Effects of proprioceptive neuromuscular facilitation stretching and deep-breathing exercises on upper extremity lymphedema in stroke patients
Identifieur interne : 004125 ( Pmc/Corpus ); précédent : 004124; suivant : 004126Effects of proprioceptive neuromuscular facilitation stretching and deep-breathing exercises on upper extremity lymphedema in stroke patients
Auteurs : Woon Taek Hwang ; Yeon-Jae Jeong ; Seong-Yeol Kim ; Yeon-Gyu JeongSource :
- Journal of Physical Therapy Science [ 0915-5287 ] ; 2016.
Abstract
[Purpose] The purpose of this study was to determine the effects of deep-breathing and proprioceptive neuromuscular facilitation stretching exercises on upper limb lymphedema in stroke patients. [Subjects and Methods] The study consisted of 10 patients with lymphedema that had occurred after stroke. Neurodevelopmental treatment was applied in the same manner as that used for the existing treatment. The subjects performed deep-breathing and stretching exercises three times per week for 4 weeks (12 sessions total). Body water volume in the upper limbs was measured before and after exercise by using an InBody S10 analyzer. [Results] Performance of deep-breathing and stretching exercises significantly reduced body water volume in both the affected and unaffected arms. The extracellular-to-total cellular fluid volume ratio in the affected arm improved to 0.379 after exercise, although this change was not significant. [Conclusion] The results of the present study show that deep-breathing and proprioceptive neuromuscular facilitation stretching exercises reduce upper extremity lymphedema in stroke patients.
Url:
DOI: 10.1589/jpts.28.3276
PubMed: 28174433
PubMed Central: 5276742
Links to Exploration step
PMC:5276742Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Effects of proprioceptive neuromuscular facilitation stretching and
deep-breathing exercises on upper extremity lymphedema in stroke patients</title><author><name sortKey="Hwang, Woon Taek" sort="Hwang, Woon Taek" uniqKey="Hwang W" first="Woon Taek" last="Hwang">Woon Taek Hwang</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="Jeong, Yeon Jae" sort="Jeong, Yeon Jae" uniqKey="Jeong Y" first="Yeon-Jae" last="Jeong">Yeon-Jae Jeong</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="Kim, Seong Yeol" sort="Kim, Seong Yeol" uniqKey="Kim S" first="Seong-Yeol" last="Kim">Seong-Yeol Kim</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="Jeong, Yeon Gyu" sort="Jeong, Yeon Gyu" uniqKey="Jeong Y" first="Yeon-Gyu" last="Jeong">Yeon-Gyu Jeong</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28174433</idno><idno type="pmc">5276742</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5276742</idno><idno type="RBID">PMC:5276742</idno><idno type="doi">10.1589/jpts.28.3276</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">004125</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004125</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Effects of proprioceptive neuromuscular facilitation stretching and
deep-breathing exercises on upper extremity lymphedema in stroke patients</title><author><name sortKey="Hwang, Woon Taek" sort="Hwang, Woon Taek" uniqKey="Hwang W" first="Woon Taek" last="Hwang">Woon Taek Hwang</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="Jeong, Yeon Jae" sort="Jeong, Yeon Jae" uniqKey="Jeong Y" first="Yeon-Jae" last="Jeong">Yeon-Jae Jeong</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="Kim, Seong Yeol" sort="Kim, Seong Yeol" uniqKey="Kim S" first="Seong-Yeol" last="Kim">Seong-Yeol Kim</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="Jeong, Yeon Gyu" sort="Jeong, Yeon Gyu" uniqKey="Jeong Y" first="Yeon-Gyu" last="Jeong">Yeon-Gyu Jeong</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Physical Therapy Science</title><idno type="ISSN">0915-5287</idno><idno type="eISSN">2187-5626</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>[Purpose] The purpose of this study was to determine the effects of deep-breathing and
proprioceptive neuromuscular facilitation stretching exercises on upper limb lymphedema in
stroke patients. [Subjects and Methods] The study consisted of 10 patients with lymphedema
that had occurred after stroke. Neurodevelopmental treatment was applied in the same
manner as that used for the existing treatment. The subjects performed deep-breathing and
stretching exercises three times per week for 4 weeks (12 sessions total). Body water
volume in the upper limbs was measured before and after exercise by using an InBody S10
analyzer. [Results] Performance of deep-breathing and stretching exercises significantly
reduced body water volume in both the affected and unaffected arms. The
extracellular-to-total cellular fluid volume ratio in the affected arm improved to 0.379
after exercise, although this change was not significant. [Conclusion] The results of the
present study show that deep-breathing and proprioceptive neuromuscular facilitation
stretching exercises reduce upper extremity lymphedema in stroke patients.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Gustafsson, L" uniqKey="Gustafsson L">L Gustafsson</name></author><author><name sortKey="Walter, A" uniqKey="Walter A">A Walter</name></author><author><name sortKey="Bower, K" uniqKey="Bower K">K Bower</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mayrovitz, Hn" uniqKey="Mayrovitz H">HN Mayrovitz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Szuba, A" uniqKey="Szuba A">A Szuba</name></author><author><name sortKey="Cooke, Jp" uniqKey="Cooke J">JP Cooke</name></author><author><name sortKey="Yousuf, S" uniqKey="Yousuf S">S Yousuf</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yang, Ej" uniqKey="Yang E">EJ Yang</name></author><author><name sortKey="Kim, Hj" uniqKey="Kim H">HJ Kim</name></author><author><name sortKey="Ahn, Hs" uniqKey="Ahn H">HS Ahn</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hwang, Wt" uniqKey="Hwang W">WT Hwang</name></author><author><name sortKey="Chung, Sh" uniqKey="Chung S">SH Chung</name></author><author><name sortKey="Chung, Ms" uniqKey="Chung M">MS Chung</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Moseley, Al" uniqKey="Moseley A">AL Moseley</name></author><author><name sortKey="Piller, Nb" uniqKey="Piller N">NB Piller</name></author><author><name sortKey="Carati, Cj" uniqKey="Carati C">CJ Carati</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hwang, O" uniqKey="Hwang O">O Hwang</name></author><author><name sortKey="Ha, K" uniqKey="Ha K">K Ha</name></author><author><name sortKey="Choi, S" uniqKey="Choi S">S Choi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hindle, Kb" uniqKey="Hindle K">KB Hindle</name></author><author><name sortKey="Whitcomb, Tj" uniqKey="Whitcomb T">TJ Whitcomb</name></author><author><name sortKey="Briggs, Wo" uniqKey="Briggs W">WO Briggs</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Phys Ther Sci</journal-id><journal-id journal-id-type="iso-abbrev">J Phys Ther Sci</journal-id><journal-id journal-id-type="publisher-id">JPTS</journal-id><journal-title-group><journal-title>Journal of Physical Therapy Science</journal-title></journal-title-group><issn pub-type="ppub">0915-5287</issn><issn pub-type="epub">2187-5626</issn><publisher><publisher-name>The Society of Physical Therapy Science</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28174433</article-id><article-id pub-id-type="pmc">5276742</article-id><article-id pub-id-type="publisher-id">jpts-2015-1123</article-id><article-id pub-id-type="doi">10.1589/jpts.28.3276</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Effects of proprioceptive neuromuscular facilitation stretching and
deep-breathing exercises on upper extremity lymphedema in stroke patients</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Hwang</surname><given-names>Woon Taek</given-names></name><degrees>PT, BS</degrees><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Jeong</surname><given-names>Yeon-Jae</given-names></name><degrees>PT, PhD</degrees><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Seong-Yeol</given-names></name><degrees>PT, PhD</degrees><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Jeong</surname><given-names>Yeon-Gyu</given-names></name><degrees>PT, PhD</degrees><xref ref-type="aff" rid="aff3"><sup>3</sup></xref><xref rid="cor1" ref-type="corresp"><sup>*</sup></xref></contrib><aff id="aff1"><label>1)</label> Rehabilitation Medicine, Hanyang University Medical Center, Republic of Korea</aff><aff id="aff2"><label>2)</label> Department of Physical Therapy, College of Natural Sciences, Kyungnam University, Republic of Korea</aff><aff id="aff3"><label>3)</label> Department of Physical Therapy, Sangji University, Republic of Korea</aff></contrib-group><author-notes><corresp id="cor1"><label>*</label>Corresponding author. Yeon-Jae Jeong, Department of Physical Therapy, Sangji University: 83
Sangjidae-gil, Wonju-city, Gangwon-do, Republic of Korea. (E-mail: <email xlink:href="jyjion@hanmail.net">jyjion@hanmail.net</email>)</corresp></author-notes><pub-date pub-type="epub"><day>27</day><month>12</month><year>2016</year></pub-date><pub-date pub-type="ppub"><month>12</month><year>2016</year></pub-date><volume>28</volume><issue>12</issue><fpage>3276</fpage><lpage>3278</lpage><history><date date-type="received"><day>06</day><month>2</month><year>2016</year></date><date date-type="accepted"><day>07</day><month>5</month><year>2016</year></date></history><permissions><copyright-statement>2016©by the Society of Physical Therapy Science. Published by IPEC
Inc.</copyright-statement><copyright-year>2016</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-nd/4.0/"><license-p>This is an open-access article distributed under the terms of the Creative
Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License. </license-p></license></permissions><abstract><p>[Purpose] The purpose of this study was to determine the effects of deep-breathing and
proprioceptive neuromuscular facilitation stretching exercises on upper limb lymphedema in
stroke patients. [Subjects and Methods] The study consisted of 10 patients with lymphedema
that had occurred after stroke. Neurodevelopmental treatment was applied in the same
manner as that used for the existing treatment. The subjects performed deep-breathing and
stretching exercises three times per week for 4 weeks (12 sessions total). Body water
volume in the upper limbs was measured before and after exercise by using an InBody S10
analyzer. [Results] Performance of deep-breathing and stretching exercises significantly
reduced body water volume in both the affected and unaffected arms. The
extracellular-to-total cellular fluid volume ratio in the affected arm improved to 0.379
after exercise, although this change was not significant. [Conclusion] The results of the
present study show that deep-breathing and proprioceptive neuromuscular facilitation
stretching exercises reduce upper extremity lymphedema in stroke patients.</p></abstract><kwd-group><kwd>Lymphedema</kwd><kwd>Deep-breathing exercise</kwd><kwd>Proprioceptive neuromuscular facilitation</kwd></kwd-group></article-meta></front><body><sec sec-type="intro" id="s1"><title>INTRODUCTION</title><p>Affected-side lymphedema (LE) is a frequent aftereffect of stroke<xref rid="r1" ref-type="bibr">1</xref><sup>)</sup>. Although no specific etiology has been identified,
immobility, impaired venous return, and paralysis of the sympathetic system are thought to
promote LE. LE can increase arm weight, alter appearance, and cause pain and joint
contracture<xref rid="r1" ref-type="bibr">1</xref><sup>)</sup>. Because it hinders
rehabilitation, LE therapies for stroke patients are needed. Complex decongestive therapy
effectively treats edema<xref rid="r2" ref-type="bibr">2</xref>, <xref rid="r3" ref-type="bibr">3</xref><sup>)</sup>, but involves the onerous daily rewinding of short-stretch
bandages because pressure is not maintained. Moreover, the procedures for treating LE in the
hands are inconvenient for stroke patients, because their performance requires the aid of a
caretaker or therapist<xref rid="r1" ref-type="bibr">1</xref>, <xref rid="r4" ref-type="bibr">4</xref><sup>)</sup>. Previous studies have described the effects of
deep-breathing and proprioceptive neuromuscular facilitation (PNF) stretching exercises,
which can be performed unassisted, on LE. Owing to limited information, it is unclear
whether these exercises benefit stroke patients per se<xref rid="r5" ref-type="bibr">5</xref><sup>)</sup>. Therefore, the aim of present study was to determine the effects of
deep breathing and PNF stretching exercises in stroke patients with upper extremity LE.</p></sec><sec sec-type="methods" id="s2"><title>SUBJECTS AND METHODS</title><p>The study consisted of 10 patients with LE that had occurred after stroke. All patients
were alert and conscious and could move by themselves. The range of motion of their upper
limbs was not limited, and their muscle strength was considered fair.</p><p>Neurodevelopmental treatment was applied in the same manner as that used for the existing
treatment. The patients performed deep breathing and PNF stretching exercises three times
per week for 4 weeks for a total of 12 sessions. Starting in the supine position, they
performed shoulder extension, adduction, internal rotation, elbow extension, forearm
pronation, and wrist and finger flexion exercises. Then, while inhaling, they slowly
performed shoulder flexion, abduction, external rotation, elbow extension, forearm
supination, and wrist and finger extension exercises. The arm was kept 8–10 inches away from
the ear, and the thumbs were pointed at the floor. When the motions were complete, and
maximum stretching of the upper limb muscles was achieved, the patients held their breath
for 5 s while maintaining their positions. They then slowly returned to their starting
position while exhaling. This exercise routine was performed 10 times and was followed by a
1-min rest period, and three sets of exercise/rest were performed. The present study
conformed to the ethical standards of the Declaration of Helsinki (1975, revised 1983), and
the protocol for this study was approved by the institutional review board of Kyungnam
University (2014-023-HR-02; IRB). Subjects provided written informed consent prior to
testing.</p><p>An InBody S10 analyzer (Biospace, Seoul, Korea) was used to measure the body water volume
(BWV) in the upper limbs. The patients rested for 30 min in a supine position before the
electrodes were attached to both thumbs and forefingers and just below the ankles of both
feet. BWV was measured before and 4 weeks after the exercise intervention began.</p><p>The characteristics of the subjects are presented as frequencies or mean ± SD. Differences
in the circumferences at each site of BWV measurement and in the extracellular-to-total
cellular (E/F) fluid volume ratios were compared in the paretic and non-paretic limbs by
using the Wilcoxon signed-rank test. Statistical analysis was performed by using SPSS
version 17.0 software, with the significance level set at p<0.05.</p></sec><sec sec-type="results" id="s3"><title>RESULTS</title><p>The general characteristics of the subjects who participated in the study are shown in
<xref rid="tbl_001" ref-type="table">Table 1</xref><table-wrap id="tbl_001" orientation="portrait" position="float"><label>Table 1.</label><caption><title>General characteristics of the subjects (n=7)</title></caption><table frame="hsides" rules="groups"><tbody><tr><td align="left" rowspan="1" colspan="1">Age (years), mean ± SD</td><td align="center" rowspan="1" colspan="1">53.7 ± 10.8</td></tr><tr><td align="left" rowspan="1" colspan="1">Gender (male/female), n</td><td align="center" rowspan="1" colspan="1">6/4</td></tr><tr><td align="left" rowspan="1" colspan="1">Height (cm), mean ± SD</td><td align="center" rowspan="1" colspan="1">160.0 ± 8.0</td></tr><tr><td align="left" rowspan="1" colspan="1">Weight (kg), mean ± SD</td><td align="center" rowspan="1" colspan="1">56.7 ± 5.8</td></tr><tr><td align="left" rowspan="1" colspan="1">Hemiplegic side (right/left), n</td><td align="center" rowspan="1" colspan="1">4/3</td></tr><tr><td align="left" rowspan="1" colspan="1">Body mass index (kg/m<sup>2</sup>), mean ± SD</td><td align="center" rowspan="1" colspan="1">22.2 ± 2.1</td></tr><tr><td align="left" rowspan="1" colspan="1">Body fat (%), mean ± SD</td><td align="center" rowspan="1" colspan="1">15.0 ± 3.8</td></tr><tr><td align="left" rowspan="1" colspan="1">Fat-free mass, mean ± SD</td><td align="center" rowspan="1" colspan="1">41.8 ± 4.6</td></tr></tbody></table></table-wrap>. After performance of deep breathing and PNF stretching exercises, the BWVs of
the affected and unaffected upper extremities were significantly reduced. Although not
significant, the E/T fluid ratios improved to 0.379 in the affected upper extremity, as
shown in <xref rid="tbl_002" ref-type="table">Table 2</xref><table-wrap id="tbl_002" orientation="portrait" position="float"><label>Table 2.</label><caption><title>The body water volume (BWV) and extracellular-to-total cellular (E/T) fluid ratio
of each upper extremity</title></caption><table frame="hsides" rules="groups"><thead><tr><th align="center" valign="middle" rowspan="1" colspan="1">Intervention</th><th align="center" valign="middle" rowspan="1" colspan="1">Body<break></break>weight (kg)</th><th align="center" valign="middle" rowspan="1" colspan="1">Body mass<break></break>index (kg/m<sup>2</sup>)</th><th align="center" valign="middle" rowspan="1" colspan="1">Affected<break></break>BWV (ml)</th><th align="center" valign="middle" rowspan="1" colspan="1">Unaffected<break></break>BWV (ml)</th><th align="center" valign="middle" rowspan="1" colspan="1">Affected<break></break>E/T fluid ratio (%)</th><th align="center" valign="middle" rowspan="1" colspan="1">Unaffected<break></break>E/T fluid ratio (%)</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Before</td><td align="center" rowspan="1" colspan="1">56.7 ± 5.8</td><td align="center" rowspan="1" colspan="1">22.2 ± 2.1</td><td align="center" rowspan="1" colspan="1">1.58 ± 0.23</td><td align="center" rowspan="1" colspan="1">1.46 ± 0.25</td><td align="center" rowspan="1" colspan="1">0.38 ± 0.01</td><td align="center" rowspan="1" colspan="1">0.38 ± 0.01</td></tr><tr><td align="left" rowspan="1" colspan="1">After</td><td align="center" rowspan="1" colspan="1">56.4 ± 4.3</td><td align="center" rowspan="1" colspan="1">22.2 ± 2.0</td><td align="center" rowspan="1" colspan="1">1.46 ± 0.26* </td><td align="center" rowspan="1" colspan="1">1.39 ± 0.27*</td><td align="center" rowspan="1" colspan="1">0.38 ± 0.01</td><td align="center" rowspan="1" colspan="1">0.38 ± 0.01</td></tr></tbody></table><table-wrap-foot><p>*p<0.05</p></table-wrap-foot></table-wrap>.</p></sec><sec sec-type="discussion" id="s4"><title>DISCUSSION</title><p>The present study determined the effects of deep breathing and PNF stretching exercises on
upper extremity LE in stroke patients. A previous case report showed that these exercises
effectively reduced LE; however, because this report included only one patient, who had not
suffered a stroke, this finding cannot be generalized to all patients with LE. The present
study was therefore conducted and is most likely the first to show beneficial effects of
deep breathing and PNF stretching exercises on BWVs and E/T fluid ratios in stroke patients
with upper extremity LE. Its results suggest that these exercises can effectively alleviate
LE in such patients, and thus are useful interventions.</p><p>Following deep breathing and PNF stretching exercises, the BWVs in the affected and
unaffected upper limbs decreased to 1.457 ± 0.3 ml and 1.391 ± 0.3 ml, respectively, and the
ratio of the extracellular fluid volume to the total volume of water in the affected upper
limb decreased (albeit insignificantly) to 0.002%. These results indicate that deep
breathing and PNF stretching exercises can alleviate LE in stroke patients. A recent study
showed that these exercises effectively reduced edema, although the subjects in that study
differed from those in the present study<xref rid="r5" ref-type="bibr">5</xref><sup>)</sup>.
In another study, deep breathing and PNF stretching exercises reduced the circumference of
the following: the armpit (by 0.5 cm), the arm 10 cm above and below the elbow (both by
1 cm), the elbow (by 0.5 cm), and the back of the hand (by 0.5 cm)<xref rid="r6" ref-type="bibr">6</xref><sup>)</sup>. They also eliminated 100 ml (9.4%) of the BWV in the right
upper extremity and decreased the E/T fluid ratio by 0.005%<xref rid="r6" ref-type="bibr">6</xref><sup>)</sup>. Moreover, upper extremity edema decreased by 46 ml (5.8%), 50 ml
(5.3%), 46 ml (4.3%), and 33 ml (3.5%) immediately, 30 minutes, 24 hours, and 1 week after
completion of gentle arm and deep-breathing exercises<xref rid="r6" ref-type="bibr">6</xref><sup>)</sup>. When re-measured after exercising for 1 month, the edema had
decreased by 101 ml (9.0%)<xref rid="r6" ref-type="bibr">6</xref><sup>)</sup>, which was
similar to the results in the present study.</p><p>Although the effects of PNF on edema are underreported, a previous study found that PNF
stretching of upper arms with LE reduced the rate of edema by 27.21% (from 63.49% to
36.28%)<xref rid="r7" ref-type="bibr">7</xref><sup>)</sup>. According to Hindle et
al.<xref rid="r8" ref-type="bibr">8</xref><sup>)</sup>, the decline in muscle energy
consumption during PNF exercise apparently accounts for the subsequent reduction in LE.
Overall, as shown in the present study and previous studies, deep breathing and upper
extremity exercises appear to be beneficial for stroke patients with upper extremity LE.</p><p>The present study has three limitations. First, it was a pilot study without a control
group. Therefore, its findings may not apply to all stoke patients with upper extremity LE.
Second, the correlation between exercise performance and edema was imprecise. Third, the
rehabilitation period was only 4 weeks, and similar studies with longer intervention times
are required for more conclusive results. However, the present study is meaningful because
it suggests that a simple, cost-free exercise routine can reduce upper extremity LE in
stroke patients in the absence of other treatments. Lastly, it provides objective data on a
relatively unexplored topic. Owing to the limitations of the present study, further studies
are needed.</p></sec></body><back><ref-list><title>REFERENCES</title><ref id="r1"><label>1</label><mixed-citation publication-type="journal"><person-group><name><surname>Gustafsson</surname><given-names>L</given-names></name><name><surname>Walter</surname><given-names>A</given-names></name><name><surname>Bower</surname><given-names>K</given-names></name><etal>et al.</etal></person-group>: <article-title>Single-case design evaluation of compression therapy for
edema of the stroke-affected hand</article-title>. <source>Am J Occup Ther</source>,
<year>2014</year>, <volume>68</volume>: <fpage>203</fpage>–<lpage>211</lpage>.
<pub-id pub-id-type="pmid">24581407</pub-id></mixed-citation></ref><ref id="r2"><label>2</label><mixed-citation publication-type="journal"><person-group><name><surname>Mayrovitz</surname><given-names>HN</given-names></name></person-group>: <article-title>The standard of care for lymphedema: current concepts and
physiological considerations</article-title>. <source>Lymphat Res Biol</source>,
<year>2009</year>, <volume>7</volume>: <fpage>101</fpage>–<lpage>108</lpage>.
<pub-id pub-id-type="pmid">19522678</pub-id></mixed-citation></ref><ref id="r3"><label>3</label><mixed-citation publication-type="journal"><person-group><name><surname>Szuba</surname><given-names>A</given-names></name><name><surname>Cooke</surname><given-names>JP</given-names></name><name><surname>Yousuf</surname><given-names>S</given-names></name><etal>et al.</etal></person-group>: <article-title>Decongestive lymphatic therapy for patients with
cancer-related or primary lymphedema</article-title>. <source>Am J Med</source>,
<year>2000</year>, <volume>109</volume>: <fpage>296</fpage>–<lpage>300</lpage>.
<pub-id pub-id-type="pmid">10996580</pub-id></mixed-citation></ref><ref id="r4"><label>4</label><mixed-citation publication-type="journal"><person-group><name><surname>Yang</surname><given-names>EJ</given-names></name><name><surname>Kim</surname><given-names>HJ</given-names></name><name><surname>Ahn</surname><given-names>HS</given-names></name><etal>et al.</etal></person-group>: <article-title>The effect of early upper extremities passive exercise on
the hand edema and upper spasticity of the hemiplegia patient after
stroke</article-title>. <source>J Korean Clin Nurse Res</source>, <year>2006</year>,
<volume>12</volume>: <fpage>147</fpage>–<lpage>157</lpage>.</mixed-citation></ref><ref id="r5"><label>5</label><mixed-citation publication-type="journal"><person-group><name><surname>Hwang</surname><given-names>WT</given-names></name><name><surname>Chung</surname><given-names>SH</given-names></name><name><surname>Chung</surname><given-names>MS</given-names></name><etal>et al.</etal></person-group>: <article-title>Effect of proprioceptive neuromuscular facilitation D2
flexion and breathing exercises on lymphedema without a short stretch compression
bandage</article-title>. <source>J Phys Ther Sci</source>, <year>2015</year>,
<volume>27</volume>: <fpage>3341</fpage>–<lpage>3343</lpage>. <pub-id pub-id-type="pmid">26644706</pub-id></mixed-citation></ref><ref id="r6"><label>6</label><mixed-citation publication-type="journal"><person-group><name><surname>Moseley</surname><given-names>AL</given-names></name><name><surname>Piller</surname><given-names>NB</given-names></name><name><surname>Carati</surname><given-names>CJ</given-names></name></person-group>: <article-title>The effect of gentle arm exercise and deep breathing on
secondary arm lymphedema</article-title>. <source>Lymphology</source>,
<year>2005</year>, <volume>38</volume>: <fpage>136</fpage>–<lpage>145</lpage>.
<pub-id pub-id-type="pmid">16353491</pub-id></mixed-citation></ref><ref id="r7"><label>7</label><mixed-citation publication-type="journal"><person-group><name><surname>Hwang</surname><given-names>O</given-names></name><name><surname>Ha</surname><given-names>K</given-names></name><name><surname>Choi</surname><given-names>S</given-names></name></person-group>: <article-title>The effects of PNF techniques on lymphoma in the upper
limbs</article-title>. <source>J Phys Ther Sci</source>, <year>2013</year>,
<volume>25</volume>: <fpage>839</fpage>–<lpage>841</lpage>. <pub-id pub-id-type="pmid">24259865</pub-id></mixed-citation></ref><ref id="r8"><label>8</label><mixed-citation publication-type="journal"><person-group><name><surname>Hindle</surname><given-names>KB</given-names></name><name><surname>Whitcomb</surname><given-names>TJ</given-names></name><name><surname>Briggs</surname><given-names>WO</given-names></name><etal>et al.</etal></person-group>: <article-title>Proprioceptive neuromuscular facilitation (PNF): its
mechanisms and effects on range of motion and muscular function</article-title>.
<source>J Hum Kinet</source>, <year>2012</year>, <volume>31</volume>:
<fpage>105</fpage>–<lpage>113</lpage>. <pub-id pub-id-type="pmid">23487249</pub-id></mixed-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 004125 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 004125 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= LymphedemaV1
|flux= Pmc
|étape= Corpus
|type= RBID
|clé= PMC:5276742
|texte= Effects of proprioceptive neuromuscular facilitation stretching and
deep-breathing exercises on upper extremity lymphedema in stroke patients
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:28174433" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a LymphedemaV1
| This area was generated with Dilib version V0.6.31. |  |