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this study will be conducted to investigate the therapeutic effect of complete decongestive therapy on carpal tunnel syndrome post-upper limb lymphedema.
lymphedema is a chronic condition characterized by lymphatic vessel ectasia and valve dysfunction, followed by the reflux of lymphatic fluid into the interstitial space. Lymph stasis may lead to a chronic inflammatory process, resulting in adipose tissue differentiation and fibro adipose tissue deposition. One consequence of post-mastectomy lymphedema may be the development of nerve entrapments. One example is median nerve entrapment in the carpal canal, or carpal tunnel syndrome (CTS). many studies assessed the relationship of CTS as a risk factor for developing lymphedema, other studies stated the possibility of lymphedema as a potential contributor to CTS development. Complex decongestive treatment of breast cancer-related lymphoedema is an accepted strategy and is considered as an international standard for treatment. A previous review concluded that complex decongestive therapy has a positive impact on the volume of arm and quality of life in different stages of lymphedema.sixty females will be allocated randomly to two groups; first one will receive decongestive therapy and the second one will receive the routine medical treatment for ten weeks
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Complete decongestive therapy | Experimental | the patients will receive complete decongestive therapy twice a week for ten weeks |
|
| medical treatment | Active Comparator | the patients will receive routine medical treatment for ten weeks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Complete decongestive therapy | Other | the patients will receive Complete decongestive therapy in the form of intermittent pneumatic compression, Exercising, bandaging, and manual lymphatic drainage with Pressures of 50, 80, and 120 mmHg and timing 5, 20, and 50 secs |
| Measure | Description | Time Frame |
|---|---|---|
| hand strength | hand held dynamometer will be used for measuring the hand strength | up to ten weeks |
| median nerve conduction velocity | median nerve conduction velocity will be measured by electromyography device | up to ten weeks |
| Measure | Description | Time Frame |
|---|---|---|
| pain intensity | Visual analogue scale which is 100 mm horizontal line will be used for measuring pain intensity. the scale has no pain on the left side and worst pain on the right side | up to ten weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| ID | Term |
|---|---|
| D008209 | Lymphedema |
| D002349 | Carpal Tunnel Syndrome |
| ID | Term |
|---|---|
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D020423 | Median Neuropathy |
| D020422 | Mononeuropathies |
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complete decongestive therapy and routine medical treatment
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opaque sealed envelope
| Medical treatment | Other | the patients will receive routine medical treatment |
|
| D010523 |
| Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D009408 | Nerve Compression Syndromes |
| D012090 | Cumulative Trauma Disorders |
| D013180 | Sprains and Strains |
| D014947 | Wounds and Injuries |