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Therapists' Perspectives and Interventions in the Management of Axillary Web Syndrome: An Exploratory Study

Black, Jill PT, DPT, EdD1; Green, Devan DPT2; McKenna, Caitlin DPT2; Squadrito, James DPT2; Taylor, Stephanie DPT2; Palombaro, Kerstin M. PT, PhD, CAPS3


Background: Axillary cording or axillary web syndrome (AWS) is a condition that may manifest after surgical interference in the axillary lymph nodes. AWS can cause significant impairments and has been treated with physical and occupational therapy. Little is known about the pathophysiology of AWS or about the therapeutic interventions that are most effective. The purpose of this study is to explore the perspectives and preferred interventions of physical and occupational therapists from a particular region, experienced in treating AWS.

Methods: Qualitative methodology was used to explore the practices of 7 therapists with experience treating AWS. The participants were interviewed and their intervention techniques video recorded for content analysis.

Results: Five physical therapists and two occupational therapists from one region were interviewed and their intervention techniques video recorded. Results showed that the therapists differed in opinion on the pathophysiology of the condition but shared many similarities in treatment approaches. Video recordings captured specific techniques that can further inform therapeutic practice.

Conclusions. AWS is a condition seen in women after surgical treatment for breast cancer. Unlike previous literature accounts, the participants in this study do not think that the condition spontaneously resolves. Intervention can successfully manage the condition and restore functional, painfree use of the upper extremity. AWS is a condition that should be recognized by all therapists and additional study should be done to determine precise pathophysiology and best practices in intervention.

1Assistant Professor, Institute for Physical Therapy Education, Widener University, Chester, PA

2Doctor of Physical Therapy Student, Widener University, Chester, PA

3Assistant Professor, Widener University, Chester, PA

Address correspondence to: Jill Black, PT, DPT, EdD, Assistant Professor, Institute for Physical Therapy Education, Widener University, One University Place, Chester, PA 19013 Ph: 610-499-1278, FAX: 610-499-1231 (

© 2014 by Lippincott Williams & Wilkins, Inc.
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