Quality of Life Improvement in Rehabilitation. A challenge in Public Health. A case report

Lymphedema is one of the most frequent and disabling complications following surgical treatment for breast cancer, with a global prevalence that varies depending on associated therapies such as radiotherapy and chemotherapy. This condition significantly affects patients' quality of life by limiting upper limb function and causing symptoms such as pain, heaviness, reduced mobility, and difficulties in performing daily activities. Currently, Complex Decongestive Therapy (CDT), consisting of manual lymphatic drainage, multilayer bandaging, therapeutic exercise, and flat-knit compression garments, represents the gold standard for management. However, in recent years, there has been growing interest in complementary strategies that may help maintain the benefits of CDT. Among these, aquatic immersion has shown promise due to the effects of hydrostatic pressure.

This case report aims to evaluate the effect of hydrostatic pressure during a recreational scuba dive on symptoms and functional parameters in a patient with right upper limb lymphedema secondary to breast cancer.

A 51-year-old woman with post-surgical lymphedema following right breast invasive carcinoma resection. The patient underwent cycles of chemotherapy and radiotherapy. She has been receiving annual courses of Complex Decongestive Therapy (CDT) and consistently uses a custom flat-knit compression garment for maintenance.

A recreational scuba diving session was performed at an average depth of 10 meters for a duration of 35 minutes. Assessments were conducted at three time points, including limb circumference, segmental volume, and upper limb range of motion (ROM). Patient-reported outcomes were also collected regarding perceived fatigue, pressure sensation, pain intensity, heaviness, and overall satisfaction with the proposed activity.

The intervention resulted in a reduction of limb volume and circumference, which was maintained over time, along with an increase in ROM of the affected upper limb. The patient also reported reduced perceived exertion during the activity and expressed a high level of satisfaction, noting an improved sense of lightness and mobility.

Although limited to a single case, these findings suggest that recreational scuba diving may serve as a valuable complementary approach to CDT, supporting the maintenance of therapeutic benefits and contributing to patients' physical and psychological well-being. Further research with larger cohorts is needed to confirm the efficacy and safety of this innovative intervention.