Impact of Activity-Oriented Propioceptive Antiedema Therapy on the Health-Related Quality of Life of Women with Upper-Limb Lymphedema Secondary to Breast Cancer—A Randomized Clinical Trial

Abstract

Background: Alterations derived from lymphedema in the upper-limb secondary to breast cancer-related lymphedema (BCRL) decrease the health-related quality of life (HRQoL), but there is limited evidence of the impact of the different interventions on it. The aim of this research was to compare the effect of conventional treatment with another treatment based on Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) on HRQoL in women diagnosed with BCRL. Methods: A prospective clinical study was designed with two parallel arms. The study population consisted of women diagnosed with BCRL in stage I and II, belonging to different institutions in Córdoba and Aragon, Spain. Sociodemographic and HRQoL-related variables, pain, tightness, heaviness and functionality were obtained before and after treatments. Results: 51 women participated in the study, 25 received the conventional treatment and 26 the TAPA, with a mean age of 59.24 ± 9.55 years. HRQoL was significantly related to upper-limb function and pain on the participants’ affected side. In addition, covariance analysis (ANCOVA) showed that the TAPA treatment interfered less in the performance of activities of daily life and produced significant improvements in the social dimension of HRQoL. Conclusions: the non-use of compressive elements in the rehabilitative treatment of the BCRL that is proposed with TAPA improves aspects such as self-image and participation in social and recreational activities.

Effect of Conservative Rehabilitation Interventions on Health-Related Quality of Life in Women with Upper Limb Lymphedema Secondary to Breast Cancer: A Systematic Review

“…Table 4 shows a summary of the main aspects of each of the articles included [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. The eighteen trials included a total of 1293 patients, all women with stage I, II, or III BCRL in the upper limb, with an age range of 0–86 years.…”

“…Other programs also improved various aspects of patients’ HRQoL, such as aquatic lymphatic therapy [ 22 ], which favored emotional and social functions, an activity-oriented anti-edema proprioceptive treatment [ 29 ], which also favored the social dimension, or other programs, such as the Domiciliary Allied Health and Acute Care Rehabilitation Team (DAART) or the Strength Through Recreation Exercise Togetherness Care Health (STRETCH), which also contributed to increasing the level of quality of life reported by their participants [ 35 ]. Furthermore, another study showed that performing exercises with low and high loads and resistance can also improve general health and the perception of HRQoL [ 30 ].…”

“…Decongestive therapy, standard or routine treatment: Of the 18 studies selected in this review, 5 of them [ 20 , 24 , 26 , 29 , 30 ] compared the effect of CDT with other therapeutic modalities on HRQoL in BCRL. Studying the effect of conventional CDT compared to CDT using an electronic device for MLD, CDT did not show any effect on HRQoL regardless of the modality and the order in which they were applied [ 20 ].…”

“…Contrasting its use in isolation, or in combination with face-to-face or virtual health education groups, it demonstrated a significant improvement in HRQoL in any of the three modalities, and this improvement was greater in the face-to-face education group [ 26 ]. Relating TDC with an experimental therapy that does not use compression, activity-oriented proprioceptive antiedema therapy (TAPA), showed improvements in HRQoL, but these were higher in the social dimension with the experimental treatment and were maintained three months after follow-up [ 29 ]. In their study, in comparison with low- or high-load resistance exercise interventions, TDC showed improvements in the physical dimension, but these were higher in the other two intervention groups that did not include it [ 30 ].…”

“…Other recommended approaches for improvements in HRQoL are lymphatic aquatic therapy with self-management recommendations [ 22 ], face-to-face self-management group sessions [ 23 ], virtual reality-based Xbox games [ 25 ], low-frequency and intensity electrotherapy [ 27 ], activity-oriented proprioceptive anti-edema therapy (TAPA) [ 29 ], low- or high-load resistance exercise [ 30 ], rehabilitation support services [ 35 ], and yoga with optional garment use compression [ 36 ].…”