Scapulothoracic Stabilization and Postural Training in Upper Extremity Lymphedema

Toros University

Status: Enrolling

Conditions: Secondary Lymphedema

Treatments: Procedure: Complex Decongestive Therapy; Behavioral: Scapulothoracic Stabilization and Postural Training

Study type: Interventional

Funder types: Other

Identifiers

NCT07697495

25.02.2026-1214/23

Details and patient eligibility

About

This single-center randomized controlled trial aims to investigate the effects of adding scapulothoracic stabilization and postural training to standard lymphedema care in women with secondary upper extremity lymphedema following breast cancer surgery. Participants will be randomly assigned to receive either standard lymphedema care alone or standard care combined with scapulothoracic stabilization and postural training. Outcomes including scapular muscle strength, posture, upper extremity function, limb volume, and neck awareness will be assessed at baseline, immediately after treatment, and at a 2-month follow-up. The findings are expected to provide evidence regarding the effectiveness of incorporating targeted stabilization and postural exercises into conventional lymphedema rehabilitation.

Full description

Secondary upper extremity lymphedema is a common complication following breast cancer treatment and is characterized by chronic swelling, pain, reduced muscle strength, impaired upper extremity function, and postural alterations. These impairments may negatively affect daily activities, body perception, and quality of life. Although Complex Decongestive Therapy (CDT) is considered the gold standard for lymphedema management, conventional treatment primarily focuses on edema reduction and does not specifically address scapular stability, postural alignment, or neuromuscular control.

Altered scapulothoracic biomechanics and postural dysfunction are frequently observed in individuals with breast cancer-related lymphedema. These impairments may contribute to shoulder dysfunction, muscle weakness, compensatory movement patterns, and persistent functional limitations. Scapulothoracic stabilization exercises aim to restore scapular muscle balance and improve dynamic shoulder stability, whereas postural training promotes optimal alignment and body awareness. The combined application of these interventions may enhance functional recovery beyond the effects of standard CDT alone; however, evidence from randomized controlled trials remains limited.

This single-center, prospective, randomized controlled trial aims to evaluate the effectiveness of adding scapulothoracic stabilization and postural training to standard lymphedema care in women with secondary upper extremity lymphedema following breast cancer surgery. Participants will be randomly allocated to either a control group receiving standard lymphedema care or an intervention group receiving standard care plus scapulothoracic stabilization and postural training. Randomization will be performed using a computer-generated allocation sequence, and all outcome assessments will be conducted by a blinded assessor.

Outcome measures will be collected at baseline, immediately after completion of treatment, and at a 2-month follow-up. Primary and secondary outcomes will include scapular muscle strength measured with a handheld dynamometer (MicroFET2), postural alignment assessed using the PostureScreen application, upper extremity function evaluated with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, limb volume calculated from serial circumference measurements, and neck awareness assessed using the Fremantle Neck Awareness Questionnaire (FreNAQ). The findings of this study are expected to provide evidence regarding the clinical benefits of incorporating targeted scapulothoracic stabilization and postural training into conventional lymphedema rehabilitation and may contribute to the development of more comprehensive rehabilitation protocols for breast cancer survivors.

Enrollment: 60 estimated patients

Sex: Female

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Female patients aged 18 to 65 years.
• Diagnosed with secondary upper extremity lymphedema following breast cancer surgery (mastectomy).
• Willing to participate in the study.
• Able to provide written informed consent.

Exclusion criteria

• Active infection (e.g., cellulitis or lymphangitis).
• Advanced shoulder or cervical pathology.
• Neurological disorders affecting upper extremity function.
• Metastatic disease.
• Receiving active chemotherapy.
• Participation in another intensive lymphedema rehabilitation program within the previous 3 months.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 2 patient groups

Scapulothoracic Stabilization

Experimental group

Description:

Participants assigned to the experimental group will receive standard Complex Decongestive Therapy (CDT), including manual lymphatic drainage, compression therapy, skin care, and therapeutic exercises, together with a structured scapulothoracic stabilization and postural training program. The additional exercise program is designed to improve scapular muscle function, postural alignment, and upper extremity function. Assessments will be performed at baseline, immediately after treatment, and at a 2-month follow-up.

Treatment:

Behavioral: Scapulothoracic Stabilization and Postural Training

Procedure: Complex Decongestive Therapy

Control

Active Comparator group

Description:

Participants assigned to the control group will receive standard Complex Decongestive Therapy (CDT), including manual lymphatic drainage, compression therapy, skin care, and therapeutic exercises according to routine clinical practice. Outcome assessments will be performed at baseline, immediately after treatment, and at a 2-month follow-up.

Treatment:

Procedure: Complex Decongestive Therapy