Appropriateness of a physiotherapic treatment protocol for the axillary web syndrome, applied in a territorial rehabilitation service: Description of a clinical case

Abstract

The “Axillary web syndrome” (AWS) is an early complication following breast cancer surgery with axillary lymph
nodes dissection.
To apply an appropriated physiotherapic protocol to deal with patients having AWS who show up in territorial rehabilitation service.
The enrolled patient underwent quadrantectomy and right axillary lymphadenectomy surgery resulting in painful
shoulder, functional limitation and a clinical picture that gave evidence for AWS, and for this she was addressed to
the territorial rehabilitation service.
The rehabilitation treatment carried out was composed of active and passive mobilization of the upper-right limb of
the cervico-dorsal segment together with self-mobilization exercises (MAPEA), that lasted two months with a threemonth follow-up.
The outcomes of reference were the numerical rating scale (N.R.S), the Constant-Murley Scale (C.M.S.) and the EuroQoL questionnaire (EQ-5D).
After two months of treatment, the results show an improvement in both functionality and pain in the upper limb and
in the patient’s quality of life, in particular: 43% on the N.R.S scale, 59% on the C.M.S. scale and 81% on the EQ-5D
questionnaire.
After three-month follow-up, the improvement was 75% in the N.R.S, 27% in the C.M.S. and 23% in the EQ-5D.
The description of the clinical case afflicted with AWS and the treatment protocol applied, highlighted the good
performance of the results, notably as concerns patient’s quality of life. This result could represent a starting point
for creating clinical trials aimed at building appropriate rehabilitation courses in territorial rehabilitation services