Manual lymphatic drainage therapy in patients with breast cancer related lymphoedema
TL;DR: The results of this study will provide information on the effectiveness of Manual Lymphatic Drainage and its impact on the quality of life and physical limitations of these patients, as well as the improvement of the concomitant symptomatology.
Abstract: Background
Lymphoedema is a common and troublesome condition that develops following breast cancer treatment. The aim of this study is to analyze the effectiveness of Manual Lymphatic Drainage in the treatment of postmastectomy lymphoedema in order to reduce the volume of lymphoedema and evaluate the improvement of the concomitant symptomatology.
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31 May 2017
TL;DR: The chapter will begin by reviewing the basic physiopathology of CVD, including the role of calf muscle pump, and the CEAP classification system and the chronic venous severity score will be presented, as these are main tools for clinical assessment ofCVD severity.
Abstract: Chronic venous disease (CVD) is a chronic condition that is associated with venous hypertension, vein’s valves damage, venous obstruction, and calf muscle pump impairment. This blood circulatory condition is also characterized by important inflammatory changes affecting the skin, the subcutaneous tissue and the muscles, which are probably triggered by blood stasis and venous edema. With disease progression, severe ulcerative skin damage might occur, which when present represent the more severe stage of this condition. CVD has a significant economic, social and health impact, mostly due to raised morbidity and chronicity. The treatment of patients with CVD might focus on both the symptoms and secondary changes of the disease, such as edema, skin and subcutaneous changes or ulcers. Usually, initial treatment of CVD patients involves a non-invasive, conservative treatment to reduce symptoms, treat secondary changes, and help prevent the development of secondary complications and the progression of the disease. Complementary, some interventional or surgical treatments can be undertaken. There are several conservative treatments to treat and prevent complications associated with CVD that have been described in the literature, like manual lymphatic drainage (MLD) and compression, physical exercise, intermittent pneumatic pressure, kinesio taping, electrical muscle stimulation, transcutaneous electrical nerve stimulation, hydrotherapy, and health education. Most of these techniques are complementary to compression therapy or pharmacological treatment. © 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This chapter will address the role of physical therapists in the management of CVD. The chapter will begin by reviewing the basic physiopathology of CVD, including the role of calf muscle pump. The CEAP classification system and the chronic venous severity score will be presented, as these are main tools for clinical assessment of CVD severity. In the remainder of the chapter will address the physiological effects and recommendations for treating CVD of MLD, based on our clinical experience and own research.
5 citations
Cites background from "Manual lymphatic drainage therapy i..."
...MLD must take into account venous anatomy and venous blood flow direction just like the lymphatic anatomy and the lymph flow directions, particularly when applied to larger body segments (like the course of GSV), such as the thigh, to be more effective in increasing venous flow [23, 128, 129, 145, 148]....
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TL;DR: In this article , the efficacy of low-level laser therapy (LLLT) in the treatment of metastatic breast cancer-related lymphedema (BCRL) was investigated.
Abstract: Abstract Background Breast cancer-related lymphedema (BCRL) is a frequent issue that arises after mastectomy surgery in women and compromises physical and mental function. Previously published studies have shown positive effects with the use of Low-level laser therapy in another term Photo-biomodulation therapy (PBM). This research investigated the efficacy of clinical use of LLLT (PBM) in the treatment of metastatic breast cancer-related lymphedema. Methods PubMed, PEDro, Medline, and the Cochrane Library were searched for LLLT clinical trials published before October 2021. The methodological quality of randomized trials and the effectiveness of Laser Therapy for BCRL were evaluated. The primary objectives were arm circumference or arm volume, whereas the secondary goals were to assess shoulder mobility and pain severity. Results Eight clinical trials were analyzed in total. Typically, the included RCTs had good research quality. At four weeks, there was a considerable reduction in arm circumference/volume, and this continued with long-term follow-up. However, no statistically significant change in shoulder mobility or pain severity was seen between the laser and placebo groups at 0-, 1-, 2-, and 3-month short-term follow-up. Conclusions The findings of this comprehensive study demonstrated that LLLT (PBM) was successful in diminishing arm circumference and volume than improving shoulder mobility and pain. Data indicates that laser therapy (PBM) may be a beneficial treatment option for females with PML. Because of the scarcity of evidence, there is a strong need for well-conducted and longer-duration trials in this field. Trial registration Details of the protocol for this systematic review were registered on PROSPERO and can be accessed at www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42022315076 .
4 citations
18 Oct 2012
4 citations
Additional excerpts
...Dans d’autres études analysées, elles tendent toutes à faire valoir son potentiel à être employé (113, 122, 130, 131)....
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09 Jun 2012
TL;DR: The authors revisou artigos nas bases de dados do MEDLINE (PubMed) e demais fontes de pesquisa, sem limite de tempo, adotou-se a estrategia de busca baseada em perguntas estruturadas na forma (P.I.C.O.).
Abstract: Este estudo revisou artigos nas bases de dados do MEDLINE (PubMed) e demais fontes de pesquisa, sem limite de tempo. Para tan-to, adotou-se a estrategia de busca baseada em perguntas estruturadas na forma (P.I.C.O.) das iniciais: "Paciente"; "Intervencao"; "Controle" e "Outcome". Como descritores utilizaram-se: Breast Neoplasm, Mastectomy, Mastectomy, Radical; Lymph Node Excision, Surgery, Lymphedema, Breast Cancer-related Lymphedema (BCRL); Arm/pathology, Postoperative Complications, Shouder Joint, Range of Motion, Articular*; Shoulder Joint/Radiation Effects, Drainage, Manual Lymphatic Drainage, Decongestive (MLD), Lymphatic Therapy (DLT), Massage, Compression Bandages, Bandages, Alginates*, Physical Therapy Modalities, Exercise, Exercise/Physiology*, Exercise Therapy, Exercise Training, Exercise Movement Techniques, Exercise Tolerance, Weight Lifting*, Kinesiotherapy, Musculoskeletal Manipulation, Prevention and Control, Primary Prevention, Postoperative Care, Rehabilitation, Early Intervention, Recovery of Function, Disability Evaluation, Complications*, Survivor*, Neoplasm Recurrence; Immune System, Stress, Psychological; Quality of Life, Value of life, Sickness Impact Profile, Life Style, Risk, Risk Factors, Overweight, Diet, Food, Diet Therapy, Diet Reducing, Dietetics, Malnutrition, Nutrition Policy, Nutritional Sciences, Pressure*, Intermittent Pneumatic Compression, Intermittent Pneumatic Compression Devices, Hydrotherapy, Complementary Therapies, Cognitive Therapy, Mind-body Therapies, Mindfulness, Meditation, Psychotherapy, Psychophysics, Holistic Health, Adaptation, Psychological; Self-help Groups, Psychotherapy, Group*; Occupational Therapy, Social Support. Com esses descritores efetivaram-se cruzamentos de acordo com o tema proposto em cada topico das perguntas (P.I.C.O.). Analisado esse material, foram selecionados os artigos relativos as perguntas e, por meio do estudo dos mesmos, estabeleceram-se as evidencias que fundamentaram as diretrizes do presente documento.
4 citations
Journal Article•
TL;DR: Lymphatic drainage massage and low pressure bandage are effective in reducing post-mastectomy complications with a significant reduction in the means of shoulder pain intensity and dysfunction.
Abstract: Background: Mastectomic patients experience complications such as edema of the operated hand, shoulder pain and dysfunction. This study was conducted to compare the effects of manual lymph drainage and low pressure bandage on shoulder pain and dysfunction after modified radical mastectomy. Materials and Methods: In this clinical trial study, 90 women with radical mastectomy referred to the oncology ward of Imam Khomeini hospital (Tehran) were randomly assigned to three groups: the massage, massage+bandage and control groups. Groups were trained how to use manual lymph drainage massage and low pressure bandage. Shoulder pain intensity and dysfunction were measured at 7 and 30 days post-surgery. Edema was measured at 24 hours post-surgery and also 30 days post-intervention. Data were analyzed using descriptive and inferential statistics (one-way ANOVA and Kruskal-Wallis). Results: There was no statistically significant difference among three groups in the means of three measured variables (the arm circumference, shoulder pain intensity and dysfunction) before the intervention. Moreover, the results showed a significant reduction in the means of shoulder pain intensity and dysfunction among the three groups on the 30th intervention day (P=0.001), but the difference was not significant in the mean of arm circumference. Conclusion: Lymphatic drainage massage and low pressure bandage are effective in reducing post-mastectomy complications.
4 citations
Cites background from "Manual lymphatic drainage therapy i..."
...[1] Martin ML, Hernandez MA, Avendaño C, Rodríguez F, Martinez H....
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References
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TL;DR: Chronic oedema arising for reasons other than cancer treatment is much more prevalent than generally perceived, yet resources for treatment are mainly cancer-based, leading to inequalities of care.
Abstract: Summary Background: Lymphoedema/chronic oedema is an important cause of morbidity in the population, but little is known of its epidemiology and impact on patients or health services. Aim: To determine the magnitude of the problem of chronic oedema in the community, and the likely impact of oedema on use of health resources, employment and patient’s quality of life.
499 citations
"Manual lymphatic drainage therapy i..." refers background in this paper
...Problems associated with lymphoedema include: pain, altered sensations such as discomfort and heaviness, difficulties with physical mobility, physiological distress, recurrent infections and social isolation [3,4]....
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TL;DR: Treatment for breast cancer is associated with considerable arm morbidity, which has a negative impact on QOL, andArm morbidity should be carefully monitored in future studies involving local treatment modalities for Breast cancer.
Abstract: PURPOSE: To determine the prevalence of and contributing factors for chronic arm morbidity including lymphedema in breast cancer patients after treatment and to assess the impact of arm morbidity on quality of life (QOL). PATIENTS AND METHODS: A four-question screening questionnaire was developed and mailed to a random sample of 744 breast cancer patients treated curatively in two cancer centers from 1993 to 1997. Patients were without recurrence and at least 2 years from diagnosis. Respondents were classified as with or without arm-related symptoms on the basis of the survey. Stratified random samples from each group were then invited for a detailed assessment of their symptoms and signs, including the presence of lymphedema. Their QOL was assessed by the European Organization for Research and Treatment of Cancer QOL Questionnaire C-30 and by a detailed arm problem questionnaire that assessed various aspects of daily arm functioning. RESULTS: Approximately half of all screened patients were symptomatic a...
344 citations
"Manual lymphatic drainage therapy i..." refers background in this paper
...In a study in which 744 patients with breast cancer were assessed with these quality of life scales, some imbalances regarding the quality of life in those patients with lymphoedema were found [ 8 ]....
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TL;DR: HRQOL was lower for BrCa survivors with diagnosed lymphedema and for those with arm symptoms without diagnosed lyMPhedema in the IWHS, according to a dose-response relation between number of arm symptoms and lower HRQOL.
Abstract: Purpose The impact of lymphedema or related arm symptoms on health-related quality of life (HRQOL) in breast cancer (BrCa) survivors has not been examined using a large population-based cohort. Patients and Methods The Iowa Women’s Health Study (IWHS) collected self-report data for lymphedema, arm symptoms, and HRQOL (Medical Outcomes Study Short Form-36) in 2004 and data for cancer diagnosis, treatment, and behavioral and health characteristics between 1986 and 2003. We studied 1,287 women, age 55 to 69 years at baseline, who developed unilateral BrCa. We used cross-sectional analyses to describe the prevalence of lymphedema and arm symptoms and multivariate-adjusted generalized linear models to compare HRQOL (physical functioning, bodily pain, general health, physical and emotional role limitations, vitality, social functioning, and mental health) between the following three survivor groups: women with lymphedema (n 104), women with arm symptoms without diagnosed lymphedema (n 475), and women without lymphedema or arm symptoms (n 708).
343 citations
TL;DR: It is suggested that CB on its own should be considered as a primary treatment option in reducing arm lymphedema volume, as well as manual lymph drainage massage in combination with multi-layered compression bandaging.
Abstract: Purpose. The purpose of this investigation was to compare the reduction in arm lymphedema volume achieved from manual lymph drainage massage (MLD) in combination with multi-layered compression bandaging (CB) to that achieved by CB alone.
235 citations
"Manual lymphatic drainage therapy i..." refers background in this paper
...On the other hand, the fact that CPT implies several techniques (manual lymph drainage, skin care and multilayer compression bandaging followed by a compression garment to reduce oedema and therapeutic exercises) makes it difficult to recognize which of them is the truly effective one in the treatment of lymphoedema [ 12-14 ]....
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TL;DR: The study showed that both groups obtained a significant reduction in edema and that MLD did not contribute significantly to reduce edema volume.
Abstract: A prospective randomized study was carried out to investigate whether the addition of manual lymphatic drainage (MLD) to the standard therapy could improve treatment outcome in women with lymphedema of the ipsilateral arm after breast cancer treatment. Forty-two patients were randomly assigned to receive standard therapy or standard therapy plus MLD 8 times in 2 weeks and training in self-massage. The standard therapy consisted of use of a compression garment, exercises and information about lymphedema and skin care. The efficacy of treatment was evaluated by reduction in lymphedema volume during treatment and by improvement in symptoms potentially related to lymphedema. The patients were followed-up for a total of 12 months. The study showed that both groups obtained a significant reduction in edema and that MLD did not contribute significantly to reduce edema volume.
220 citations