Academic journal article International Journal of Yoga

Yoga Protocol for Treatment of Breast Cancer-Related Lymphedema

Academic journal article International Journal of Yoga

Yoga Protocol for Treatment of Breast Cancer-Related Lymphedema

Article excerpt

Byline: S. Narahari, Madhur. Aggithaya, Liselotte. Thernoe, Kuthaje. Bose, Terence. Ryan

Introduction: Vaqas and Ryan (2003) advocated yoga and breathing exercises for lymphedema. Narahari et al. (2007) developed an integrative medicine protocol for lower-limb lymphedema using yoga. Studies have hypothesized that yoga plays a similar role as that of central manual lymph drainage of Foldi's technique. This study explains how we have used yoga and breathing as a self-care intervention for breast cancer-related lymphedema (BCRL). Methods: The study outcome was to create a yoga protocol for BCRL. Selection of yoga was based on the actions of muscles on joints, anatomical areas associated with different groups of lymph nodes, stretching of skin, and method of breathing in each yoga. The protocol was piloted in eight BCRL patients, observed its difficulties by interacting with patients. A literature search was conducted in PubMed and Cochrane library to identify the yoga protocols for BCRL. Results: Twenty yoga and 5 breathing exercises were adopted. They have slow, methodical joint movements which helped patients to tolerate pain. Breathing was long and diaphragmatic. Flexion of joints was coordinated with exhalation and extension with inhalation. Alternate yoga was introduced to facilitate patients to perform complex movements. Yoga's joint movements, initial positions, and mode of breathing were compared to two other protocols. The volume reduced from 2.4 to 1.2 L in eight patients after continuous practice of yoga and compression at home for 3 months. There was improvement in the range of movement and intensity of pain. Discussion: Yoga exercises were selected on the basis of their role in chest expansion, maximizing range of movements: flexion of large muscles, maximum stretch of skin, and thus part-by-part lymph drainage from center and periphery. This protocol addressed functional, volume, and movement issues of BCRL and was found to be superior to other BCRL yoga protocols. However, this protocol needs to be tested in centers routinely managing BCRL.

Introduction

Options for the management of lymphedema in long term which promote self-efficacy and improved function are integral to patient management. Yoga for lymphedema was first successfully demonstrated, both in institutional and community setting as self-care tool for lower-limb lymphedema by Narahari et al .[sup][1],[2] They used yoga in 3543 patients as part of the integrative treatment. The integrative medicine (IM) protocol included skin wash, soaking with herbalized solution, phanta , bacterial entry point (BEP) care using modern dermatology drugs, Indian Manual Lymph Drainage (IMLD), and compression bandaging with two sessions of yoga. Aggithaya et al . used yoga as the only intervention in 425 patients in village camps.[sup][3] Since then, yoga is used by many patients with lymphedema.[sup][4] Yoga is currently the focus of a number of studies internationally. “Using yoga in breast cancer-related lymphedema (BCRL)” was reviewed by Loudon et al .[sup][5] They identified differences in the interventions of using yoga as the only intervention in each protocol. It is important that therapists gain quality, objective evidence about its benefits physically, medically, and mentally. When it is shown to be effective, it means an increasing emphasis on home-based management and patient-centered protocol. To use yoga as a self-care tool in the management of BCRL, it should be in alignment with the International Consensus of Lymphology.[sup][6] Only then studies conducted in higher levels of evidence methods will reflect actual benefit in BCRL. However, there is a dearth of researches on structured ways of using yoga exercises (postures/asana, commonly known as yoga) for upper-limb lymphedema.[sup][5]

This study explains the methodology used to develop yoga and breathing as a self-care protocol for upper-limb lymphedema and the physiological basis of yoga sequence to achieve maximum outcome. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.