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

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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.

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Acknowledgements

The authors are most grateful to the women who took part in the study, and to Mr. Alessandro Sarti (Ortopedia Fiorentina Srl, Florence, Italy) for manufacturing of Hand-Walk proprioceptive board.

Funding

This research was supported by MIUR (Ministry of Education, University and Research, Italy)-University of Florence funds (ex 60%; Grant number: MIRCAMARINIRICATEN21) granted to M.M. (Mirca Marini).

Author information

Author notes

  1. Giuditta Carretti and Daniela Mirandola contributed equally to this work.

Authors and Affiliations

  1. Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, Largo Brambilla 3, 50134, Florence, Italy

    Giuditta Carretti, Daniela Mirandola, Sara Germano, Mirko Manetti & Mirca Marini

  2. The Italian League Against Tumors (LILT), 50126, Florence, Italy

    Daniela Mirandola, Francesca Maestrini & Lisa Sequi

  3. Oncological Rehabilitation Centre (Ce.Ri.On.), 50139, Florence, Italy

    Maria Grazia Muraca

  4. Oncological Network, Prevention and Research Institute (ISPRO), 50139, Florence, Italy

    Maria Grazia Muraca & Guido Miccinesi

Authors
  1. Giuditta Carretti
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  2. Daniela Mirandola
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  4. Lisa Sequi
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  5. Sara Germano
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  6. Maria Grazia Muraca
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  8. Mirko Manetti
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Contributions

Conceptualization, DM, MGM and MM (Mirca Marini); methodology, DM, MGM and MM (Mirca Marini); formal analysis, GC, DM, FM, LS, SG and GM; investigation, GC, DM, FM, MM (Mirko Manetti) and MM (Mirca Marini); data curation, GC, DM, MM (Mirko Manetti) and MM (Mirca Marini); writing—original draft preparation, GC, MM (Mirko Manetti) and MM (Mirca Marini); writing—review and editing, GC, DM, FM, LS, SG, MGM, GM, MM (Mirko Manetti) and MM (Mirca Marini); supervision, MM (Mirca Marini); funding acquisition, MM (Mirca Marini). All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Mirca Marini.

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Conflict of interest

The authors declare no conflict of interest.

Institutional review board statement

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the ISPRO Review Board (approval number: 137/2016- cdc 755; approval date: 12 April 2017).

Informed consent statement

Written informed consent was obtained from all study participants.

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Carretti, G., Mirandola, D., Maestrini, F. et al. 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 29, 437–449 (2022). https://doi.org/10.1007/s12282-021-01322-0

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