Impact of cancer-related and primary lymphedema and compression bandaging on limb range of motion: a cross-sectional study

INTRODUCTION: Lymphedema is chronic and can be a consequence of cancer treatment. Little is known about the range of movement (ROM) of the limbs with lymphedema. We aimed to quantify the ROM in patients with lymphedema to assess the impact of lymphedema and multilayer bandaging on mobility. METHODS: A motion analysis system quantified ROM. The ankle and knee of 22 patients (57 years, 14 females) with lower limb lymphedema (mainly secondary to gynecological or urological cancer) were evaluated. The wrist and elbow of 21 women (58 years) affected by upper limb lymphedema secondary to breast cancer were studied. Tests were repeated on the lymphedematous limb before (L) and after (B) bandaging, and with the compression garment (G, only for upper limb). The contralateral healthy limb (H) was set as a reference. RESULTS: Lymphedema limited the knee maximal flexion (H 97.7°; L 83.1°) and the forearm rotation (H 140°, L 131°). Bandaging further limited the maximal knee ROM (70°). Bandaging restricted the maximal ROM of the ankle, elbow (H 147°, B 130°; only flexion limited), and wrist (H 113°, B 86°; both extension and flexion limited). Bandaging limits the ROM of the knee (H 40.7°; B 36.6°), ankle (H 29.6°; B 25.3°), and elbow (L 59°, B 54°) during the dynamic test. G limited the rotation of the forearm (111°). Data reported as median. CONCLUSION: Lymphedema and its treatment introduce important restrictions on joint mobility that may impact the quality of life, as adequate joint dorsiflexion is necessary for daily functional activities.