Effects of complex decongestive therapy on upper extremity lymphedema

Öz

Anahtar Kelimeler

• -

Üst ekstremite lenfödeminde kompleks dekonjestif tedavinin etkinliği

Öz

Amaç: Bu çalışmanın amacı, üst ekstremite lenfödemi olan hastalarda kompleks dekonjestif fizyoterapinin etkinliğini değerlendirmekti. Gereç ve yöntem: Meme cerrahisi ve adjuvan radyoterapi sonrası üst ekstremite lenfödemi gelişen 102 kadın, çalışmaya dahil edildi. Olgular 31’i hafif, 34’ü orta ve 37’si şiddetli lenfödem olmak üzere üç gruba ayrıldı. Hastalara dört hafta süresince, haftada beş gün manuel lenf drenajı, çok katlı bandajlama, drenaj egzersizleri ve cilt bakımını içeren kompleks dekonjestif fizyoterapi programı uygulandı. Aynı zamanda kişisel tedaviden (kişisel lenf drenajı, lenfödem çorabı, kendi bakım aktiviteleri, egzersiz) oluşan koruyucu fizyoterapi programı verildi. Lenfödem, çevre ve volumetrik ölçüm yöntemleri ile tedavi öncesi ve sonrası değerlendirildi. Sonuçlar: Tedavi sonrası her üç grupta da lenfödem volümü anlamlı olarak azaldı (p

Anahtar Kelimeler

• Lenfödem, Üst ekstremite, Kompleks dekonjestif tedavi, Lenf drenajı

Kaynakça

1. Moseley AL, Carati CJ, Piller NB. A systematic review of common conservative therapies for arm lymphoedema secondary to breast cancer treatment. Ann Oncol. 2007;18: 639–646.
2. Lee TS, Kilbreath SL, Refshauge KM, et al. Prognosis of the upper limb following surgery and radiation for breast cancer. Breast Cancer Res Treat. 2008;110:19-37.
3. Bani HA, Fasching PA, Lux MM, et al. Lymphedema in breast cancer survivors: assessment and information provision in a specialized breast unit. Patient Educ Couns. 2007;66:311-318.
4. Golshan M, Smith B. Prevention and management of arm lymphedema in the patient with breast cancer. J Support Oncol. 2006;4:381-386.
5. Vignes S, Porcher R, Arrault M, et al. Long-term management of breast cancer-related lymphedema after intensive decongestive physiotherapy. Breast Cancer Res Treat. 2007;101:285-290.
6. Ozaslan C, Kuru B. Lymphedema after treatment of breast cancer. Am J Surg. 2004;187:69–72.
7. Bosompra K, Ashikaga T, O'Brien PJ, et al. Swelling, numbness, pain, and their relationship to arm function among breast cancer survivors: a disablement process model perspective. Breast J. 2002;8:338-348.
8. Johansson K, Ingvar C, Albertsson M, et al. Arm lymphedema, shoulder mobility and muscle strength after breast cancer treatment? a prospective 2-years study. Adv Physiother. 2001;3:55-66.

9. Harris SR, Niesen-Vertommen SL. Challenging the myth of exercise-induced lymphedema following breast cancer: a series of case reports. J Surg Oncol. 2000;74:95-99.
10. Lymphology Executive Committee. The diagnosis and treatment of peripheral lymphedema. Consensus document of the International Society of Lymphology Executive Committee. Lymphology. 1995;28:113-117.
11. Szuba A, Cooke JP, Yousuf S, et al. Decongestive lymphatic therapy for patients with cancer-related or primary lymphedema. Am J Med. 2000;109:296-300.
12. Doś J, Górska-Doś M, Szuba A. The integrated and interdisciplinary treatment of chronic lymphedema. Rocz Akad Med Bialymst. 2005;50:141-144.
13. Karadibak D, Yurdalan SU, Saydam S, et al. The comparison of two different physiotherapy methods in treatment of lymphedema after breast surgery. Breast Cancer Res Treat. 2005;95:49-54.
14. Badger C, Seers K, Preston N, et al. Physical therapies for reducing and controlling lymphedema of the limbs. Cochrane Database Syst Rev. 2004 Oct 18;(4):CD003141.
15. Yamamoto T, Todo Y, Kaneuchi M., et al., Study of edema reduction patterns during the treatment phase of complex decongestive physiotherapy for extremity lymphedema. Lymphology. 2008;41:80-86.
16. McKenzie DC, Kalda AL. Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study. J Clin Oncol. 2003;21:463-466.
17. Karges JR, Mark BE, Stikeleather SJ, et al. Concurrent validity of upper-extremity volume estimates: comparison of calculated volume derived from girth measurements and water displacement volume. Phys Ther. 2003;83:134-145.
18. Tewari N, Gill PG, Bochner MA, et al. Comparison of volume displacement versus circumferential arm measurements for lymphedema: implications for the SNAC trial. ANZ J Surg. 2008;78:889-893.
19. Damstra RJ, Glazenburg EJ, Hop WC. Validation of the inverse water volumetry method: A new gold standard for arm volume measurements. Breast Cancer Res Treat. 2006;99:267-273.
20. Taylor R, Jayasinghe UW, Koelmeyer L, et al. Reliability and validity of arm volume measurements for assessment of lymphedema Phys Ther. 2006;86:205-214.
21. Megens A, Harris SR. Physical therapist management of lymphedema following treatment for breast cancer: a critical review of its effectiveness. Phys Ther. 1998;78:1302-1311.
22. Rietman JS, Dijkstra PU, Hoekstra HJ, et al., Late morbidity after treatment of breast cancer in relation to daily activities and quality of life: asystematic Review. Eur J Surg Oncol. 2003;29:229-238.
23. Cohen SR, Payne DK, Tunkel RS., Lymphedema: Strategies for management. Cancer. 2004;92:980-987.
24. Wozniewski M, Jasinski R, Pilch U, et al. Complex physical therapy for lymphedema of the limbs. 33. Brorson H, Svensson H. Liposuction combined with Physiotherapy. 2001;87:252-256.
25. Matthews K, Smith J. Effectiveness of modified Complex Physical Therapy for lymphoedema treatment. Aust J Physiother. 1996;42:323-328.
26. Pezner RD, Patterson MP, Hill LR, et al. Arm lymphedema in patients treated conservatively for breast cancer: relationship to patient age and axillary node dissection technique. Int Radiat Oncol Biol Phys. 1986;12:2079-2083.
27. Soran A, D'Angelo G, Begovic M, et al. Breast cancer-related lymphedema-what are the significant predictors and how they affect the severity of lymphedema? Breast J. 2006;12:536-543.
28. Rockson SG, Miller LT, Senie R, et al. American Cancer Society Lymphedema Workshop. Workgroup III: Diagnosis and management of lymphedema. Cancer. 1998;83(12 Suppl American):2882-2885.
29. Földi E. The treatment of lymphedema. Cancer. 1998;83:2833-2834.
30. Casley-Smith JR, Boris M, Weindorf S, et al. Treatment for lymphedema of the arm--the Casley- Smith method: a noninvasive method produces continued reduction. Cancer. 1998;83(12 Suppl American):2843-2860.
31. Ko DS, Lerner R, Klose G, et al. Effective treatment of lymphedema of the extremities. Arch Surg. 1998;133:452-458.
32. Andersen L, Hİjris I, Erlandsen M, et al. Treatment of breast cancer-related lymphedema with or without manual lymphatic drainage. Acta Oncol. 2000;39:395-405. controlled compression therapy reduced arm lymphedema more effectively than controlled compression therapy alone. Plast Reconstr Surg. 1998;102:1058-1067.