Effect of Cytoskeletal Manual Therapy, a Novel Soft Tissue Mobilization Technique, on Axillary Web Syndrome after Axillary Lymph Node Dissection: A Case Report

Abstract

Objective: Axillary web syndrome (AWS) is a condition comprising fibrous band-like cords that appear in the axilla of patients after axillary lymph node dissection (ALND) during breast cancer surgery and result in pain and reduced mobility. The cords appearing with AWS are hardened veins or lymphatic vessels. Manual therapy and stretching are recommended for pain control and mobility improvement. Therefore, this study investigated the effect of cytoskeletal manual therapy (CMT), which is a new soft tissue mobilization technique. Design: A case reportMethods: A 41-year-old woman with AWS after breast cancer surgery and ALND visited a physical therapy clinic because of shoulder pain, decreased function, and decreased mobility. The cords were palpable and pain occurred 2 weeks after surgery. CMT was performed three times per week for a total of 6 weeks. Her pain intensity, range of motion (ROM), and shoulder function were measured. Results: Measurements were performed after 2 weeks and 6 weeks of CMT and evaluated using the numeric pain rating scale (NPRS). Her pain intensity largely decreased after 2 weeks (4-point score reduction) and after 6 weeks (5-point score reduction) of CMT. After CMT, her full ROM was restored and her shoulder function was improved (7-point score reduction). Conclusions: CMT is effective for pain control, mobility improvement, and functional improvement of patients with AWS.

A Case Report on the Immediate Effects of Cytoskeletal Manual Therapy on Pain, Muscle Thickness, and Pressure Pain Threshold in a Patient with Scoliosis

“…CMT is a nobel softtissue mobilization technique that emerged from touch science based on neuroscientific insights and cell biological evidence [15]. As for the technical characteristics, the compression force would be increased due to the counter force of the stimulus pressed on the tissue, and the ischemic pain would be increased [16].…”

“…However, in the study, it was applied to the thoracic spine, lumbar erector spinae muscle, and semitendinosus muscle (15 minutes) during CMT to find out the immediate effect and then measured. The techniques of CMT used are transverse local stretching, transverse vibration, hold and move [15].…”

Effects of Manual Therapy on Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…또 다른 메타 분석에서는 도수치료, 운동, 족욕 등이 제안되었다 [11]. 근골격계 통증 뿐만 아니라 암환자들의 다양한 증상 및 통증조절을 위한 수단으로 도수치료(manual therapy)는 효과적인 치료방법 중 하나로 제안된다 [12,13].…”