Patients should maintain a normal level of function, mobility and activity. Exercise and movement are used to reduce lymphedema. Exercise improves muscle strength, cardiovascular function, mood and functionality. Gentle resistance exercises stimulate the muscle pump and increase lymphatic flow. Aerobic exercise increases intra-abdominal pressure, which in turn facilitates pumping in the thoracic duct (Lane et al, 2005a, 2005b).
Movement is one of the key elements of treating lymphedema, since the muscles act as pumps to increase lymph flow and push lymph toward the center to enter the venous circulation. Maintaining muscle tone and joint range of motion is also important. Finally, breathing exercises with deep breathing should not be neglected. The exercise program includes, in addition to wide-ranging exercises, breathing exercises and exercises for flexibility, strengthening and improving aerobic capacity. A combination of aerobic exercise with flexibility and resistance exercises is beneficial in controlling lymphedema, but the program must be individualized. Patients with difficulty in movement and muscle or joint problems need special physical therapy treatment. Exercise and movement must respond to the needs and abilities of the patient and the stage of the disease. They are organized specifically for each patient and are best done in conjunction with a compression bandage or elastic stockings to maximize the benefit. Exercise should be done on a daily basis (Badger et al, 2004).
The exercise will be done daily and if the conditions allow it twice a day. For each patient, a special personalized exercise program will be organized by the multifactorial team and will be implemented under the supervision of physiotherapists in a specially designed area of ​​the Physiotherapy Department. The program will include exercises from the supine and standing position and exercises on special fitness equipment that will be provided (Chapter 3).