Effect of active resistive exercise versus manual lymphatic drainage in patients with secondary lymphedema

Background: Lymphedema is an abnormal extracellular accumulation of interstitial fluid containing proteins, cytokines, extravascular blood cells, and products of parenchymal and stromal cell. It occurs as a result of an insufficient lymphatic system or decreased lymphatic transport.Purpose: To compare between active resistive exercises and lymphatic drainage on upper limb size and function in patients with secondary lymphedema. Subject and methods: Thirty females diagnosed clinically by physician as having upper limb secondary lymphedema. They suffered from moderate lymphedema based on clinical investigations. Their age ranged from 40 to 50 years. They were assigned randomly into two groups (A, B) equal in number. Group A received active resistive exercises plus intermittent pneumatic compression. Group B received manual lymphatic drainage plus the intermittent pneumatic compression. Treatment sessions was three times per week for 12 weeks. Lymphedema and upper limb functions were assessed by tape measurement and the ULL-27 questionnaire after 12 weeks. Results: There was no statistically significant difference between both groups in upper limb size and function. Conclusion: Both active resistive exercises and manual lymphatic drainage were effective in the management of upper limb secondary lymphedema.