Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) for Shoulder Mobility Improvement in Women with Upper Limb Lymphedema Secondary to Breast Cancer: A Multicenter Controlled Clinical Trial

Muñoz-Alcaraz, Maria Nieves ; Jimenez-Vilchez, Antonio José ; Santamaria-Peláez, Mirian ; Perula de Torres, Luis A. ; Olmo-Carmona, Maria Victoria ; Muñoz-Garcia, María Teresa ; Jorge-Gutierrez, Presentacion ; Serrano-Merino, Jesús ; Romero-Rodriguez, Esperanza ; Rodriguez-Elena, Lorena ; Refusta-Ainaga, Raquel ; Lahoz-Sanchez, Maria Pilar ; Miro-Palacios, Belen ; Medrano-Cid, Mayra (Universidad de Zaragoza) ; Magallon-Botaya, Rosa (Universidad de Zaragoza) ; Minguez-Minguez, Luis A. ; Gonzalez-Santos, Josefa ; Gonzalez-Bernal, Jeronimo J.

Resumen: Background: Lymphedema, secondary to breast cancer (BCRL), is the abnormal accumulation of protein-rich fluid in the interstitium caused by a malfunction of the lymphatic system. It causes swelling, deficiencies in upper limb functions and structures, sensory pain and emotional alterations, which have a chronic course and affect the upper limb''s functionality. This study aims to verify the efficacy and efficiency in the upper limb '' s functionality of a protocolized experimental approach based on occupational therapy, TAPA (activity-oriented proprioceptive antiedema therapy), in the rehabilitation of BCRL in stages I and II, comparing it with the conservative treatment considered as the standard, complex decongestive therapy (CDT), through a multicenter randomized clinical trial. Methods: a randomized and prospective clinical trial was conducted with experimental and control groups. Women diagnosed with BCRL belonging to institutions in Cordoba and Aragon (Spain) participated. Sociodemographic variables and those related to the functionality of the affected upper limb were evaluated before and after the intervention. Results: The results showed statistically significant differences in the analysis of covariance performed for the variable joint balance of the shoulder '' s external rotation (p = 0.045) that could be attributed to the intervention performed; however, the effect size was minimal (eta(2) <= 0.080). In the rest of the variables, no significant differences were found. Conclusions: TAPA may be an alternative to the conservative treatment of women with BCRL. It was shown to be just as effective for volume reduction and activity performance as CDT but more effective in improving external rotation in shoulder joint balance.

Idioma: Inglés

DOI: 10.3390/jcm11082234

Año: 2022

Publicado en: Journal of Clinical Medicine 11, 8 (2022), 2234 [11 pp.]
ISSN: 2077-0383

Factor impacto JCR: 3.9 (2022)

Categ. JCR: MEDICINE, GENERAL & INTERNAL rank: 58 / 169 = 0.343 (2022) - Q2 - T2

Factor impacto CITESCORE: 5.4 - Medicine (Q2)

Factor impacto SCIMAGO: 0.935 - Medicine (miscellaneous) (Q1)

Financiación: info:eu-repo/grantAgreement/ES/DGA/B21-17R

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
Área (Departamento): Área Fisioterapia (Dpto. Fisiatría y Enfermería)