The Effect of Hand Exercises on Upper Limb Volume, Quality of Life, and Hand Function in Breast Cancer Survivors

NCT ID: NCT05983380

Last Updated: 2024-04-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-10-01

Study Completion Date

2024-12-30

Brief Summary

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The purpose of this study is to determine whether the addition of simple hand mobility and grip strengthening exercises to the usual care for upper extremity lymphedema will reduce limb volume and improve the quality of life, hand dexterity, and grip strength for those experiencing breast cancer-related lymphedema. Researchers will compare those receiving the usual treatment to those receiving the usual treatment plus hand mobility and grip strengthening exercises.

Detailed Description

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The purpose of this study is to determine whether the addition of simple hand mobility and grip strengthening exercises to the usual care for upper extremity lymphedema will reduce limb volume and improve the quality of life, hand dexterity, and grip strength for those experiencing early, moderate, or late stage breast cancer-related lymphedema.

This study is an experimental clinical trial to determine the effectiveness of hand mobility and grip exercises on limb volume, quality of life, hand dexterity, and grip strength in women with breast cancer-related lymphedema. The two independent variables are group, a between-subject factor, and time, a within subject factor. There are two levels of the independent variable of group: (1)usual care plus hand exercises and (2) usual care alone. The independent variable of time will be assessed at three timepoints: initial to 4 weeks, 4 to 8 weeks, and initial to 8 weeks of intervention. The four dependent variables are: (1) upper limb volume, (2) quality of life, (3) hand dexterity, and (4) grip strength. If a relationship (r\>0.5) is found between any of the dependent variables, MANOVA will used for analysis. If no relationship is found, a 2x3 mixed ANOVA will be used to analyze each dependent variable without a significant relationship to the others. The comparison group will receive the usual physical or occupational therapy treatment, including compression bandaging, manual lymphatic drainage, shoulder and scapular muscle exercises, and education regarding skin hygiene and monitoring. The experimental group will receive the usual treatment plus additional hand mobility and grip strengthening exercises.

Conditions

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Breast Cancer Lymphedema

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Two groups will be compared, with treatment occurring at the same time. One group will receive the experimental exercises plus the usual treatment, the comparison group will only receive the usual treatment for breast cancer-related lymphedema.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
Participants will be masked regarding whether they are assigned to the intervention or comparison group.

Study Groups

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Experimental

Participants will receive hand mobility and grip strengthening exercises in addition to the usual care for breast cancer-related lymphedema of the upper limb.

Group Type EXPERIMENTAL

Hand Mobility and Grip Strengthening Exercises

Intervention Type OTHER

Addition of hand mobility and grip strengthening exercises to the usual care for breast cancer-related lymphedema to assess changes in limb volume, quality of life, and hand function.

Usual Care

Intervention Type OTHER

Manual lymphatic drainage, compression, exercise, skin hygiene.

Comparison

Participants will receive only the usual care for breast cancer-related lymphedema.

Group Type ACTIVE_COMPARATOR

Usual Care

Intervention Type OTHER

Manual lymphatic drainage, compression, exercise, skin hygiene.

Interventions

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Hand Mobility and Grip Strengthening Exercises

Addition of hand mobility and grip strengthening exercises to the usual care for breast cancer-related lymphedema to assess changes in limb volume, quality of life, and hand function.

Intervention Type OTHER

Usual Care

Manual lymphatic drainage, compression, exercise, skin hygiene.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Biologic women age 18 years or older with a diagnosis of clinical lymphedema of one upper extremity-early (clinical), moderate, or late stage, following treatment for breast cancer within the previous 10 years.
* Women concurrently receiving immunotherapy or chemotherapy are eligible for inclusion, but an additional information request may be necessary (e.g., any activity restrictions and nadir periods) to determine whether they can safely participate in the exercise activities and apply compression.

Exclusion Criteria

* Prior history of paresis in either upper limb, though paresis related to nerve compression from increased lymphatic volume will be eligible for inclusion.
* Current open wounds (\> 0.5 inch in length or diameter) of the axilla or edematous upper limb would be excluded, though the presence of lymphorrhea without visible skin tears will be eligible for inclusion.
* Previous treatment for upper limb lymphedema or a prior diagnosis of congestive heart failure or end-stage renal disease due to the impact on edematous limbs and risk of cardiac overload.
* Women who cannot speak or read English or Spanish sufficiently to complete the Lymphedema Life Impact Scale or understand the consent forms, educational information, and printed exercises will be excluded.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Presbyterian Healthcare Services

UNKNOWN

Sponsor Role collaborator

Texas Woman's University

OTHER

Sponsor Role lead

Responsible Party

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Elisabeth Wise

Primary Investigator, Physical Therapist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Elisabeth Wise, DPT

Role: PRINCIPAL_INVESTIGATOR

Texas Woman's University

Locations

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Presbyterian Healthplex

Albuquerque, New Mexico, United States

Site Status RECRUITING

Presbyterian Southern Outpatient Rehab

Rio Rancho, New Mexico, United States

Site Status RECRUITING

Presbyterian Santa Fe Medical Center

Santa Fe, New Mexico, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Elisabeth Wise, DPT

Role: CONTACT

505-772-1770

Tiffany Ryan, MOT/R

Role: CONTACT

505-772-1775

Facility Contacts

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Elisabeth Wise, DPT

Role: primary

Elisabeth Wise, DPT

Role: primary

Elisabeth Wise, DPT

Role: primary

References

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Ahmad FB, Anderson RN. The Leading Causes of Death in the US for 2020. JAMA. 2021 May 11;325(18):1829-1830. doi: 10.1001/jama.2021.5469. No abstract available.

Reference Type BACKGROUND
PMID: 33787821 (View on PubMed)

Ahmed RL, Prizment A, Lazovich D, Schmitz KH, Folsom AR. Lymphedema and quality of life in breast cancer survivors: the Iowa Women's Health Study. J Clin Oncol. 2008 Dec 10;26(35):5689-96. doi: 10.1200/JCO.2008.16.4731. Epub 2008 Nov 10.

Reference Type BACKGROUND
PMID: 19001331 (View on PubMed)

Chromy A, Zalud L, Dobsak P, Suskevic I, Mrkvicova V. Limb volume measurements: comparison of accuracy and decisive parameters of the most used present methods. Springerplus. 2015 Nov 19;4:707. doi: 10.1186/s40064-015-1468-7. eCollection 2015.

Reference Type BACKGROUND
PMID: 26618096 (View on PubMed)

Davies C, Levenhagen K, Ryans K, Perdomo M, Gilchrist L. Interventions for Breast Cancer-Related Lymphedema: Clinical Practice Guideline From the Academy of Oncologic Physical Therapy of APTA. Phys Ther. 2020 Jul 19;100(7):1163-1179. doi: 10.1093/ptj/pzaa087.

Reference Type BACKGROUND
PMID: 32589208 (View on PubMed)

De Groef A, Van Kampen M, Dieltjens E, Christiaens MR, Neven P, Geraerts I, Devoogdt N. Effectiveness of postoperative physical therapy for upper-limb impairments after breast cancer treatment: a systematic review. Arch Phys Med Rehabil. 2015 Jun;96(6):1140-53. doi: 10.1016/j.apmr.2015.01.006. Epub 2015 Jan 13.

Reference Type BACKGROUND
PMID: 25595999 (View on PubMed)

Feys P, Lamers I, Francis G, Benedict R, Phillips G, LaRocca N, Hudson LD, Rudick R; Multiple Sclerosis Outcome Assessments Consortium. The Nine-Hole Peg Test as a manual dexterity performance measure for multiple sclerosis. Mult Scler. 2017 Apr;23(5):711-720. doi: 10.1177/1352458517690824. Epub 2017 Feb 16.

Reference Type BACKGROUND
PMID: 28206826 (View on PubMed)

Giray E, Akyuz G. Assessment of Family Caregiver Burden and Its Relationships Between Quality of Life, Arm Disability, Grip Strength, and Lymphedema Symptoms in Women with Postmastectomy Lymphedema: A Prospective Cross-Sectional Study. Eur J Breast Health. 2019 Feb 15;15(2):111-118. doi: 10.5152/ejbh.2019.4385. eCollection 2019 Apr.

Reference Type BACKGROUND
PMID: 31001613 (View on PubMed)

Provided Documents

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Document Type: Informed Consent Form

View Document

Other Identifiers

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FY2023-183

Identifier Type: -

Identifier Source: org_study_id

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