Funcionalidade e qualidade de vida em indivíduos com linfedema unilateral em membro inferior: um estudo transversal

Pedrosa, Bruna Rafaele Vieira; Maia, Juliana Netto; Ferreira, Ana Paula de Lima; Araújo, Maria das Graças Rodrigues de; Montenegro, Eduardo José Nepomuceno; Silva, Fernando Leonel da; Castro, Célia Maria Machado Barbosa de; Andrade, Maria do Amparo

doi:10.1590/1677-5449.006618

Cited by 15 publications

(7 citation statements)

References 27 publications

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“…Similarly, patients with LELE(1) mostly reported moderate restrictions while those with LELE(2) predominantly reported severe or very severe restrictions. The findings pertaining to the restrictive effect of both UE and LE lymphedema on patients’ quality of life are in line with the existing research, indicating that patients with limb lymphedema generally experienced negative impacts on their quality of life and functionality [ 3 , 4 ]. However, changes in arm volume appear to have a limited impact on patients' quality of life [ 5 ], and the importance of self-care and continuing follow-ups has been emphasized [ 6 ].…”

Section: Discussionsupporting

confidence: 84%

Coping Mechanisms for Lymphedema: An Analysis of Patient Experiences

Admoun¹,

Mayrovitz²

2023

Cureus

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Background and objective Lymphedema is a condition caused by impaired lymphatic function. Acquired lymphedema is often due to neoplasia, infection, trauma, or radiation damage. Most patients rely on advice from fellow patients and personal research to manage their symptoms. We believe coping mechanisms for lymphedema can be more streamlined and made easily accessible if the most common effective strategies are determined and collected in a single repository for reference. To that end, we aimed to assess the experiences of lymphedema patients and the coping mechanisms they employed. Methods Feedback from lymphedema patients was obtained using a 19-item questionnaire-based survey distributed to multiple online lymphedema support groups. It focused on the type of lymphedema and its effect on the respondents and sought data to characterize coping mechanisms that individuals with lymphedema use and their effectiveness. Results The respondents (n=400) had a median age of 55 years (range: 18-83 years). The overall mean BMI was 35.8 kg/m 2 , with respondents with lower extremity (LE) lymphedema having a greater mean BMI (38.4 vs. 31.0, p<0.05). Most of the respondents were female (n=382, 95.5%). LE lymphedema was more common (n=280, 70%) than the upper extremity (UE) variant (n=120, 30%). Within the LE group, 99 were unilateral (35.4%) and 181 were bilateral (64.6%). Moderate restriction was the most reported level with 44% in the unilateral group and 64% in the bilateral group. Stretching, low-impact exercise, manual lymphatic drainage (MLD), and compression bandages were the most commonly used coping methods and most of the respondents rated them as somewhat effective. Of note, 30% of respondents in either group rated increased water intake as either slightly, moderately, or very helpful; 25% of respondents also rated decreased alcohol intake as very helpful. The use of a therapist and family and doctor support was rated as extremely helpful. Within the UE group, 105 were unilateral (87.5%) and 15 were bilateral (12.5%). The most common cause of UE lymphedema was breast cancer-related (98/120, 81.7%) followed by melanoma treatment. Mild restriction was the most reported level (n=48, 45.7%). The UE group had similar results as the LE group in terms of coping mechanisms, dietary changes, and psychosocial support. Conclusion Based on the experiences of the lymphedema patients surveyed, the management of the condition is multifactorial and hence not compatible with a one-size-fits-all strategy. LE lymphedema was more common than the UE variant; but both groups reported engaging in stretching, low-impact exercise, manual lymphatic drainage, and compression bandages with similar rates of satisfaction reported in both groups. Dietary changes were not commonly employed. Therapy, doctor, and family support were the most commonly used support mechanisms, with high satisfaction among both groups. The overall coping mechanisms...

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Section: Discussionsupporting

confidence: 84%

Coping Mechanisms for Lymphedema: An Analysis of Patient Experiences

Admoun¹,

Mayrovitz²

2023

Cureus

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“…In our sample, 25% of the individuals had lymphedema of the lower limbs secondary to cancer or its treatment. However, even though the association between lymphedema and cancer is consistent, the truth is that studies that include different causes of lower limb lymphedema continue to show samples that are mostly female ( 29 , 50 ). The predominance of females in the sample may be of paramount importance in interpreting the results of this investigation, since women are more likely to develop depressive symptoms than men ( 51 ).…”

Section: Discussionmentioning

confidence: 99%

Depressive symptoms and their severity in a sample with lymphedema: a case–control investigation

et al. 2023

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ObjectivesDepression is a condition that can be associated with other illnesses, especially chronic illnesses. Lower limb lymphedema is a chronic, disabling condition that can affect the quality of life and be related to psychological and psychosocial factors that interfere with people’s lives. This study aims to characterize and analyze the depressive symptoms and their severity reported by people with lower limb lymphedema and compare them with a matched group without lymphedema.MethodsA case–control study was carried out (n = 80) with participants divided into a case group (40 people with lower limb lymphedema) and a control group (40 people without lower limb lymphedema). Both groups were anthropometrically, sociodemographically, and clinically characterized. In the case group, a characterization of lymphedema was performed. Participants completed the Beck Depression Inventory-II.ResultsIndividuals with lower limb lymphedema have higher BDI-II scores than the matched group without lymphedema. Somatic depressive symptoms were, in general, the most reported and the ones with the highest scores. The depressive symptoms most reported by the case group were tiredness or fatigue, loss of energy, and changes in sleeping. Tiredness or fatigue, loss of energy, and loss of interest in sex were the most severe depressive symptoms reported by individuals with lower limb lymphedema.ConclusionConsidering the apparent tendency to depression, greater attention should be given to the mental health of people with lower limb lymphedema.

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“…When a change from this baseline occurs during the long-term maintenance phase, then the patient must return to the reduction phase of CDT. It is important to detect small changes as soon as possible, because small changes require shorter durations of treatment, and early detection of minute changes in lymphedema are associated with more favorable long-term outcomes and improved quality of life and function (9,10,32). Circumference and volume measurement are commonly used to monitor lymphedema during the maintenance phase because they are easy and cost effective to conduct.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Bioimpedance Analysis to Assess the Outcome of Complex Decongestive Therapy in Cancer Treatment-Related Lymphedema

Cho¹,

Han²,

Lee³

et al. 2020

Front. Oncol.

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Background: Cancer treatment-related lymphedema (CTRL) affects patients physically, psychologically and emotionally, and remains a significant quality of life issue among patients with cancer. Reliable methods to measure changes in lymphedema are required for early detection, acute intensive treatment, and long-term management. Here, we evaluated the use of bioimpedance analysis (BIA) as a tool to measure lymphedema before and after treatment. Patients and Methods: Patients with CTRL who were admitted to a secondary university hospital between October 2017 and July 2018 for complex decongestive therapy (CDT) were eligible for this prospective cohort study. Circumferential measure (CM) and BIA were used to evaluate lymphedema at admission (initial) and before discharge (follow-up, FU). Volume was calculated from the CM using the truncated cone formula. The inter-limb ratios (ILRs) of the circumference, volume, and impedance were also calculated as the unaffected limb to affected limb. Each parameter before and after treatment and correlations between parameters also were analyzed. Results: A total of 29 patients (12 upper-and 17 lower-extremity CTRL) completed were included in this analysis. Absolute value and the ILRs of circumference, volume or impedance, and extracellular water/total body water (ECW/TBW) were significantly improved at FU (p < 0.01, p < 0.05). The initial and FU absolute values, ILRs, ECW/TBW correlated significantly with each other (p < 0.01, p < 0.05). The cutoff values of ECW/TBW for moderate and severe degree of CTRL were 0.3855 and 0.3955, respectively. The changes of ILRs between initial and FU assessments were significantly different among three groups according to lymphedema severity (p < 0.01, p < 0.05). Conclusions: BIA data correlates significantly with clinical measurement, and therefore can be a practical tool in monitoring outcome measure after lymphedema treatment. In addition, BIA is more sensitive to subtle changes in lymphedema, and therefore can be useful for the long-term maintenance of lymphedema.

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Funcionalidade e qualidade de vida em indivíduos com linfedema unilateral em membro inferior: um estudo transversal

Cited by 15 publications

References 27 publications

Coping Mechanisms for Lymphedema: An Analysis of Patient Experiences

Coping Mechanisms for Lymphedema: An Analysis of Patient Experiences

Depressive symptoms and their severity in a sample with lymphedema: a case–control investigation

Feasibility of Bioimpedance Analysis to Assess the Outcome of Complex Decongestive Therapy in Cancer Treatment-Related Lymphedema

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