Efficacy of self-administered complex decongestive therapy on breast cancer-related lymphedema: a single-blind randomized controlled trial

Efficacy of self-administered complex decongestive therapy on breast cancer-related lymphedema: a single-blind randomized controlled trial

Purpose After surgery, breast cancer-related lymphedema (BCRL) is a frequent chronic condition. The complex decongestive therapy (CDT) delivered by physiotherapists at hospitals is the state-of-the-art treatment choice. As lymphedema requires continuous management, we designed a 1-month-long course...

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Bibliographic Details
Published in:Breast cancer research and treatment Vol. 175; no. 1; pp. 191 - 201
Main Authors: Ligabue, M. B., Campanini, I., Veroni, P., Cepelli, A., Lusuardi, M., Merlo, A.
Format: Journal Article
Language:English
Published: New York Springer US 01-05-2019
Springer
Springer Nature B.V
Subjects:
Arm
Asymmetry
Breast cancer
Cancer research
Cancer treatment
Care and treatment
Chronic illnesses
Clinical Trial
Clinical trials
Health aspects
Hospitals
Lymphedema
Medicine
Medicine & Public Health
Oncology
Pain
Physical therapists
Retirement benefits
Self care (Health)
Surgery
Working women
Breast cancer
Complex decongestive therapy
Lymphedema
Self-care
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Summary:Purpose After surgery, breast cancer-related lymphedema (BCRL) is a frequent chronic condition. The complex decongestive therapy (CDT) delivered by physiotherapists at hospitals is the state-of-the-art treatment choice. As lymphedema requires continuous management, we designed a 1-month-long course to train women to professionally carry out a self-administered CDT (saCDT) and tested its efficacy while keeping the benefits of CDT. Methods Consecutive patients treated with CDT over a 1-year period at an Italian facility were randomly assigned to either experimental (EXP, saCDT course) or control (CTRL, usual care) group. Women were assessed before, at 1, and 6 months from enrolment. Pain assessed by the numerical pain rating scale (NPRS) was the primary outcome. Arm asymmetry assessed by the excess limb volume (ELV) was the secondary outcome. Outcome variations were compared to their MCID to classify women as improved, stable, or worsened. Results Forty-one women were included. The proportion of stable or improved women was significantly different between EXP and CTRL groups at 6 months after enrolment for both arm pain ( p  = 0.01) and asymmetry ( p  < 0.01). Noteworthy, only one EXP woman had worsened after 6 months. NPRS significantly decreased in the EXP group only, with a median variation of 2 points. Arm ELV significantly decreased with respect to the baseline value in the EXP group only, with a median reduction of 8%. Conclusions Teaching saCDT to women with BCRL is effective in maintaining or improving the benefits of CDT and can be used as a self-care tool in the management of BCRL.
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ISSN:0167-6806
1573-7217
DOI:10.1007/s10549-019-05136-9