Download Life After Breast Cancer: Exercise! Exercise! Exercise!

Life After Breast
Cancer:
Exercise! Exercise!
Exercise!
Jodi Steele RPT
Treatments for Breast
Cancer
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Lumpectomy vs. mastectomy
Sentinel Lymph Node Biopsy
Chemotherapy
Radiation
Hormone treatment
HER2NU and Herceptin
Reconstruction
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Implants
TRAM
DIEP
Side Effects
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Lymphedema
Neutropenia
Nausea and/or
Vomiting
Hair Loss
Decreased Nutritional
Status
Joint Pain
Fatigue
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Anemia
Peripheral Neuropathy
Shoulder Problems
Depression
Chemo Fog
Postural Problems
Axillary Web
Syndrome
Postural Problems
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Anterior displacement of the shoulder with
protraction of the scapula.
Treatment
 Leukotape
 Postural Exercises
 Stretch anterior and strengthen posterior
muscle groups
Shoulder Dysfunction
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Frozen shoulder due
to immobility and pain
Tendonitis due to
postural problems
Treatments
 Exercise for range
 Contract Relax
 Low load prolonged
stretch
 Leaukotape
Axillary Web Syndrome
A fibrotic cord starting
in the armpit and
running down the
arm
Can be like a piano
string
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Rehab Techniques Used to Treat
Axillary Web Syndrome
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Passive and active ROM – slowly bring arm
into painful range (DARE)
Dynamic arm/wrist exercises ‘Bye Bye’
Myofascial release
Manual lymph drainage
Light weight (20-30 mmHg) compression
garments may provide mild pressure to
the cords and lessen discomfort
Scar Tightness
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Scar Massage
PROM
AAROM
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Wand
Lymphedema
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An accumulation of
lymph fluid causing
swelling in the arm
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Risk Factors:
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Extent of surgery
Radiation
Infection
Axillary Web Syndrome
Immobility
Obesity
What Are The Treatments?
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Treatment Phase; Skin care, short stretch
bandages, EXERCISE, MLD and regular
visits to physiotherapist
Maintenance Phases; Skin care,
EXERCISE, massage and garments
Aqua Therapy (which is also exercise)
The Truth About Lymphedema
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A recent study by Schmitz and others (August,
2009) reported that weight lifting in a slowly
progressive program, while wearing a compressive
garment, did not significantly affect the severity of
lymphedema
In addition, weight lifting:
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reduced the number and severity of arm and
hand symptoms
Increased muscle strength
Reduced the number of lymphedema flare-ups
Effectiveness of Early Physiotherapy to
Prevent Lymphoedema After Surgery for
Breast Cancer: Randomized, Single
Blinded, Clinical Trial
Lacomba M, et. al. BMJ 2010;340
116 women with Breast Cancer
Surgery + lymph node dissection
• Intervention: Manual lymph drainage,
scar massage, shoulder exercises and
AWS treatment + lymphatic education
 25% developed lymphoedema in the
control group
 7% in the early physiotherapy group
(p<0.01)
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Exercise
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Research: THR 50% to 80% of MaxHR
(not just casual physical activity)
Improve survival
Improve ROM
Improve insulin resistance
Improve Bone Mineral Density
Improve immune response
Get back to LIFE!
Lymphedema Dance
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Debuting today for the first time ever!
Lymphedema Dance
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Deep diaphragmatic breaths
Shoulder rolls
Shoulder Abduction ‘chicken wing’
Bicep Curl
Myofascial Stretch of arm ‘Bye Bye’
Abduction/Adduction of fingers ‘No No’
Reverse Phalen’s Manoeuver
Let’s see it Live!
The End
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Any Questions?