Virtual Reality Versus Proprioceptive Neuromuscular Facilitation on Postmastectomy Lymphedema

Study Overview
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Brief Summary
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This study aimed to compare the therapeutic efficacy of VR and PNF on lymphedema and function in unilateral post-mastectomy lymphedema (UPML) patients. The patients were subdivided into two equal groups, 15 in each. Fifteen patients performed virtual reality-based exercises plus complete decongestive therapy, while the other fifteen patients performed proprioceptive neuromuscular facilitation plus complete decongestive therapy. The volume difference between normal and affected limbs was calculated before and after eight sessions of treatment for both groups by using the circumferential method. And the upper limb function was assessed before and after eight sessions of treatment for both groups by using the Arabic version of the Quick DASH scale.

Official Title
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Virtual Reality Versus Proprioceptive Neuromuscular Facilitation on Postmastectomy Lymphedema

Conditions
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Postmastectomy Lymphedema

Intervention / Treatment
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* Other: virtual reality
* Other: proprioceptive neuromuscular facilitation
* Other: complete decogestive therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients will suffer from unilateral post-mastectomy lymphedema. Stage I and stage II lymphedema as defined by the classification of the International Society of Lymphology (The International Society of Lymphology, 2003). Patients had no physical therapy before the current treatment or the last time to receive sessions was at least three months ago. Exclusion Criteria: Excluded patients were having musculoskeletal or neurological disorders that would impair performance during training and tests. Visual disorders that could affect imitation of video game-based exercise. Uncontrolled cardiovascular or pulmonary diseases. Psychiatric illness, severe behavior, and cognitive disorders.

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: virtual reality<br> | Other: virtual reality<br>* wii video game based exercise<br>Other: complete decogestive therapy<br>* pneumatic compression, manual lymph drainage, skin care and home exercise program<br>|
| Active Comparator: propreoceptive neuromuscular facilitation<br> | Other: proprioceptive neuromuscular facilitation<br>* PNF with breathing<br>Other: complete decogestive therapy<br>* pneumatic compression, manual lymph drainage, skin care and home exercise program<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| lymphedema volume | turncated cone formula using circumferential measurement of both upper limbs | 4 weeks | 
| upper limb function | quick-disability of arm, shoulder and hand (DASH) scale. minimum score is zero and maximum score is 44. higher score means worse outcome. | 4 weeks |