title: Manual Lymphatic Drainage and Active Exercise Effects on Lymphatic Function Do Not Translate Into Morbidities in Women Who Underwent Breast Cancer Surgery.
abstract: To evaluate manual lymphatic drainage (MLD) and active exercise effects on lymphatic alterations of the upper limb (UL), range of motion (ROM) of shoulder, and scar complications after breast cancer surgery.
  
  
  
  Clinical trial.
  
  
  
  Health care center.
  
  
  
  Women (N=105) undergoing radical breast cancer surgery who were matched for staging, age, and body mass index.
  
  
  
  Women (n=52) were submitted to MLD and 53 to active exercises for UL for 1 month and followed up.
  
  
  
  Shoulder ROM, surgical wound inspection and palpation, UL circumference measurements, and lymphoscintigraphy were performed in preoperative and postoperative periods.
  
  
  
  There was no significant difference between groups with regard to wound healing complications, ROM, and UL circumferences. After surgery, 25 (48.1%) of the MLD group and 19 (35.8%) of the active exercise group showed worsening in radiopharmaceutical uptake velocity, whereas 9 (17.3%) of the MLD group and 11 (20.8%) of the active exercise group showed improved velocity (P=.445). With regard to uptake intensity, 27 (51.9%) of the MLD group and 21 (39.6%) of the active exercise group showed worsening whereas 7 (13.5%) of the MLD group and 7 (13.2%) of the active exercise group showed some improvement (P=.391). The presence of collateral circulation was similar in both groups at both time points evaluated. The active exercise group had a significant increase in postoperative liver absorption (P=.005), and the MLD group had a significant increase in postoperative dermal backflow (P=.024).
  
  
  
  MLD and active exercise effects are equivalent with regard to morbidity. Minor changes in lymphatic function associated with either MLD or active exercises were not related to patients' symptoms or signs.
authors: Physical Therapy Sector, Women's Integrated Healthcare Center, University of Campinas, Campinas, SP, Brazil. Electronic address: marimfo@yahoo.com.br.
authors: Mariana Maia
authors: MM
authors: Freire de Oliveira
authors: Department of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, SP, Brazil.
authors: Maria Salete
authors: MS
authors: Costa Gurgel
authors: Management and Health Care Department, Physical Therapy Sector, Federal University of São Paulo, São Paulo, SP, Brazil.
authors: Maria Teresa
authors: MT
authors: Pace do Amaral
authors: Nuclear Medicine and Radiology Department, School of Medicine, University of Campinas, Campinas, SP, Brazil.
authors: Bárbara Juarez
authors: BJ
authors: Amorim
authors: Nuclear Medicine and Radiology Department, School of Medicine, University of Campinas, Campinas, SP, Brazil.
authors: Celso Darío
authors: CD
authors: Ramos
authors: Nuclear Medicine and Radiology Department, School of Medicine, University of Campinas, Campinas, SP, Brazil.
authors: José Geraldo
authors: JG
authors: Almeida Filho
authors: University Center of Associated Teaching Colleges, São Paulo, SP, Brazil.
authors: Laura Ferreira
authors: LF
authors: de Rezende
authors: Department of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, SP, Brazil.
authors: Luís Otávio
authors: LO
authors: Zanatta Sarian
mesh_terms: D000328:Adult; D000368:Aged; D000072656:Breast Cancer Lymphedema / Q000534:rehabilitation*; D001943:Breast Neoplasms / Q000601:surgery; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008405:Massage / Q000379:methods*; D008408:Mastectomy / Q000009:adverse effects; D008875:Middle Aged; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular / Q000502:physiology; D034941:Upper Extremity / Q000502:physiology
keywords: Breast neoplasms; Lymphatic system; Physical therapy modalities; Rehabilitation