Altered gait characteristics in women with breast cancer-related lymphedema: A case-control analysis using inertial sensor-based assessment

Background: Breast cancer-related lymphedema (BCRL) is a common complication resulting from cancer treatments in women with breast cancer. As functional status of the upper extremity play a key role in walking, BCRL may lead to alterations in gait. This study aimed to evaluate gait characteristics in women with breast cancer-related lymphedema and to compare these parameters with those of healthy counterparts. Methods: Women with BCRL and age-matched healthy controls were included. Descriptive characteristics including lymphedema severity and shoulder range of motion of the affected limb, were recorded. Lymphedema was assessed using upper extremity circumference measurements. Gait analysis was conducted using the BTS G-Walk system (BTS Bioengineering, Italy). Spatiotemporal parameters, range of pelvic angles, and pelvic symmetry indexes were recorded. Comparisons were made between women with BCRL and healthy controls, as well as between the affected and unaffected sides in women with BCRL. Findings: A total of 46 women (23 with BCRL and 23 healthy controls) were included in the study. Compared with healthy controls, women with BCRL demonstrated significantly reduced cadence, speed, swing phase, and pelvic obliquity range, as well as prolonged gait cycle duration and stance phase (p < 0.05). There was no significant difference between groups in other parameters (p > 0.05). In the BCRL group, the affected side showed a shorter swing phase and longer stance and single support phase than the unaffected side (p < 0.05). Interpretation: Women with BCRL may exhibit gait abnormalities in terms of speed, cadence, gait cycle duration, stance, and swing phases. The findings suggest that lymphedema rehabilitation should shift from an arm-centered approach to a holistic, whole-body perspective. Incorporating strategies to achieve gait symmetry in BCRL rehabilitation may be beneficial.NCT Registration: 07011277.