The efficacy in shoulder range of motion of a snapping manual maneuver added to a standardized exercise protocol in axillary web syndrome: a randomized controlled trial

Abstract

BACKGROUNDAxillary Web Syndrome (AWS) is one of the most frequent conditions after surgical axillary lymph node dissection (ALND). The key symptom is the functional disability of the limb, which requires rehabilitation. Notwithstanding, a standardized rehabilitation protocol is currently lacking in clinical practice. Our primary objective therefore, was to evaluate the effectiveness of the use of a snapping manual maneuver (used in our clinical practice) in enhance range of motion (ROM) when compared with a standardized stretching exercise protocol. A three-year follow-up of the enrolled patients was also carried out to determine the incidence of Breast Cancer-Related Lymphedema (BCRL). MATERIAL AND METHODSBetween July 2013 and January 2019 we conducted a single blinded randomized clinical trial. ALND patients with subsequent appearance of clinical symptoms of AWS were randomly assigned into two groups who underwent one treatment session per week for two weeks with a one month follow-up. RESULTSThere were no statically signi cant differences in ROM at our one month follow-up and the incidence of BCRL was equally distributed after three years. CONCLUSION the addition of the manual snapping maneuver in a rehabilitation protocol was not better than a stretching exercise and does not appear to be a risk factor for lymphedema.

An original technique for the treatment of Axillary Web Syndrome: the Onorato-Ausbergher method

“…7 A recent study has underlined the lack of significance in the increase of the Range of Motion (ROM) of the shoulder of a frequently used technique, the manual snapping maneuver, associated with passive stretching, in comparison with just the passive stretching. 8 The aim of this work is to check the efficacy of the Onorato-Ausbergher method on signs and symptoms of AWS, which are: i) reduction of active ROM in one or more directions of movement;…”