300 Section - The effect of aerobic exercise based on the cardiopulmonary exercise test combined with manual lymphatic drainage on lymphedema after breast cancer surgery

Lymphedema is a common complication after breast cancer treatment. Manual lymphatic drainage(MLD) is an effective intervention, but its effect is limited. Aerobic exercise based on cardiopulmonary exercise test(CPET) can promote lymphatic return while ensuring safety. Therefore, we explored the aerobic exercise combined with MLD to further alleviate lymphedema related to breast cancer.

Design:

A total of 24 patients were randomized into the experimental group (n=12) and the control group (n=12). Patients in both groups received MLD for 30 minutes each time. The experimental group conducted an additional 30 minutes of exercise at a 50% PeakVO₂ intensity, while the control group took an additional 30 minutes of walking under the supervision of the nurse. The training was conducted 3 times a week for a total of 4 weeks. Before and after the treatment, the arm edema was measured using a tissue dielectric constant (TDC), and the grip strength on the affected side was accessed using J-Tech grip strength device. The maximum oxygen uptake(VO₂max) was measured using CPET and quality of life(Qol) was measured using the short form-36(SF-36).

Results:

There were no significant differences in TDC, grip strength, VO₂max and SF-36scores between two groups before treatment (p >0.05). After four weeks of intervention, the TDC of the experimental group (1.00 (0.97, 1.10)) was significantly lower than that of the control group (1.15 (1.08, 1.40)) (p = 0.040). The VO₂max of the experimental group (31.0 (25.8, 33.3)) was significantly higher than that of the control group (21.5 (21.0, 28.5)) (p = 0.035). The scores of physiological function, general health and emotional function of SF-36 in experimental group were significantly higher than those in the control group(p< 0.05).

Conclusion:

Compared with the simple MLD, the combination of aerobic exercise based on the CPET with MLD showed a more significant improvement in lymphedema.