Clinical Effectiveness of Complex Decongestive Physiotherapy for Malignant Lymphedema: A Pilot Study
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective To evaluate the effect of complex decongestive physiotherapy (CDPT) on malignant lymphedema patients. Methods Patients (n=22) with malignant lymphedema of the upper or the lower limb were assigned to this study. CDPT without manual lymphatic drainage (MLD) was used five times per week for two weeks. The main outcome measurements included measurement of the circumference of the limb (proximal, distal, and total) to assess volume changes. We also employed the visual analog scale (VAS) to evaluate pain, and the short form-36 version 2 questionnaire (SF-36) to assess quality of life (QOL). All items were assessed pre and post-treatment for each patient.Results There was a statistically significant difference in the volume change of the upper limbs (3.7%, p=0.001) and the lower limbs (10.9%, p=0.001). A 1.5 point reduction on the ten-point VAS was noted after CDPT. The scores on the physical and the mental components of the SF-36 showed statistical improvement after treatment (p=0.006, p=0.001, respectively).Conclusion These results suggest that all components of the CDPT program except MLD are helpful in treating malignant lymphedema in terms of pain reduction and reduction of the volume of the affected upper or lower limb. This treatment regimen also has positive effects on QOL.
Abstract
Objective To evaluate the effect of complex decongestive physiotherapy (CDPT) on malignant lymphedema patients. Methods Patients (n=22) with malignant lymphedema of the upper or the lower limb were assigned to this study. CDPT without manual lymphatic drainage (MLD) was used five times per week for two weeks. The main outcome measurements included measurement of the circumference of the limb (proximal, distal, and total) to assess volume changes. We also employed the visual analog scale (VAS) to evaluate pain, and the short form-36 version 2 questionnaire (SF-36) to assess quality of life (QOL). All items were assessed pre and post-treatment for each patient.Results There was a statistically significant difference in the volume change of the upper limbs (3.7%, p=0.001) and the lower limbs (10.9%, p=0.001). A 1.5 point reduction on the ten-point VAS was noted after CDPT. The scores on the physical and the mental components of the SF-36 showed statistical improvement after treatment (p=0.006, p=0.001, respectively).Conclusion These results suggest that all components of the CDPT program except MLD are helpful in treating malignant lymphedema in terms of pain reduction and reduction of the volume of the affected upper or lower limb. This treatment regimen also has positive effects on QOL.
참고문헌 (18)
- Warren AG., "Lymphedema : a comprehensive review", Ann Plast Surg, 59, pp.464~472 (2007)
- Querci della Rovere G., "An audit of the incidence of arm lymphoedema after prophylactic level I", II axillary dissection without division of the pectoralis minor muscle, 2003, pp.85, 158~161
- Hinrichs CS., "Lymphedema secondary to postmastectomy radiation : incidence and risk factors", Ann Surg Oncol, 11, pp.573~580 (2004)
- Zuther JE., "Lymphedema management : the comprehensive guide for practitioners. 1st ed" (2005), Thieme
- Weissleder H., "Lymphedema diagnosis and therapy. 4th ed" (2008), Viavital Verlag Gmbh
- Schuchhardt C., "Diagnostic-therapylong term observation of lymphedema following cancer treatment", J Exper Clin Hematol, 51, pp.175~ (1985)
- Lee BB., "New clinical and laboratory staging systems to improve management of chronic lymphedema", Lymphology, 38, pp.122~129 (2005)
- Taylor R., "Reliability and validity of arm volume measurements for assessment of lymphedema", Phys Ther, 86, pp.205~214 (2006)
- Ahmed RL., "Lymphedema and quality of life in breast cancer survivors : the Iowa Women’s Health Study", J Clin Oncol, 26, pp.5689~5696 (2008)
- Beaton R., "Effects of exercise intervention on persons with metastatic cancer : a systematic review", Physiother Can, 61, pp.141~153 (2009)
- Spiegel D., "Effect of psychosocial treatment on survival of patients with metastatic breast cancer", Lancet, 2, pp.888~891 (1989)
- Spiegel D., "A randomized outcome study", Arch Gen Psychiatry, 38, pp.527~533 (1981)
- Spiegel D., "Psychosocial aspects of breast cancer treatment", Semin Oncol, 24(1 Suppl 1), pp.S1-36~S1-47 (1997)
- Herpertz U., "Malignant lymphedema", Z Lymphol, 14, pp.17~23 (1990)
- Piller N., "The diagnosis and treatment of peripheral lymphedema", Lymphology, 42, pp.146~147 (2009)
- Preisler VK., "Indications and risks of manual lymph drainage in head-neck tumors", Laryngorhinootologie, 77, pp.207~212 (1998)
- Godette K., "Can manual treatment of lymphedema promote metastasis?", J Soc Integr Oncol, 4, pp.8~12 (2006)
- Pinell XA., "Manipulative therapy of secondary lymphedema in the presence of locoregional tumors", Cancer, 112, pp.950~954 (2008)