Samenvatting 1MA Physiotherapy in Internal Diseases - Oedema Treatment
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Course
Physiotherapy In Internal Diseases (2708GENRVK)
Institution
Universiteit Antwerpen (UA)
Samenvatting Physiotherapy in Internal Diseases van het 1e master jaar revalidatiewetenschappen en kinesitherapie op de Universiteit van Antwerpen.
Deze samenvatting bestaat uit het onderdeel Oedema treatment, gegeven door Dr. H. Verbelen
Physiotherapy in internal diseases
OEDEMA TREATMENT – H. VERBELEN, N. GEBRUERS
YORICK VAN HULST
,Physiotherapy in Internal Diseases 1e master jaar Revaki UA
1 INHOUDSOPGAVE
2 HC 1 – Breast cancer and lymphedema .................................................................................. 3
2.1 Breast Cancer .......................................................................................................................... 3
2.1.1 Introduction ..................................................................................................................... 3
2.1.2 What is breast cancer? .................................................................................................... 4
2.1.3 Types of breast cancer? ................................................................................................... 4
2.1.4 Metastases ...................................................................................................................... 4
2.1.5 Risk factors ...................................................................................................................... 4
2.1.6 Diagnosis.......................................................................................................................... 6
2.1.7 TNM staging system ........................................................................................................ 7
2.1.8 Treatment ........................................................................................................................ 8
2.1.9 Survival .......................................................................................................................... 12
2.2 Arm lymphedema after breast cancer .................................................................................. 13
2.2.1 Definition ....................................................................................................................... 13
2.2.2 Incidence ....................................................................................................................... 13
2.2.3 Risk factors .................................................................................................................... 15
2.2.4 Complications ................................................................................................................ 15
3 HC2 – evaluation, prevention and treatment of lymphedema .............................................. 17
3.1 Evaluation .............................................................................................................................. 17
3.1.1 Circumference measurements ...................................................................................... 17
3.1.2 Water displacement method ........................................................................................ 18
3.1.3 Perometer...................................................................................................................... 19
3.1.4 Tonometer ..................................................................................................................... 19
3.1.5 Ultrasound ..................................................................................................................... 20
3.1.6 Lymphoscintigraphy ...................................................................................................... 20
3.1.7 Lymphofluoroscopy ....................................................................................................... 21
3.1.8 CT/MRI ........................................................................................................................... 21
3.1.9 Questionnaires .............................................................................................................. 21
3.2 Prevention ............................................................................................................................. 22
3.2.1 Identify patients at risk.................................................................................................. 22
3.2.2 Preventive treatment of patients at risk ....................................................................... 23
3.3 Treatment .............................................................................................................................. 27
3.3.1 Decongestive lymphatic therapy ................................................................................... 27
3.3.2 Intermittent pneumatic compression ........................................................................... 30
3.3.3 Elevation ........................................................................................................................ 30
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,Physiotherapy in Internal Diseases 1e master jaar Revaki UA
3.3.4 Lymphtaping .................................................................................................................. 30
4 HC3 – Arm en breast morbidity after breast cancer .............................................................. 31
4.1 Epidemiology ......................................................................................................................... 31
4.1.1 Loss of mobility .............................................................................................................. 31
4.1.2 Pain ................................................................................................................................ 32
4.1.3 Loss of strength ............................................................................................................. 34
4.1.4 Shortened muscles ........................................................................................................ 35
4.1.5 Sensory disturbances..................................................................................................... 36
4.1.6 Axillary web syndrome .................................................................................................. 37
4.1.7 Scapula alata.................................................................................................................. 38
4.1.8 Seroma........................................................................................................................... 39
4.1.9 Breast edema................................................................................................................. 39
4.1.10 Conclusion ..................................................................................................................... 40
4.2 Prevention and treatment ..................................................................................................... 41
4.2.1 Information.................................................................................................................... 41
4.2.2 Stretching and mobilization AWS .................................................................................. 41
4.2.3 Mobilization ................................................................................................................... 41
4.2.4 Soft tissue techniques ................................................................................................... 41
4.2.5 PNF ................................................................................................................................ 41
4.2.6 Scar tissue treatment .................................................................................................... 41
4.2.7 Posture exercices........................................................................................................... 41
4.2.8 Exercise program ........................................................................................................... 42
4.2.9 Conclusion ..................................................................................................................... 42
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, Physiotherapy in Internal Diseases 1e master jaar Revaki UA
2 HC 1 – BREAST CANCER AND LYMPHEDEMA
Upper limb lymphedema
2.1 BREAST CANCER
2.1.1 Introduction
- 10% of all cancers worldwide are breast cancers (GloboCan 2002)
- 35% of all cancers in women are breast cancers
- 1 man for every 100 women gets diagnosed
- 2014: 91 men and 10466 women with breast cancer in Belgium (www.kankerregister.org)
- ! Incidence is increasing !
Survival after breast cancer
- Survival = % of survivors on the long term
- 5 year survival in Belgium:
o 88,0% in women
o 78,2% in men
- Good survival compared to other cancers
- Importance of QOL is growing
- Prevention and treatment of complaints related to breast cancer and its treatment
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