PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION FOR POST MASTECTOMY LYMPHEDEMA: A Systematic Review

Document Type : Original Article

Authors

1 Faculty of physical therapy, Cairo University, Giza, Egypt

2 Department of physical therapy for pediatrics, faculty of physical therapy, Cairo University, Giza Egypt

3 Department of physical therapy for surgery, faculty of physical therapy, Cairo University, Giza, Egypt

10.21608/iptccu.2025.440728

Abstract

Background: Lymphedema is known as a secondary complication of breast cancer treatment. Proprioceptive neuromuscular facilitation (PNF) stretching techniques are commonly used to enhance both active and passive range of motion (ROM) with a view to optimizing motor performance and rehabilitation.  Aim: To systematically review the primary studies about the effect of PNF for post mastectomy lymphedema. Methods: An electronic search was made in Cochrane library, Physiotherapy Evidence Database (PEDro) and PubMed database and last updated on February 2025 on the effect of PNF for post mastectomy lymphedema. Two independent reviewers selected the eligible studies according to inclusion criteria and extracted data from the included studies and assessed their methodological quality using ROB 2 tool and Grading of Recommendations Assessment, Developmental and Evaluation (GRADE) approaches. Results: four included RCTs out of 201 studies screened. Three studies with high risk of bias and one study with some concern. The certainty of evidence was rated as very low (GRADE D). Conclusion: Although PNF showed improvement in the measured outcomes in the included studies compared to control groups, the present evidence for its effectiveness is still very low and more studies with high quality methods are needed to confirm the evidence.

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