Blood and Lymph Conditions

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Lymphedema

Breast Neoplasms

Breast Cancer Lymphedema

Breast Diseases

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Complete decongestive treatment program consists of manual lymph drainage, multi-layer bandaging, skin/nail care and exercise treatments. The treatment will last 45 minutes/session, 5 sessions/week and 3 weeks. Patients in the intervention group will also receive balance exercises with a BOSU ball. These exercises will be performed in 2 sets, 5 days a week for 3 weeks. Each set will last 15 minutes. It will take 15 sessions in total. These exercises include 10 balance exercise movements performed on a bosu ball.

Patients in this group will receive only a complete decongestive treatment program consisting manual lymph drainage, multilayer bandaging, skin/nail care, and exercise treatments. The treatment will last 45 minutes/session, 5 sessions/week and 3 weeks.

It consists of manual lymph drainage, multi-layer bandaging, skin/nail care and exercise treatments. The treatment will last 45 minutes/session, 5 sessions/week and 3 weeks.

Complete decongestive treatment program

These exercises will be performed in 2 sets, 5 days a week for 3 weeks. Each set will last 15 minutes. It will take 15 sessions in total. These exercises include 10 balance exercise movements performed on a bosu ball.

Balance exercises

Esra Karaköseli

Oya Topuz

The aim of the study is to investigate the effect of balance exercises performed with the BOSU ball added to complete decongestive treatment on static and dynamic balance in patients with breast cancer-related lymphedema.

The study was planned as a randomized controlled study. The patients who had unilateral breast cancer-associated lymphedema according to the 2020 diagnostic criteria of the International Society of Lymphology for at least six months and met the inclusion and exclusion criteria will be randomly divided into 2 groups.

The trial will be carried out at Pamukkale University Department of Physical Medicine and Rehabilitation PAUTERM between December 2023 and June 2025. The local ethics committee approved the study. All women will be informed about the purpose and content of the study and all women will sign written consent to participate in the study.

Group1: Group receiving balance exercise with BOSU Ball added to complete decongestive treatment (Intervention group) Complete decongestive treatment program consists of manual lymph drainage, multi-layer bandaging, skin/nail care and exercise treatments. The treatment will last 45 minutes/session, 5 sessions/week and 3 weeks. Patients in the intervention group will also receive balance exercises with a BOSU ball. These exercises will be performed in 2 sets, 5 days a week for 3 weeks. Each set will last 15 minutes. It will take 15 sessions in total. These exercises include 10 balance exercise movements performed on a bosu ball.

Group 2: Group receiving complete decongestive treatment (Active control group) Patients in this group will receive only a complete decongestive treatment program consisting manual lymph drainage, multilayer bandaging, skin/nail care, and exercise treatments. The treatment will last 45 minutes/session, 5 sessions/week and 3 weeks.

All patients will be evaluated with the following evaluation parameters before the treatment and at the time of discharge.

Effect of BOSU Exercises Added to Complete Decongestive Treatment on Balance in Breast Cancer-associated Lymphedema.

The Effect of BOSU Ball Balance Exercises Added to Complete Decongestive Treatment on Static and Dynamic Balance in Breast Cancer-associated Lymphedema.

The TecnoBody Prokin 252 system was used to assess balance in the standing position for all participants. This equipment provides data on the center of pressure path length and the area over which the center of pressure moves. Smaller values indicate greater stability and balance ability in the lower extremities.

The TecnoBody Prokin 252 system was used to assess balance in the standing position for all participants. This equipment provides data on the average track error and stability index.

Arm-hand circumference measurements will be made with a tape measure at four points: metacarpal circumference, wrist, 10 cm below the lateral epicondyle and 15 cm above the lateral epicondyle. The measurement will be made on both upper extremities and the difference between them will be recorded.

Arm-hand volume measurements will be made with the help of a water displacement volumeter. After placing a mark 15 cm below the acromioclavicular joint from the anterior on both arms of the patients, they will be dipped into the volumeter one by one up to this level and the overflowing water will be measured.

It is a 10-item scale. Each question is given a score between 1 (not completely safe) and 10 (very safe), with the total score ranging from 0 to 100. As the score increases, the fear of falling decreases.

It is a checklist of 17 questions. 4-point Likert scoring (1 = Strongly disagree, 4 = Completely agree) is used in the scale. The person receives a total score between 17-68. A high score on the scale indicates that the person has a high level of kinesiophobia.

The FAB scale was developed to assess subtle changes in many dimensions of balance. This performance-based scale consists of 10 test items that assess functional balance status in older people. Each test item is scored using a scale of 0-4. The person receives a total score between 0-40. Higher scores indicate better balance ability.

It is a balance test commonly used to examine functional mobility in community-dwelling, frail older adults. The test requires the subject to stand, walk 3 m, turn and walk backwards, and sit down. Older adults who can complete the task in less than 20 seconds have better balance. In contrast, older adults who require 30 seconds or more to complete the task have worse balance.

ULL-27 quality of life questionnaire, developed specifically for upper extremity lymphedema patients. The scale has physical, psychological and social dimensions. It consists of 27 questions. A high score on the scale indicates that lymphedema negatively affects the quality of life.

The scale is used to determine the risk of anxiety and depression in the patient and to measure its level and change in severity. The scale consists of a total of 14 questions. The items in the scale are evaluated on a 4-point Likert scale and are based on a scoring system between 0-3. According to the scoring, 0-1 is considered as not sick, 2 is considered as borderline sick, and 2-3 is considered as seriously ill. The total scores of the subscales are obtained by adding these item scores.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Effect of BOSU Exercises Added to Complete Decongestive Treatment on Balance in Breast Cancer-associated Lymphedema.	NCT06182046	Breast Cancer R...	Complete decong... Balance exercis...	18 Years - 65 Years	Pamukkale University
Effect of BOSU Exercises Added to Complete Decongestive Treatment on Balance in Breast Cancer-associated Lymphedema.	NCT06182046	Breast Cancer R...	Complete decong... Balance exercis...	18 Years - 65 Years	Pamukkale University
Effect of BOSU Exercises Added to Complete Decongestive Treatment on Balance in Breast Cancer-associated Lymphedema.	NCT06182046	Breast Cancer R...	Complete decong... Balance exercis...	18 Years - 65 Years	Pamukkale University

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