Araştırma Makalesi
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The Effect of Complex Decongestive Therapy on Physical Performance, Balance, Muscle Strength and Mood in Patients with Lower Extremity Lymphedema

Yıl 2025, Cilt: 52 Sayı: 4, 703 - 711, 12.12.2025
https://doi.org/10.5798/dicletip.1840652

Öz

Purpose: We aimed to investigate the effects of complex decongestive therapy (CDT) on physical performance, balance, muscle strength and mood in patients with lower extremity lymphedema.
Methods: Twenty female patients diagnosed with lower extremity lymphedema were included. Therapy was applied once a day, 5 days a week, for 4 weeks. Sessions lasted approximately 60 minutes. All measurements and evaluations were recorded before and after therapy.
Results: A significant difference was found between healthy and affected circumferential measurements. Mean of timed up and go test 6.70±1.71 before the treatment and 6.15±1.56 after the treatment, the difference was significant. The mean of standing on one leg was 8.31±5.16 before treatment and 9.2±6.20 after treatment, difference was not significant. Before treatment, there was no significance between hip flexion, hip extension, knee flexion and plantar flexion muscle strength values in healthy extremities and in affected extremities. The number of participants classified as non-depressed was 4 before therapy but 8 after therapy. 9 people were mildly depressed before therapy, this number decreased to 7 after therapy. Before and after the therapy, 4 people were evaluated as moderately depressed. Number of patients with severe depression was 3 before therapy, but decreased to 1 after therapy.
Conclusion: Complex decongestive therapy is a standard treatment method for lymphedema. We suggest that CDT had beneficial and curative effects on physical performance, balance, muscle strength and depression parameters in our patients.

Etik Beyan

This study was approved and certified by Dicle University Faculty of Medicine Ethics Committee (14.04.2022/110).

Kaynakça

  • 1.Kayıran O, De La Cruz C, Tane K et al. Lymphedema:From diagnosis to treatment. Turk J Surg. 2017; 33(2):51-5.
  • 2.Greene AK, Goss JA. Diagnosis and Staging ofLymphedema. Semin. Plast. Surg. 2018; 32(1): 12-6.
  • 3.Brix B, Sery O, Onorato A et al. Biology ofLymphedema. Biology (Basel). 2021; 10(4).
  • 4.Bakar Y, Tuğral A. Lower Extremity LymphedemaManagement after Gynecologic Cancer Surgery: AReview of Current Management Strategies. Ann. Vasc.Surg. 2017; 44: 442-50.
  • 5.Gebruers N. Current and future perspectives on theevaluation, prevention and conservative managementof breast cancer related lymphoedema: A best practiceguideline. Eur. J. Obstet. Gynecol. Reprod. Biol. 2017;216: 245-53.
  • 6.The Diagnosis and Treatment of PeripheralLymphedema: 2016 Consensus Document of theInternational Society of Lymphology. Lymphology.2016; 49(4): 170-84.
  • 7.Rockson SG. Lymphedema after Breast CancerTreatment. N. Engl. J. Med. 2018; 379(20): 1937-44.
  • 8.Sousa N, Sampaio J. Effects of progressive strengthtraining on the performance of the Functional ReachTest and the Timed Get-Up-and-Go Test in an elderlypopulation from the rural north of Portugal. Am. J.Hum. Biol. 2005; 17(6): 746-51.
  • 9.Bohannon RW, Larkin PA, Cook AC, et al. Decrease intimed balance test scores with aging. Phys. Ther. 1984; 64(7): 1067-70.
  • 10. Whitney SL, Wrisley DM, Marchetti GF, et al. Clinical measurement of sit-to-stand performance in peoplewith balance disorders: validity of data for the Five-Times-Sit-to-Stand Test. Phys Ther. 2005; 85(10):1034-45.
  • 11.Mentiplay BF, Perraton LG, Bower KJ, et al.Assessment of Lower Limb Muscle Strength and Power Using Hand-Held and Fixed Dynamometry: AReliability and Validity Study. PLoS One. 2015 Oct28;10(10):e0140822.
  • 12.Durak A, Palabıyıkoğlu R. Beck Hopelessness ScaleValidity Study. Crisis journal. 1994; 2(2): 311-9.
  • 13.Breslin JW, Yang Y, Scallan JP, et al. LymphaticVessel Network Structure and Physiology. ComprPhysiol. 2018; 9(1): 207-99.
  • 14.Steele ML, Janda M, Vagenas D, et al. ABioimpedance Spectroscopy-Based Method forDiagnosis of Lower-Limb Lymphedema. Lymphat. Res.Biol. 2020; 18(2): 101-9.
  • 15.Czerniec SA, Ward LC, Refshauge KM, et al.Assessment of breast cancer-related armlymphedema--comparison of physical measurementmethods and self-report. Cancer Invest. 2010; 28(1):54-62.
  • 16.Kostanoğlu A, Ramoğlu M, Güneren E. Results ofhome-based modified combined decongestive therapyin patients with lower extremity lymphedema. Turk JMed Sci. 2019; 49(2): 610-6.
  • 17.Michopoulos E, Papathanasiou G, Vasilopoulos G, et al. Effectiveness and Safety of Complete DecongestiveTherapy of Phase I: A Lymphedema Treatment Studyin the Greek Population. Cureus. 2020; 12(7): e9264.
  • 18.Noble-Jones R, Rowley L, Rowley C. Clinicalinnovation: wider collaboration on lymphoedemaresearch is needed—footwear and gait analysis.Wounds International. 2017; 8(1): 21-4.
  • 19.Sousa N, Sampaio J. Effects of progressive strengthtraining on the performance of the Functional ReachTest and the Timed Get-Up-and-Go Test in an elderlypopulation from the rural north of Portugal. Am. J.Hum. Biol. 2005; 17(6): 746-51.
  • 20.Kokkonen K, Saarto T, Mäkinen T, et al. Thefunctional capacity and quality of life of women withadvanced breast cancer. Breast Cancer. 2017; 24(1):128-36.
  • 21.Sousa N, Sampaio J. Effects of progressive strengthtraining on the performance of the Functional ReachTest and the Timed Get-Up-and-Go Test in an elderlypopulation from the rural north of Portugal. Am. J.Hum. Biol. 2005; 17(6): 746-51.
  • 22.Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res. Q. Exerc. Sport. 1999; 70(2):113-9.
  • 23.Do JH, Choi KH, Ahn JS, et al. Effects of a complexrehabilitation program on edema status, physicalfunction, and quality of life in lower-limb lymphedema after gynecological cancer surgery. Gynecol. Oncol.2017; 147(2): 450-5.
  • 24.Hsieh KL, Wood TA, An R, et al. Gait and BalanceImpairments in Breast Cancer Survivors: A SystematicReview and Meta-analysis of Observational Studies.Arch Rehabil Res Clin Transl. 2019; 1(1-2): 100001.
  • 25.Angin S, Karadibak D, Yavuzşen T, et al. Unilateralupper extremity lymphedema deteriorates thepostural stability in breast cancer survivors. ContempOncol (Pozn). 2014; 18(4): 279-84.
  • 26.Şahin A. Examination of the effect of phase Icomplex decongestive physiotherapy on balance andgait in lower extremity lymphedema, in PhysicalTherapy and Rehabilitation. 2019, PamukkaleUniversity.
  • 27.Cemal Y, Jewell S, Albornoz CR, et al. Systematicreview of quality of life and patient reported outcomes in patients with oncologic related lower extremitylymphedema. Lymphat. Res. Biol. 2013; 11(1): 14-9.
  • 28. Cohen MD. Complete decongestive physical therapy in a patient with secondary lymphedema due toorthopedic trauma and surgery of the lower extremity. Phys. Ther. 2011; 91(11): 1618-26.
  • 29.Katz E, Dugan NL, Cohn JC, et al. Weight lifting inpatients with lower-extremity lymphedema secondary to cancer: a pilot and feasibility study. Arch. Phys. Med. Rehabil. 2010; 91(7): 1070-6.

Alt Ekstremite Lenfödemli Hastalarda Kompleks Dekonjestif Tedavinin Fiziksel Performans, Denge, Kas Gücü ve Duygudurum Üzerine Etkisi

Yıl 2025, Cilt: 52 Sayı: 4, 703 - 711, 12.12.2025
https://doi.org/10.5798/dicletip.1840652

Öz

Amaç: Alt ekstremite lenfödemli hastalarda kompleks dekonjestif tedavinin (KDT) fiziksel performans, denge, kas gücü ve ruh hali üzerine etkilerini araştırmayı amaçladık.
Yöntemler: Alt ekstremite lenfödem tanısı alan 20 kadın hasta çalışmaya dahil edildi. Terapi 4 hafta boyunca haftada 5 gün, günde bir kez uygulandı. Oturumlar yaklaşık 60 dakika sürdü. Tedavi öncesinde ve sonrasında tüm ölçüm ve değerlendirmeler kaydedildi.
Bulgular: Sağlıklı ve etkilenen çevresel ölçümler arasında anlamlı fark bulundu. Tedavi öncesinde 3 metre kalk ve yürü testi ortalaması 6,70±1,71 iken tedavi sonrasında 6,15±1,56 olup aradaki fark anlamlıydı. Tek ayak üzerinde durma ortalaması tedavi öncesinde 8,31±5,16 iken tedavi sonrasında 9,2±6,20 olup fark anlamlı değildi. Tedavi öncesi sağlıklı ekstremitelerde ve etkilenen ekstremitelerde kalça fleksiyon, kalça ekstansiyon, diz fleksiyon ve plantar fleksiyon kas kuvveti değerleri arasında anlamlılık yoktu. Terapiden önce depresyonda olmayan katılımcı sayısı 4 iken tedavi sonrasında 8'di. Tedavi öncesi 9 kişi hafif depresifti, tedavi sonrasında bu sayı 7'ye düştü. Terapi öncesi ve sonrasında 4 kişi orta derecede depresyonlu olarak değerlendirildi. Şiddetli depresyonu olan hasta sayısı tedavi öncesinde 3 iken tedavi sonrasında 1'e düştü.
Sonuç: Kompleks dekonjestif tedavi lenfödem için standart bir tedavi yöntemidir. Hastalarımızda KDT'nin fiziksel performans, denge, kas gücü ve depresyon parametreleri üzerinde yararlı ve iyileştirici etkilerinin olduğunu düşünüyoruz

Kaynakça

  • 1.Kayıran O, De La Cruz C, Tane K et al. Lymphedema:From diagnosis to treatment. Turk J Surg. 2017; 33(2):51-5.
  • 2.Greene AK, Goss JA. Diagnosis and Staging ofLymphedema. Semin. Plast. Surg. 2018; 32(1): 12-6.
  • 3.Brix B, Sery O, Onorato A et al. Biology ofLymphedema. Biology (Basel). 2021; 10(4).
  • 4.Bakar Y, Tuğral A. Lower Extremity LymphedemaManagement after Gynecologic Cancer Surgery: AReview of Current Management Strategies. Ann. Vasc.Surg. 2017; 44: 442-50.
  • 5.Gebruers N. Current and future perspectives on theevaluation, prevention and conservative managementof breast cancer related lymphoedema: A best practiceguideline. Eur. J. Obstet. Gynecol. Reprod. Biol. 2017;216: 245-53.
  • 6.The Diagnosis and Treatment of PeripheralLymphedema: 2016 Consensus Document of theInternational Society of Lymphology. Lymphology.2016; 49(4): 170-84.
  • 7.Rockson SG. Lymphedema after Breast CancerTreatment. N. Engl. J. Med. 2018; 379(20): 1937-44.
  • 8.Sousa N, Sampaio J. Effects of progressive strengthtraining on the performance of the Functional ReachTest and the Timed Get-Up-and-Go Test in an elderlypopulation from the rural north of Portugal. Am. J.Hum. Biol. 2005; 17(6): 746-51.
  • 9.Bohannon RW, Larkin PA, Cook AC, et al. Decrease intimed balance test scores with aging. Phys. Ther. 1984; 64(7): 1067-70.
  • 10. Whitney SL, Wrisley DM, Marchetti GF, et al. Clinical measurement of sit-to-stand performance in peoplewith balance disorders: validity of data for the Five-Times-Sit-to-Stand Test. Phys Ther. 2005; 85(10):1034-45.
  • 11.Mentiplay BF, Perraton LG, Bower KJ, et al.Assessment of Lower Limb Muscle Strength and Power Using Hand-Held and Fixed Dynamometry: AReliability and Validity Study. PLoS One. 2015 Oct28;10(10):e0140822.
  • 12.Durak A, Palabıyıkoğlu R. Beck Hopelessness ScaleValidity Study. Crisis journal. 1994; 2(2): 311-9.
  • 13.Breslin JW, Yang Y, Scallan JP, et al. LymphaticVessel Network Structure and Physiology. ComprPhysiol. 2018; 9(1): 207-99.
  • 14.Steele ML, Janda M, Vagenas D, et al. ABioimpedance Spectroscopy-Based Method forDiagnosis of Lower-Limb Lymphedema. Lymphat. Res.Biol. 2020; 18(2): 101-9.
  • 15.Czerniec SA, Ward LC, Refshauge KM, et al.Assessment of breast cancer-related armlymphedema--comparison of physical measurementmethods and self-report. Cancer Invest. 2010; 28(1):54-62.
  • 16.Kostanoğlu A, Ramoğlu M, Güneren E. Results ofhome-based modified combined decongestive therapyin patients with lower extremity lymphedema. Turk JMed Sci. 2019; 49(2): 610-6.
  • 17.Michopoulos E, Papathanasiou G, Vasilopoulos G, et al. Effectiveness and Safety of Complete DecongestiveTherapy of Phase I: A Lymphedema Treatment Studyin the Greek Population. Cureus. 2020; 12(7): e9264.
  • 18.Noble-Jones R, Rowley L, Rowley C. Clinicalinnovation: wider collaboration on lymphoedemaresearch is needed—footwear and gait analysis.Wounds International. 2017; 8(1): 21-4.
  • 19.Sousa N, Sampaio J. Effects of progressive strengthtraining on the performance of the Functional ReachTest and the Timed Get-Up-and-Go Test in an elderlypopulation from the rural north of Portugal. Am. J.Hum. Biol. 2005; 17(6): 746-51.
  • 20.Kokkonen K, Saarto T, Mäkinen T, et al. Thefunctional capacity and quality of life of women withadvanced breast cancer. Breast Cancer. 2017; 24(1):128-36.
  • 21.Sousa N, Sampaio J. Effects of progressive strengthtraining on the performance of the Functional ReachTest and the Timed Get-Up-and-Go Test in an elderlypopulation from the rural north of Portugal. Am. J.Hum. Biol. 2005; 17(6): 746-51.
  • 22.Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res. Q. Exerc. Sport. 1999; 70(2):113-9.
  • 23.Do JH, Choi KH, Ahn JS, et al. Effects of a complexrehabilitation program on edema status, physicalfunction, and quality of life in lower-limb lymphedema after gynecological cancer surgery. Gynecol. Oncol.2017; 147(2): 450-5.
  • 24.Hsieh KL, Wood TA, An R, et al. Gait and BalanceImpairments in Breast Cancer Survivors: A SystematicReview and Meta-analysis of Observational Studies.Arch Rehabil Res Clin Transl. 2019; 1(1-2): 100001.
  • 25.Angin S, Karadibak D, Yavuzşen T, et al. Unilateralupper extremity lymphedema deteriorates thepostural stability in breast cancer survivors. ContempOncol (Pozn). 2014; 18(4): 279-84.
  • 26.Şahin A. Examination of the effect of phase Icomplex decongestive physiotherapy on balance andgait in lower extremity lymphedema, in PhysicalTherapy and Rehabilitation. 2019, PamukkaleUniversity.
  • 27.Cemal Y, Jewell S, Albornoz CR, et al. Systematicreview of quality of life and patient reported outcomes in patients with oncologic related lower extremitylymphedema. Lymphat. Res. Biol. 2013; 11(1): 14-9.
  • 28. Cohen MD. Complete decongestive physical therapy in a patient with secondary lymphedema due toorthopedic trauma and surgery of the lower extremity. Phys. Ther. 2011; 91(11): 1618-26.
  • 29.Katz E, Dugan NL, Cohn JC, et al. Weight lifting inpatients with lower-extremity lymphedema secondary to cancer: a pilot and feasibility study. Arch. Phys. Med. Rehabil. 2010; 91(7): 1070-6.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi, Tıp Eğitimi, Sağlık Hizmetleri ve Sistemleri (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Meral Karakoç

Dilek Aygün Keşim

Serda Em

Gönderilme Tarihi 13 Mayıs 2025
Kabul Tarihi 19 Eylül 2025
Yayımlanma Tarihi 12 Aralık 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 52 Sayı: 4

Kaynak Göster

APA Karakoç, M., Aygün Keşim, D., & Em, S. (2025). The Effect of Complex Decongestive Therapy on Physical Performance, Balance, Muscle Strength and Mood in Patients with Lower Extremity Lymphedema. Dicle Medical Journal, 52(4), 703-711. https://doi.org/10.5798/dicletip.1840652
AMA Karakoç M, Aygün Keşim D, Em S. The Effect of Complex Decongestive Therapy on Physical Performance, Balance, Muscle Strength and Mood in Patients with Lower Extremity Lymphedema. diclemedj. Aralık 2025;52(4):703-711. doi:10.5798/dicletip.1840652
Chicago Karakoç, Meral, Dilek Aygün Keşim, ve Serda Em. “The Effect of Complex Decongestive Therapy on Physical Performance, Balance, Muscle Strength and Mood in Patients with Lower Extremity Lymphedema”. Dicle Medical Journal 52, sy. 4 (Aralık 2025): 703-11. https://doi.org/10.5798/dicletip.1840652.
EndNote Karakoç M, Aygün Keşim D, Em S (01 Aralık 2025) The Effect of Complex Decongestive Therapy on Physical Performance, Balance, Muscle Strength and Mood in Patients with Lower Extremity Lymphedema. Dicle Medical Journal 52 4 703–711.
IEEE M. Karakoç, D. Aygün Keşim, ve S. Em, “The Effect of Complex Decongestive Therapy on Physical Performance, Balance, Muscle Strength and Mood in Patients with Lower Extremity Lymphedema”, diclemedj, c. 52, sy. 4, ss. 703–711, 2025, doi: 10.5798/dicletip.1840652.
ISNAD Karakoç, Meral vd. “The Effect of Complex Decongestive Therapy on Physical Performance, Balance, Muscle Strength and Mood in Patients with Lower Extremity Lymphedema”. Dicle Medical Journal 52/4 (Aralık2025), 703-711. https://doi.org/10.5798/dicletip.1840652.
JAMA Karakoç M, Aygün Keşim D, Em S. The Effect of Complex Decongestive Therapy on Physical Performance, Balance, Muscle Strength and Mood in Patients with Lower Extremity Lymphedema. diclemedj. 2025;52:703–711.
MLA Karakoç, Meral vd. “The Effect of Complex Decongestive Therapy on Physical Performance, Balance, Muscle Strength and Mood in Patients with Lower Extremity Lymphedema”. Dicle Medical Journal, c. 52, sy. 4, 2025, ss. 703-11, doi:10.5798/dicletip.1840652.
Vancouver Karakoç M, Aygün Keşim D, Em S. The Effect of Complex Decongestive Therapy on Physical Performance, Balance, Muscle Strength and Mood in Patients with Lower Extremity Lymphedema. diclemedj. 2025;52(4):703-11.