Efficacy of complete decongestive therapy and manual lymphatic drainage on treatment-related lymphedema in breast cancer

2007 ◽  
Vol 67 (3) ◽  
pp. 841-846 ◽  
Author(s):  
Rashmi Koul ◽  
Tarek Dufan ◽  
Catherine Russell ◽  
Wanda Guenther ◽  
Zoan Nugent ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymphatic Drainage ◽  
Manual Lymphatic Drainage ◽  
Complete Decongestive Therapy ◽  
Decongestive Therapy

scholarly journals THE EFFICACY OF INTERMITTENT PNEUMATIC COMPRESSION AS A SUBSTITUTE FOR MANUAL LYMPHATIC DRAINAGE IN COMPLETE DECONGESTIVE THERAPY IN THE TREATMENT OF BREAST CANCER RELATED LYMPHEDEMA

Lymphology ◽  
2019 ◽  
Vol 52 (2) ◽  
Author(s):  
C Sanal-Toprak ◽  
T Ozsoy-Unubol ◽  
Y Bahar-Ozdemir ◽  
G Akyuz
Keyword(s):  
Breast Cancer ◽  
Lymphatic Drainage ◽  
Intermittent Pneumatic Compression ◽  
Controlled Study ◽  
Home Exercise ◽  
Manual Lymphatic Drainage ◽  
Complete Decongestive Therapy ◽  
Arm Circumference ◽  
Breast Cancer Related Lymphedema ◽  
Decongestive Therapy

The aim of this study is to evaluate the efficacy of intermittent pneumatic compression (IPC) as a substitute for manual lymphatic drainage (MLD) in complete decongestive therapy (CDT) for treatment of advanced stages of breast cancer-related lymphedema. In this randomized, single-blind, controlled study, 46 patients with breast cancer-related lymphedema were divided into 2 groups. Both MLD with compression bandage (CB) group (n=24) and IPC with CB group (n=22) received treatment 3 days a week for 5 weeks. Home exercise program was also given to all patients. At the end of the 5th week, patients were treated with a daily 23-hour compression garment and home exercise routines. Assessments were taken at baseline, the fifth week, and the third month. Arm circumference was measured at 5 different areas, shoulder range of motion (ROM) was evaluated with a goniometer, pain, and tightness, and heaviness sensations were assessed with visual analog scale. Both groups had similar demographic and clinical characteristics (p < 0.05). There were no significant differences between groups and both groups showed significant improvement (p < 0.05) in the five measurement levels of the arm circumference at the fifth week and third month. Similarly, shoulder ROM, pain, tightness, and heaviness sensations improved in both groups (p < 0.05). Both MLD and IPC as a component of CDT were found successful at 5 weeks and 3 months without superiority to each other.

Complex decongestive therapy for secondary lymphoedema in women after breast cancer treatment

Physiotherapy ◽  
2015 ◽  
Vol 23 (1) ◽  
Author(s):  
Iwona Malicka ◽  
Dawid Marciniak
Keyword(s):  
Breast Cancer ◽  
Fungal Infections ◽  
Compression Therapy ◽  
Lymphatic Drainage ◽  
Skin Care ◽  
Lymph Edema ◽  
Two Phase ◽  
Complex Decongestive Therapy ◽  
Consolidation Phase ◽  
Decongestive Therapy

AbstractSecondary lymph edema occurs in abort 6-40% of women treated for breast cancer. This is not the only an aesthetic problem. Edema makes serious health complications for example recurrent inflammation and rose, limb elephantiasis, which leads to degenerative changes in the joints, nerve plexus damage and angiosarcoma – cancer with poor prognosis. Early diagnosis and implementation of therapy is very important. Too late intervention difficult the rehabilitation and increases the possibility of complications also. The most important in the reduction of swelling and remove the lymph balance is a complex decongestive therapy (CDT): lymphatic drainage, compression therapy, skin care and exercises. Lymphatic drainage results in increased production of the lymph and movement of the lymph. Compression therapy leads to the reduction in the effective pressure ultrafiltration. Skin care is to prevent bacterial and fungal infections. Exercises makes increase muscle pump action and transport of the lymph. CDT consist of two phase: reduction phase and consolidation phase. It is a most popular method of treatment lymph edema around the world. It is most effective therapy also.

scholarly journals Arm lymphedema after treatment of breast cancer: Etiology, diagnosis, and management

2015 ◽  
Vol 01 (02) ◽  
pp. 077-083 ◽  
Author(s):  
Ashish Goel ◽  
Juhi Agarwal ◽  
Sandeep Mehta ◽  
Kapil Kumar
Keyword(s):  
Breast Cancer ◽  
Solid Phase ◽  
Subcutaneous Tissue ◽  
Fluid Phase ◽  
Team Work ◽  
Treatment Modalities ◽  
Cancer Etiology ◽  
Complete Decongestive Therapy ◽  
Arm Lymphedema ◽  
Decongestive Therapy

ABSTRACTBreast cancer related lymphedema (BCRL) is a chronic debilitating condition seen after treatment of breast cancer. The overall incidence varies from 20% to 56% in all patients treated for breast cancer. Every patient is at a lifelong risk for BCRL and the risk goes on increasing as the followup period increases. Locoregional treatment including surgery or radiotherapy is the most common risk factor for development of arm lymphedema. There are two phases of arm lymphedema. There is increased fluid accumulation in the fluid phase of lymphedema which later on goes into the solid phase where fat and fibrotic tissue is deposited in the subcutaneous tissue. The treatment of BCRL is a challenge both for the patient and the treating surgeon and it needs multidisciplinary team work to be successful. Non-surgical treatment modalities include complete decongestive therapy (CDT) and pneumatic compression therapy. Surgery for BCRL is usually undertaken as a salvage modality after failure of conservative approaches. The surgical spectrum for BCRL varies from extensive excisional operations which were commonly done in the past to newer methods like suction assisted protein lipectomy, lymphatic reconstruction and vascular lymph node transfer (VLNT) using super-microsurgical techniques. There is no consensus regarding the preference of one procedure over other due to lack of randomised control trials. It is however suggested to do lymphovenous anastomosis and complete decongestive therapy for early cases in fluid phase; while patients in the solid phase may be treated with a combination of liposuction with CDT or VLNT alone.

scholarly journals Changes in Indocyanine Green Lymphography Patterns after Physical Treatment in Secondary Upper Limb Lymphedema

2020 ◽  
Vol 9 (2) ◽  
pp. 306
Author(s):  
María Elena Medina-Rodríguez ◽  
María de-la-Casa-Almeida ◽  
Jesús González Martín ◽  
María Hermida Anllo ◽  
Esther M. Medrano-Sánchez
Keyword(s):  
Breast Cancer ◽  
Physical Therapy ◽  
Indocyanine Green ◽  
Upper Limb ◽  
Lymphatic Drainage ◽  
Manual Lymphatic Drainage ◽  
Physical Treatment ◽  
Lymphatic Function ◽  
Disease Patterns ◽  
Before And After

Indocyanine green (ICG) lymphography is used to evaluate the lymphatic function before and after pneumatic compression or post-manual lymphatic drainage. The aim of this study was to ascertain the changes in the fluoroscopic pattern produced by the provision of complex physical therapy. This prospective analytic (pretest-posttest) study was conducted in 19 patients with upper lymphedema secondary to breast cancer. Nine patients were excluded due to ICG found after 3 weeks. The ICG patterns were analyzed under basal conditions and after three weeks of treatment. After the treatment, 45% of the patients presented tracer remains in the affected limb, and this finding was significantly related to time of the lymphedema development. In one subject, the patterns remain unchanged or cannot be defined. Three of the ten patients observed present the worsening of at least 1 of the patterns and in the rest of the subjects, six cases, the improvement of the patterns is observed. In 60% of the cases, the most severe pattern reversed towards slight (splash) cases, and moderate cases reversed towards a slight case in 70% of cases. Therefore, after treatment with complex physical therapy, the pathological patterns observed in the pretest, which evolved positively, reverted their severity toward milder disease patterns or towards normality.

scholarly journals Fluid Shifts Induced by Physical Therapy in Lower Limb Lymphedema Patients

2020 ◽  
Vol 9 (11) ◽  
pp. 3678 ◽  
Author(s):  
Bianca Brix ◽  
Gert Apich ◽  
Andreas Roessler ◽  
Christian Ure ◽  
Karin Schmid-Zalaudek ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Plasma Volume ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Lymphatic Drainage ◽  
Whole Body ◽  
Fluid Composition ◽  
Manual Lymphatic Drainage ◽  
Complete Decongestive Therapy ◽  
Fluid Shifts

Complete decongestive therapy (CDT), a physical therapy including manual lymphatic drainage (MLD) and compression bandaging, is aimed at mobilizing fluid and reducing limb volume in lymphedema patients. Details of fluid shifts occurring in response to CDT are currently not well studied. Therefore, we investigated fluid shifts before, during and after CDT. Thirteen patients (3 males and 10 females, aged 57 ± 8.0 years, 167.2 ± 8.3 cm height, 91.0 ± 23.4 kg weight) diagnosed with stage II leg lymphedema participated. Leg volume, limb and whole-body fluid composition (total body water (limbTBW/%TBW), extracellular (limbECF/%ECF) and intracellular (limbICF/%ICF fluid), as well as ECF/ICF and limbECF/limbICF ratios were determined using perometry and bioelectrical impedance spectroscopy. Plasma volume, proteins, osmolality, oncotic pressure and electrolytes were assessed. Leg volume (p < 0.001), limbECF (p = 0.041), limbICF (p = 0.005) and limbECF/limbICF decreased over CDT. Total leg volume and limbTBW were correlated (r = 0.635). %TBW (p = 0.001) and %ECF (p = 0.007) decreased over time. The maximum effects were seen within one week of CDT. LimbICF (p = 0.017), %TBW (p = 0.009) and %ICF (p = 0.003) increased post-MLD, whereas ECF/ICF decreased due to MLD. Plasma volume increased by 1.5% post-MLD, as well as albumin and the albumin-to-globulin ratio (p = 0.005 and p = 0.049, respectively). Our results indicate that physical therapy leads to fluid shifts in lymphedema patients, with the greatest effects occurring within one week of therapy. Fluid shifts due to physical therapy were also reflected in increased plasma volume and plasma protein concentrations. Perometry, in contrast to bioelectrical impedance analysis, does not seem to be sensitive enough to detect small fluid changes caused by manual lymphatic drainage.

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