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 Combined-complex Decongestive Therapy Reduces Volume and Improves Quality of Life and Functional Status in Patients with Breast Cancer-related Lymphedema

2020 ◽  
Author(s):  
Pinar Borman ◽  
Aysegul Yaman ◽  
Sina Yasrebi ◽  
Adeviye Pinar Inanli
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Functional Status ◽  
Excess Volumes ◽  
Complex Decongestive Therapy ◽  
Eortc Qlq C30 ◽  
Breast Cancer Related Lymphedema ◽  
Eortc Qlq ◽  
Decongestive Therapy

Abstract Background: The aim of this study was to evaluate the effects of complex decongestive therapy (CDT) in patients with breast cancer-related lymphedema (BCRL), in regard to volume reduction, functional status and quality of life (QoL).Methods: Fifty patients with unilateral BCRL were included. The demographic variables focusing on lymphedema were recorded. All patients received combined phase 1 CDT including skin care, manual lymphatic drainage, multilayer bandaging and supervised exercises, five times a week for three weeks, as a total of 15 sessions. Patients were assessed by limb volumes and excess volumes according to geometric approximation derived from serial circumference-measurements of the limb, prior and at the end of third week. The functional disability was evaluated by quick disability of arm, shoulder and hand questionnaire (DASH). Quality of life was assessed by the European Organization forResearch and Treatment of Cancer Core Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) and its breast cancer module (EORTC-QLQ-BR23­).Results: Fifty females with mean age of 53.22±11.2 years were included. The median duration of lymphedema was 12 months. There were 22 patients in stage1, 26 in stage2 and 2 patients in stage3. The mean baseline limb and excess volumes were significantly decreased at the end of therapies (3262±753cm³ vs 2943±646.6cm³ and 31.36±16.5% vs 19.12±10.4%, p=0.000,respectively). The DASH and EORTC-QLQ-C30 and BR23 scores were also decreased significantly (p<0.05). The improvements in volumes were related negatively with the duration of lymphedema,and the stage of lymphedema. Conclusion: In conclusion phase 1CDT in a combined manner performed daily for 3 weeks, greatly reduces the volumes as well as improves the disability and QoL, especially when performed earlier.

scholarly journals Combıned-Complex Decongestıve Therapy Reduces Volume And Improves Quality Of Lıfe And Functıonal Status In Patıents Wıth Breast Cancer-Related Lymphedema

2020 ◽  
Author(s):  
Pinar Borman ◽  
Aysegul Yaman ◽  
Sina Yasrebi ◽  
Adeviye Pinar Inanli
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Functional Status ◽  
Excess Volumes ◽  
Complex Decongestive Therapy ◽  
Eortc Qlq C30 ◽  
Breast Cancer Related Lymphedema ◽  
Eortc Qlq ◽  
Decongestive Therapy

Abstract Background: The aim of this study was to evaluate the effects of complex decongestive therapy (CDT) in patients with breast cancer-related lymphedema (BCRL), in regard to volume reduction, functional status and quality of life (QoL).Methods: Fifty patients with unilateral BCRL were included. The demographic variables focusing on lymphedema were recorded. All patients received combined phase 1 CDT including skin-care, manual lymphatic drainage, multilayer bandaging and supervised exercises, five times a week for three weeks, as a total of 15 sessions. Patients were assessed by limb volumes and excess volumes according to geometric approximation derived from serial circumference-measurements of the limb, prior and at the end of third week. The functional disability was evaluated by quick disability of arm, shoulder and hand questionnaire (DASH). Quality of life was assessed by the European Organization for Research and Treatment of Cancer Core Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) and its breast cancer module (EORTC-QLQ-BR23­).Results: Fifty females with mean age of 53.22±11.2 years were included. The median duration of lymphedema was 12 months. There were 22 patients in stage1, 26 in stage2 and 2 patients in stage3. The mean baseline limb and excess volumes were significantly decreased at the end of therapies (3262±753cm³ vs 2943±646.6cm³ and 31.36±16.5% vs 19.12±10.4%, p=0.000,respectively). The DASH and EORTC-QLQ-C30 and BR23 scores were also decreased significantly (p<0.05). The improvements in volumes were related negatively with the duration of lymphedema,and the stage of lymphedema. Conclusion: In conclusion phase 1CDT in a combined manner performed daily for 3 weeks, greatly reduces the volumes as well as improves the disability and QoL, especially when performed earlier.Trial Registration: 'retrospectively registered’

Randomized Trial of Decongestive Lymphatic Therapy for the Treatment of Lymphedema in Women With Breast Cancer

2013 ◽  
Vol 31 (30) ◽  
pp. 3758-3763 ◽  
Author(s):  
Ian S. Dayes ◽  
Tim J. Whelan ◽  
Jim A. Julian ◽  
Sameer Parpia ◽  
Kathleen I. Pritchard ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Short Form ◽  
Lymphatic Drainage ◽  
Control Group ◽  
Compression Garments ◽  
Absolute Volume ◽  
Arm Lymphedema ◽  
Decongestive Lymphatic Therapy ◽  
And Control ◽  
Decongestive Therapy

Purpose Because of its morbidity and chronicity, arm lymphedema remains a concerning complication of breast cancer treatment. Although massage-based decongestive therapy is often recommended, randomized trials have not consistently demonstrated benefit over more conservative measures. Patients and Methods Women previously treated for breast cancer with lymphedema were enrolled from six institutions. Volumes were calculated from circumference measurements. Patients with a minimum of 10% volume difference between their arms were randomly assigned to either compression garments (control) or daily manual lymphatic drainage and bandaging followed by compression garments (experimental). The primary outcome was percent reduction in excess arm volume from baseline to 6 weeks. Results A total of 103 women were randomly assigned, and 95 were evaluable. Mean reduction of excess arm volume was 29.0% in the experimental group and 22.6% in the control group (difference, 6.4%; 95% CI, −6.8% to 20.5%; P = .34). Absolute volume loss was 250 mL and 143 mL in the experimental and control groups, respectively (difference, 107 mL; 95% CI, 13 to 203 mL; P = .03). There was no difference between groups in the proportion of patients losing 50% or greater excess arm volume. Quality of life (Short Form-36 Health Survey) and arm function were not different between groups. Conclusion This trial was unable to demonstrate a significant improvement in lymphedema with decongestive therapy compared with a more conservative approach. The failure to detect a difference may have been a result of the relatively small size of our trial.

Compression therapy in obese patients

Phlebologie ◽  
2015 ◽  
Vol 44 (02) ◽  
pp. 71-76 ◽  
Author(s):  
S. Reich-Schupke
Keyword(s):  
Side Effects ◽  
High Strength ◽  
Compression Therapy ◽  
Lymphatic Drainage ◽  
Skin Care ◽  
Obese Patients ◽  
Compression Garment ◽  
Physical Shape ◽  
High Degree

SummaryTriggered by obesity, venous (obesity-associated dependency syndrome) and lymphatic drainage disorders (obesity-associated lymphoedema) can develop, which in themselves require compression therapy, or other comorbidities with indication for compression therapy may exist. In obese patients, some specific features have to be observed in compression therapy:- An adequate initial decongestive phase with padding and bandage materials,- Compression hosiery with a high degree of stiffness (high-strength materials, where appropriate, flat-knitted) and optimal fit (meticulous fitting),- Garment types that are suitable for daily use, if necessary, multi-part garment,- Need for aids or auxiliary persons to ensure correct use,- Concomitant consistent, intensive, lipid-replenishing skin care and optimised hygiene to reduce complications and side effects- Regular medical check-ups to ensure correct fit of the leg compression garment.Sometimes, particularly at the initial provision and in patients with a complicated physical shape, the stockings have to be modified several times before an optimal fit is achieved.

Effectiveness of four types of bandages and kinesio-tape for treating breast-cancer-related lymphoedema: a randomized, single-blind, clinical trial

2020 ◽  
Vol 34 (9) ◽  
pp. 1230-1241
Author(s):  
María Torres-Lacomba ◽  
Beatriz Navarro-Brazález ◽  
Virginia Prieto-Gómez ◽  
Jean Claude Ferrandez ◽  
Jean Yves Bouchet ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Excess Volume ◽  
Compression Therapy ◽  
Lymphatic Drainage ◽  
Therapeutic Education ◽  
Unilateral Breast Cancer ◽  
Kinesio Tape ◽  
The University ◽  
Single Blind

Objective: To compare the effects of four types of bandages and kinesio-tape and determine which one is the most effective in women with unilateral breast cancer-related lymphoedema. Design: Randomized, single-blind, clinical trial. Setting: Physiotherapy department in the Women’s Health Research Group at the University of Alcalá, Madrid, Spain. Subjects: A total of 150 women presenting breast-cancer-related lymphoedema. Interventions: Participants were randomized into five groups ( n = 30). All women received an intensive phase of complex decongestive physiotherapy including manual lymphatic drainage, pneumatic compression therapy, therapeutic education, active therapeutic exercise and bandaging. The only difference between the groups was the bandage or tape applied (multilayer; simplified multilayer; cohesive; adhesive; kinesio-tape). Main measurements: The main outcome was percentage excess volume change. Other outcomes measured were heaviness and tightness symptoms, and bandage or tape perceived comfort. Data were collected at baseline and finishing interventions. Results: This study showed significant differences between the bandage groups in absolute value of excess volume ( P < 0.001). The most effective were the simplified multilayer (59.5%, IQR = 28.7) and the cohesive bandages (46.3%, IQR = 39). The bandages/tape with the least difference were kinesio-tape (4.9%, IQR = 17.7) and adhesive bandage (21.7%, IQR = 17.9). The five groups exhibited a significant decrease in symptoms after interventions, with no differences between groups. In addition, kinesio-tape was perceived as the most comfortable by women and multilayer as the most uncomfortable ( P < 0.001). Conclusion: Simplified multilayer seems more effective and more comfortable than multilayer bandage. Cohesive bandage seems as effective as simplified multilayer and multilayer bandage. Kinesio taping seems the least effective.

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