Effect of CKC and WS Exercises on Postural Stability in Unilateral Post Mastectomy Lymphedema

Post-mastectomy lymphedema is one of the most common chronic complications that significantly impacts patients' quality of life following breast cancer surgery. postural stability is maintained through the intricate integration of muscular forces, sensory input from mechanoreceptors, and biomechanical feedback. closed kinetic chain (CKC) exercises play a crucial role in enhancing musculoskeletal stability by countering gravitational forces during both rest and movement. weight shifting and balance are fundamental components of functional movement. Proprioceptive training, which focuses on improving body awareness and balance, is essential for developing trunk control

Inclusion Criteria: Women who had a history of BCRS with upper limb lymphedema. • Age range of 40-60 years. • The body mass index (BMI) is less than 30 Kg/m2. • Consciousness and ability to communicate orally or in writing. • Treatment by unilateral mastectomy with lymph node dissection. • No obvious abnormal spine morphology or postural abnormalities visible to the naked eye. • All participants had moderate lymphedema according to the lymphedema severity assessment. Exclusion Criteria: Patients with metastases. • Differences between lower limb length. • Having acute or chronic vestibular, neurological, and orthopedic diseases. • Surgery related to spine causing limitation of motion. • Women with psychiatric disorders, reconstructive surgery. • Bilateral mastectomy. Diagnosis with a neurological, skeletal, or rheumatic disorder or other disease that seriously affects body posture. • History of bodily injury such as a spinal, shoulder, or neck injury, resulting in permanent alteration of the normal body posture prior to the unilateral mastectomy. • Failure to complete follow-up for any reason over the course of the study. • Peripheral polyneuropathy, cognitive dysfunction. • Patients taking medication that affects body balance. • Severe arthritis or orthopedic conditions in their lower extremity • Poor conditioning, acute pain in any reason, • Neurological disorders including visual problems.