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Different physical treatment modalities for lymphoedema developing after axillary lymph node dissection for breast cancer: a review.

Abstract

The purpose of this article is to provide a systematic review of Combined Physical Therapy, Intermittent Pneumatic Compression and arm elevation for the treatment of lymphoedema secondary to an axillary dissection for breast cancer. Combined Physical Therapy starts with an intensive phase consisting of skin care, Manual Lymphatic Drainage, exercises and bandaging and continues with a maintenance phase consisting of skin care, exercises, wearing a compression sleeve and Manual Lymphatic Drainage if needed. We have searched the following databases: PubMed/MEDLINE, CINAHL, EMBASE, PEDro and Cochrane. Only (pseudo-) randomised controlled trials and non-randomised experimental trials investigating the effectiveness of Combined Physical Therapy and its different parts, of Intermittent Pneumatic Compression and of arm elevation were included. These physical treatments had to be applied to patients with arm lymphoedema which developed after axillary dissection for breast cancer. Ten randomised controlled trials, one pseudo-randomised controlled trial and four non-randomised experimental trials were found and analysed. Combined Physical Therapy can be considered as an effective treatment modality for lymphoedema. Bandaging the arm is effective, whether its effectiveness is investigated on a heterogeneous group consisting of patients with upper and lower limb lymphoedema from different causes. There is no consensus on the effectiveness of Manual Lymphatic Drainage. The effectiveness of skin care, exercises, wearing a compression sleeve and arm elevation is not investigated by a controlled trial. Intermittent Pneumatic Compression is effective, but once the treatment is interrupted, the lymphoedema volume increases. In conclusion, Combined Physical Therapy is an effective therapy for lymphoedema. However, the effectiveness of its different components remains uncertain. Furthermore, high-quality studies are warranted. The long-term effect of Intermittent Pneumatic Compression and the effect of elevation on lymphoedema are not yet proven.

Authors+Show Affiliations

Department Physiotherapy, University Hospitals Leuven, Belgium. nele.devoogdt@artesis.beNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

20018422

Citation

Devoogdt, Nele, et al. "Different Physical Treatment Modalities for Lymphoedema Developing After Axillary Lymph Node Dissection for Breast Cancer: a Review." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 149, no. 1, 2010, pp. 3-9.
Devoogdt N, Van Kampen M, Geraerts I, et al. Different physical treatment modalities for lymphoedema developing after axillary lymph node dissection for breast cancer: a review. Eur J Obstet Gynecol Reprod Biol. 2010;149(1):3-9.
Devoogdt, N., Van Kampen, M., Geraerts, I., Coremans, T., & Christiaens, M. R. (2010). Different physical treatment modalities for lymphoedema developing after axillary lymph node dissection for breast cancer: a review. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 149(1), pp. 3-9. doi:10.1016/j.ejogrb.2009.11.016.
Devoogdt N, et al. Different Physical Treatment Modalities for Lymphoedema Developing After Axillary Lymph Node Dissection for Breast Cancer: a Review. Eur J Obstet Gynecol Reprod Biol. 2010;149(1):3-9. PubMed PMID: 20018422.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Different physical treatment modalities for lymphoedema developing after axillary lymph node dissection for breast cancer: a review. AU - Devoogdt,Nele, AU - Van Kampen,Marijke, AU - Geraerts,Inge, AU - Coremans,Tina, AU - Christiaens,Marie-Rose, Y1 - 2009/12/16/ PY - 2009/02/08/received PY - 2009/11/18/revised PY - 2009/11/19/accepted PY - 2009/12/19/entrez PY - 2009/12/19/pubmed PY - 2010/5/4/medline SP - 3 EP - 9 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur. J. Obstet. Gynecol. Reprod. Biol. VL - 149 IS - 1 N2 - The purpose of this article is to provide a systematic review of Combined Physical Therapy, Intermittent Pneumatic Compression and arm elevation for the treatment of lymphoedema secondary to an axillary dissection for breast cancer. Combined Physical Therapy starts with an intensive phase consisting of skin care, Manual Lymphatic Drainage, exercises and bandaging and continues with a maintenance phase consisting of skin care, exercises, wearing a compression sleeve and Manual Lymphatic Drainage if needed. We have searched the following databases: PubMed/MEDLINE, CINAHL, EMBASE, PEDro and Cochrane. Only (pseudo-) randomised controlled trials and non-randomised experimental trials investigating the effectiveness of Combined Physical Therapy and its different parts, of Intermittent Pneumatic Compression and of arm elevation were included. These physical treatments had to be applied to patients with arm lymphoedema which developed after axillary dissection for breast cancer. Ten randomised controlled trials, one pseudo-randomised controlled trial and four non-randomised experimental trials were found and analysed. Combined Physical Therapy can be considered as an effective treatment modality for lymphoedema. Bandaging the arm is effective, whether its effectiveness is investigated on a heterogeneous group consisting of patients with upper and lower limb lymphoedema from different causes. There is no consensus on the effectiveness of Manual Lymphatic Drainage. The effectiveness of skin care, exercises, wearing a compression sleeve and arm elevation is not investigated by a controlled trial. Intermittent Pneumatic Compression is effective, but once the treatment is interrupted, the lymphoedema volume increases. In conclusion, Combined Physical Therapy is an effective therapy for lymphoedema. However, the effectiveness of its different components remains uncertain. Furthermore, high-quality studies are warranted. The long-term effect of Intermittent Pneumatic Compression and the effect of elevation on lymphoedema are not yet proven. SN - 1872-7654 UR - https://www.unboundmedicine.com/medline/citation/20018422/Different_physical_treatment_modalities_for_lymphoedema_developing_after_axillary_lymph_node_dissection_for_breast_cancer:_a_review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301-2115(09)00691-5 DB - PRIME DP - Unbound Medicine ER -