef
• Management of Lymphoedema and Lymphorrhoea with Wrap around Compression in Breast Secondary to Carcinoma Breast: A Case Report
  Aradhana Shukla, Nitesh Gonnade, Manoj Kamal
  Indian Journal of Palliative Care.2024; 30: 85.     CrossRef
• Evidence for the clinical effectiveness of decongestive lymphoedema treatment for breast cancer–related arm lymphoedema, a systematic review
  Eunice Jeffs, Emma Ream, Cath Taylor, Arnie Purushotham, Debra Bick
  Supportive Care in Cancer.2024;[Epub]     CrossRef
• The effect of compression therapies and therapeutic modalities on lymphedema secondary to cancer: a rapid review and evidence map
  M. L. McNeely, S. M. Shallwani, M. M. Al Onazi, F. Lurie
  Medical Oncology.2024;[Epub]     CrossRef
• Efficient and precise Ultra-QuickDASH scale measuring lymphedema impact developed using computerized adaptive testing
  Cai Xu, Mark V. Schaverien, Joani M. Christensen, Chris J. Sidey-Gibbons
  Quality of Life Research.2022; 31(3): 917.     CrossRef
• The effects of complex decongestive therapy on pain and functionality in individuals with breast cancer who developed adhesive capsulitis due to lymphedema: an evaluation by an isokinetic computerized system
  Konca Kaya Tatar, Begumhan Turhan
  The Korean Journal of Pain.2022; 35(3): 280.     CrossRef
• Recent Trends in Rehabilitation for Cancer Patients
  Kwan-Sik Seo
  Annals of Rehabilitation Medicine.2022; 46(3): 111.     CrossRef
• Adipose-derived regenerative cells and lipotransfer in alleviating breast cancer-related lymphedema: An open-label phase I trial with 4 years of follow-up
  Mads Gustaf Jørgensen, Navid Mohamadpour Toyserkani, Charlotte Harken Jensen, Ditte Caroline Andersen, Søren Paludan Sheikh, Jens Ahm Sørensen
  Stem Cells Translational Medicine.2021; 10(6): 844.     CrossRef
• Étude des variations des pressions de travail sous bandage composite de décongestion sur membre supérieur sain
  Jean-Claude Ferrandez, Guillaume Cassignac, Pierre-Henri Ganchou
  Kinésithérapie, la Revue.2021; 21(238): 3.     CrossRef
• Effectiveness of four types of bandages and kinesio-tape for treating breast-cancer-related lymphoedema: a randomized, single-blind, clinical trial
  María Torres-Lacomba, Beatriz Navarro-Brazález, Virginia Prieto-Gómez, Jean Claude Ferrandez, Jean Yves Bouchet, Helena Romay-Barrero
  Clinical Rehabilitation.2020; 34(9): 1230.     CrossRef
• Features, Predictors, and Treatment of Breast Cancer–Related Lymphedema
  Xiaochen Zhang, Jill M. Oliveri, Electra D. Paskett
  Current Breast Cancer Reports.2020; 12(4): 244.     CrossRef