The efficacy of complex decongestive physiotherapy (CDP) and predictive factors of lymphedema severity and response to CDP in breast cancer-related lymphedema (BCRL).

The efficacy of complex decongestive physiotherapy (CDP) and predictive factors of lymphedema severity and response to CDP in breast cancer-related lymphedema (BCRL).

Jan 2013

Liao SF, Li SH, Huang HY, Chen ST, Kuo SJ, Chen DR, Wei TS.

Source

Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, 135 Nanxiao Street, Changhua 500, Taiwan. Electronic address: sueliao3@gmail.com.

Abstract

BCRL is the most common morbidity in women with breast cancer. We performed a retrospective analysis of 107 BCRL patients to identify the efficacy of CDP and the predictors of lymphedema severity and response to CDP. The patients received 12 sessions of CDP, the duration of lymphedema was 22.4 months, and 56% of BCRL occurred within 2 years after surgery. Lymphedema severity, baseline and post-CDP percentage of excess volume (PEV), was 27.7% and 14.9%. The baseline PEV was correlated with the duration of lymphedema. The CDP efficacy, percentage reduction of excess volume (PREV), was 50.5%, and was correlated with PEV, duration of lymphedema and age. Baseline lymphedemaseverity was the most important predictive factor for CDP efficacy. The breast cancer therapy characteristics did not affect PEV or PREV. This study showed the effectiveness of an intensive CDP interventions. The key to predicting successfullymphedema treatment is the baseline PEV.

Elsevier

Randomised controlled trial to determine the benefit of daily home-based exercise in addition to self-care in the management of breast cancer-related lymphoedema: a feasibility study.

October 2012

Jeffs E, Wiseman T.

Source

Lymphoedema Clinic, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, 3rd floor Tower Wing, Great Maze Pond, London, SE1 9RT, UK, eunice.jeffs@gstt.nhs.uk.

Abstract

Exercise is considered to be a key aspect of lymphoedema treatment, although there is little evidence for the therapeutic effect of exercise in managing breast cancer-related lymphoedema (BCRL). This small randomised controlled trial (RCT) was designed to determine the feasibility, prior to undertaking a larger RCT, of researching a daily home-based exercise programme to treat stable BCRL. An experimental design compared the exercise intervention combined with standard lymphoedema self-care to self-care alone over a 6-month period. Twenty-three women with stable unilateral BCRL of ≥10 % excess limb volume (ELV) were randomly allocated to a daily home-based exercise programme and self-care (n = 11) or self-care measures alone (n = 12). The primary objective was to determine difference in limb volume reduction for the two groups. Secondary objectives were to monitor change in other areas that impact BCRL: quality of life, arm function and range of shoulder movement. All 23 women completed the trial, providing full data for each time point. The intervention group showed a clinically and statistically significant improvement in relative ELV at week 26 (95 % confidence interval (CI) -26.57 to -5.12), whereas the control group improvement crossed the line of no effect (95 %CI -17.71 to 1.1). This study demonstrated the feasibility of conducting a RCT of exercise as a therapeutic intervention in the management of BCRL. Although the sample was small, the results support the findings of other exercise studies which have shown trends towards improvement.

Springerlink

The effect of combined decongestive therapy and pneumatic compression pump on lymphedema indicators in patients with breast cancer related lymphedema.

Apr 2012

Moattari M, Jaafari B, Talei A, Piroozi S, Tahmasebi S, Zakeri Z.

Source

Department of Nursing, College of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Keywords: Breast cancer, Lymphedema, Decongestive therapy, Pneumatic compression pump

BACKGROUND:

Lymphedema treatment is difficult and there is no consensus on the best treatment. This study evaluated the effect of combined decongestive therapy (CDT) and pneumatic compression pump on lymphedema indicators in patients with breast cancer related lymphedema (BCRL).

METHODS:

Twenty one women with BCRL were enrolled. The volume difference of upper limbs, the circumference at 9 areas and shoulder joint range of motion were measured in all patients. CDT was done by an educated nurse in two phases. In first phase, CDT was accompanied by use of a compression pump for 4 weeks, 3 days per week. In second phase, CDT was performed daily without compression pump for 4 weeks by patients at home. At the end of each phase, the same primary measurements were done for patients.

RESULTS:

The mean volume difference of the upper limbs and mean difference in circumference in all areas at different phases decreased significantly. Mean flexion, extension, abduction and external rotation (in degrees) at different phases increased significantly.

CONCLUSION:

CDT significantly reduced mean volume and mean circumference of the affected limb, and significantly increased shoulder joint range of motion. The findings support the optimal effects of CDT in the treatment of secondarylymphedema of upper extremity. CLINICAL TRIAL REGISTRATION NUMBER: 138902212621N8.

NIH