The Effect of Combined Decongestive Therapy and Pneumatic Compression Pump on Lymphedema Indicators in Patients with Lymphedema Secondary to Breast Cancer Treatment: A Randomized Clinical Control Trial

Abstract

BackgroundLymphedema treatment is difficult and there is no consensus on the best treatment. This study evaluated the effect of combined decongestive therapy (CDT) and pneumatic compression pump on lymphedema indicators in patients with breast cancer related lymphedema (BCRL).MethodsTwenty one women with BCRL were enrolled. The volume difference of upper limbs, the circumference at 9 areas and shoulder joint range of motion were measured in all patients. CDT was done by an educated nurse in two phases. In first phase, CDT was accompanied by use of a compression pump for 4 weeks, 3 days per week. In second phase, CDT was performed daily without compression pump for 4 weeks by patients at home. At the end of each phase, the same primary measurements were done for patients.ResultsThe mean volume difference of the upper limbs and mean difference in circumference in all areas at different phases decreased significantly. Mean flexion, extension, abduction and external rotation (in degrees) at different phases increased significantly.ConclusionCDT significantly reduced mean volume and mean circumference of the affected limb, and significantly increased shoulder joint range of motion. The findings support the optimal effects of CDT in the treatment of secondary lymphedema of upper extremity.Clinical trial registration number138902212621N8

Intermittent pneumatic compression in patients with postmastectomy lymphedema

“…In the studies of Moattari et al, volumetric measurements were performed together with circumference measurements, based on which a high correlation coefficient from 0.80 to 0.92 was obtained for measurements on the olecranon level, then at 10, 15 and 20 cm below and above the olecranon [5]. a similar satisfactory correlation was obtained between measurements of circumference at 4 and 10 levels and through plethysmography.…”

“…surements of limb circumference are used by other researchers [5,9,19,21]. In the studies of Moattari et al, volumetric measurements were performed together with circumference measurements, based on which a high correlation coefficient from 0.80 to 0.92 was obtained for measurements on the olecranon level, then at 10, 15 and 20 cm below and above the olecranon [5].…”

“…therefore, in the last few years, pneumatic compression combined with CtD is more frequently used in the treatment of secondary lymphedema [2,5]. Pneumatic compression is used as an independent method, e.g.…”

The Effect of Complex Decongestive Therapy on Post-Breast Surgery Quality of Life in Breast Cancer Patients With Unilateral Lymphedema and Its Predictive Factors

“…In our country, patients with severe disease receive more support by their families and community, which might explain improved SF in more severely ill patients in our study. The optimal effect of CDT + Pump on reducing the volume of arm or increasing the range of motion in the affected joint has been demonstrated (6,26). Some studies compared combined CDT + Pump with CDT alone in reducing the arm volume.…”

Usefulness of intermittent pneumatic compression in medicine

“…In the treatment of lymphedema, despite the lack of consensus [32][33][34][35][36][37][38][39] regarding additional benefits of IPC, it is an integral part of complete decongestive therapy. This comprehensive procedure is useful in the treatment and prevention of lymphedema after breast cancer surgery, but it turns out effective in any case of lymphedema not only because of its very action but also owing to good patient compliance.…”