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Effect of Myofascial Release Technique for Postoperative Treatment of Stage Ⅲ Upper Limb Lymphedema in Patients with Breast Cancer
Medical Journal of Peking Union Medical College Hospital 2022, 13(6): 1045-1050
Published: 30 November 2022
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Objective

To explore the effect of myofascial release technique in the treatment of stage Ⅲ lymphedema after breast cancer surgery.

Methods

The clinical data of breast cancer-related stage Ⅲ lymphedema patients treated in the Department of Rehabilitation Medicine of Peking Union Medical College Hospital from January 2016 to December 2021 were retrospectively collected. According to different treatment methods, the patients were divided into manual therapy group and conventional therapy group. The conventional therapy group was treated with conventional bandage compression combined with exercise training, while the manual therapy group was treated with myofascial release technique before bandage compression and exercise training. Both groups were treated 2-3 times a week, 25-30 times in total. Limb volume, pain, range of motion (ROM), and limb function were evaluated before treatment, at the end of treatment, and 3 months after treatment, with limb volume as the primary outcome index.

Results

A total of 79 breast cancer patients with stage Ⅲ lymphedema who met the inclusion and exclusion criteria were enrolled, including 39 in the conventional therapy group and 40 in the manual therapy group. There was no significant difference in limb volume, visual analogue scale (VAS) score, flexion and abduction ROM, and disability arm shoulder hand (DASH) score between the two groups before treatment (all P > 0.05). Compared with the conventional therapy group, the affected limb volume in the manual therapy group was reduced at the end of treatment[(2511.70±437.08)cm3 vs. (2823.58±537.60)cm3, P=0.006] and 3 months after treatment[(2492.91±446.52)cm3 vs. (2813.90±533.87)cm3, P=0.005], and VAS and DASH scores were decreased (all P < 0.05), while the anteriorflexion and abduction ROM of the affected limb were increased 3 months after treatment (all P < 0.05). Linear regression analysis showed that in the manual therapy group the mean reduction of limb volume after treatment was 156.260 cm3(95% CI: 124.264-188.255, P < 0.001) more than that in the conventional therapy group; the mean reduction of VAS score was 0.557(95% CI: 0.163-0.951, P=0.006) more than that in the conventional therapy group; and the mean reduction of DASH score was 16.590(95% CI: 12.270-20.911, P < 0.001) more than that in the conventional therapy group; the average increase of anteriorflexion ROM was 7.390(95% CI: 2.016-12.763, P=0.007) more than that in the conventional therapy group, and the average increase of abduction ROM was 12.737(95% CI: 6.320-19.153, P < 0.001) more than that in the conventional therapy group.

Conclusions

Myofascial relaxation may be associated with the reduction of the volume of stage Ⅲ lymphedema in patients with breast cancer. It can relieve pain and restore joint function to a certain extent.

Issue
Clinical Practice Guidelines for Tumor-related Lymphedema: Chinese Expert Consensus Based on the Delphi Method (2025 Version)
Medical Journal of Peking Union Medical College Hospital 2025, 16(6): 1449-1459
Published: 16 October 2025
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Tumor-related lymphedema is a common chronic progressive lymphatic disorder that occurs as a complication of malignant tumors and cancer-related therapy. It clinically presents with symptoms such as swelling, heaviness, stiffness and impaired mobility of the affected limb. The condition can lead to disability and trigger emotional disturbances such as anxiety and depression, significantly impairing patients' quality of life. The management of this disease is a long-term endeavor that relies on multidisciplinary collaboration. Although relevant consensus documents have been published domestically, their content remains insufficiently comprehensive, resulting in a lack of unified and standardized guidance in clinical practice. There is an urgent need to update and develop more comprehensive localized guidelines. A panel of 30 experts from 17 provinces, municipalities, and autonomous regions in China collaboratively developed the Clinical Practice Guidelines for Tumor-related Lymphedema: Chinese Expert Consensus Based on the Delphi Method (2025 Version) by integrating the latest evidence-based medical findings and applying the Delphi method. This consensus addresses nine key dimensions: risk factors, monitoring and follow-up, patient education, diagnosis and evaluation, complex decongestive therapy, pharmacotherapy, surgical intervention, nutritional management, and multidisciplinary care. In total, 113 consensus recommendations were established, providing standardized guidance for the clinical management of tumor-related lymphedema.

Review Issue
Advances in the Evaluation of Freezing of Gait in Parkinson's Disease
Medical Journal of Peking Union Medical College Hospital 2024, 15(3): 642-648
Published: 10 May 2023
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Freezing of gait (FOG) is a common motor manifestation in the middle and late stages of Parkinson's disease. It is also a major cause of falls and may lead to disability, making it important to identify and treat FOG effectively. In this paper, we review the common and practical methods of FOG detection in clinical and research studies, with a view to provide clinical reference.

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