Effects of Combined Upper Extremity Exercise and Pneumatic Compression Therapy on Breast Cancer-Related Lymphedema

• Combined Upper Extremity Exercise (Other): Warm-up (5 min): shoulder flexion, abduction, circular motion Active and resistance training (20 min): using elastic bands or 0.5 kg weights： Seated rowing/Chest press/Lat pulldown/Single-arm row/Biceps curl/Triceps extension Two sets of 10 repetitions (or up to 3 sets depending on tolerance) Stretching (5 min): overhead stretch, lateral flexion, biceps/triceps stretch
• Pneumatic Compression Therapy (Other): duration:20 minutes Multi-chamber upper limb sleeve Sequential distal-to-proximal inflation Pressure range: 20-40 mmHg (adjusted according to tolerance and safety limits) Monitoring for pain, numbness, pallor, or circulatory compromise

Primary outcomes

• Upper limb circumference point-by-point [5 weeks]: Upper Limb Circumference Measurement Upper limb circumference was measured using a non-elastic standard measuring tape at predefined anatomical landmarks to assess limb swelling. Measurement Sites: Elbow joint 5 cm, 10 cm, and 15 cm proximal to the elbow 5 cm, 10 cm, and 15 cm distal to the elbow Wrist joint Circumference was recorded in centimeters (cm) at each site. Greater circumference values indicate greater limb swelling, while lower values indicate reduction of lymphedema. Standardization Procedures: All measurements were performed by the same trained assessor. Measurements were conducted within the same time window (e.g., 9:00 AM-12:00 PM). Participants rested for 10 minutes prior to measurement. Measurements were obtained with the participant in the same standardized posture at each assessment time point.
• shoulder range of motion [5 weeks]: Shoulder Range of Motion (ROM) is measured using a standard goniometer to assess active shoulder movements, including flexion, extension, abduction, adduction, internal rotation, and external rotation. ROM is measured in degrees (°). Higher values indicate greater joint mobility and better functional movement. There is no fixed minimum or maximum score, as normal values vary by movement; however, greater degrees reflect better shoulder function.
• Disabilities of the Arm, Shoulder and Hand questionnaire, DASH [5weeks]: The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is a self-reported measure of upper extremity function and symptoms. The DASH score ranges from 0 to 100. 0 indicates no disability (best function). 100 indicates most severe disability (worst function). Higher scores represent worse upper extremity function and greater disability.
• Functional Assessment of Cancer Therapy-Breast Cancer [5 weeks]: The Functional Assessment of Cancer Therapy - Breast (FACT-B) is a validated self-reported questionnaire assessing quality of life in patients with breast cancer. It includes physical, social/family, emotional, functional well-being, and breast cancer-specific concerns. The total FACT-B score ranges from 0 to 148. Higher scores indicate better quality of life. Lower scores indicate poorer quality of life.

Sex: Female, ages: 20 Years to 70 Years

Inclusion Criteria:

1. Female breast cancer patients aged 20-70 years
2. Postoperative unilateral breast cancer surgery with a clinical diagnosis of lymphedema (stage I or II breast cancer treatment, with unilateral lymphedema greater than 2 cm and less than 8 cm at least one measurement point)
3. Completion of subsequent chemotherapy/radiotherapy or other treatments at least 3 months postoperatively
4. Ability to cooperate with 12 treatments and all assessments and sign a consent form

Exclusion Criteria:

1. Breast cancer with a tendency for recurrence or metastasis
2. Severe infection of the upper limb (cellulitis)
3. Uncontrolled heart failure, deep vein thrombosis (DVT), severe peripheral vascular disease
4. Stage III lymphedema, bilateral lymphedema, or need to take medications that may affect sweat glands in the upper limbs
5. Other musculoskeletal disorders of the upper limbs, joint deformities, or a history of surgery
6. Pregnancy or other conditions unsuitable for participation

• Study Protocol (PDF, 2026-01-21)
• Informed Consent Form (PDF, 2026-01-21)