Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial
Identifieur interne : 005B29 ( Main/Exploration ); précédent : 005B28; suivant : 005B30Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial
Auteurs : María Torres Lacomba [Espagne] ; María José Yuste Sánchez [Espagne] ; Álvaro Zapico Go I [Espagne] ; David Prieto Merino [Royaume-Uni] ; Orlando Mayoral Del Moral [Espagne] ; Ester Cerezo Téllez [Espagne] ; Elena Minayo Mogoll N [Espagne]Source :
- BMJ [ 0959-8138 ] ; 2010.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- prevention & control : Lymphedema, Postoperative Complications.
- surgery : Axilla, Breast Neoplasms.
- Arm, Female, Humans, Lymphatic Metastasis, Middle Aged, Physical Therapy Modalities, Single-Blind Method, Treatment Outcome.
Abstract
Objective To determine the effectiveness of early physiotherapy in reducing the risk of secondary lymphoedema after surgery for breast cancer. Design Randomised, single blinded, clinical trial. Setting University hospital in Alcalá de Henares, Madrid, Spain. Participants 120 women who had breast surgery involving dissection of axillary lymph nodes between May 2005 and June 2007. Intervention The early physiotherapy group was treated by a physiotherapist with a physiotherapy programme including manual lymph drainage, massage of scar tissue, and progressive active and action assisted shoulder exercises. This group also received an educational strategy. The control group received the educational strategy only. Main outcome measure Incidence of clinically significant secondary lymphoedema (>2 cm increase in arm circumference measured at two adjacent points compared with the non-affected arm). Results 116 women completed the one year follow-up. Of these, 18 developed secondary lymphoedema (16%): 14 in the control group (25%) and four in the intervention group (7%). The difference was significant (P=0.01); risk ratio 0.28 (95% confidence interval 0.10 to 0.79). A survival analysis showed a significant difference, with secondary lymphoedema being diagnosed four times earlier in the control group than in the intervention group (intervention/control, hazard ratio 0.26, 95% confidence interval 0.09 to 0.79). Conclusion Early physiotherapy could be an effective intervention in the prevention of secondary lymphoedema in women for at least one year after surgery for breast cancer involving dissection of axillary lymph nodes. Trial registration Current controlled trials ISRCTN95870846.
Url:
- https://api.istex.fr/document/2AB7A35E03B5B5803CB30FAE115ED73CD2BE79F3/fulltext/pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2806631
DOI: 10.1136/bmj.b5396
Affiliations:
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Madrid</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">BMJ</title><title level="j" type="abbrev">BMJ</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1468-5833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2010">2010</date><biblScope unit="volume">340</biblScope></imprint><idno type="ISSN">0959-8138</idno></series><idno type="istex">2AB7A35E03B5B5803CB30FAE115ED73CD2BE79F3</idno><idno type="DOI">10.1136/bmj.b5396</idno><idno type="href">bmj-340-bmj-b5396.pdf</idno><idno type="ArticleID">lacm617837</idno><idno type="PMID">20068255</idno><idno type="local">bmj;340/jan12_1/b5396</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0959-8138</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arm</term><term>Axilla (surgery)</term><term>Breast Neoplasms (surgery)</term><term>Female</term><term>Humans</term><term>Lymphatic Metastasis</term><term>Lymphedema (prevention & control)</term><term>Middle Aged</term><term>Physical Therapy Modalities</term><term>Postoperative Complications (prevention & control)</term><term>Single-Blind Method</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Aisselle ()</term><term>Bras</term><term>Complications postopératoires ()</term><term>Femelle</term><term>Humains</term><term>Lymphoedème ()</term><term>Métastase lymphatique</term><term>Méthode en simple aveugle</term><term>Résultat thérapeutique</term><term>Techniques de physiothérapie</term><term>Tumeurs du sein ()</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Lymphedema</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Axilla</term><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Arm</term><term>Female</term><term>Humans</term><term>Lymphatic Metastasis</term><term>Middle Aged</term><term>Physical Therapy Modalities</term><term>Single-Blind Method</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Aisselle</term><term>Bras</term><term>Complications postopératoires</term><term>Femelle</term><term>Humains</term><term>Lymphoedème</term><term>Métastase lymphatique</term><term>Méthode en simple aveugle</term><term>Résultat thérapeutique</term><term>Techniques de physiothérapie</term><term>Tumeurs du sein</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objective To determine the effectiveness of early physiotherapy in reducing the risk of secondary lymphoedema after surgery for breast cancer. Design Randomised, single blinded, clinical trial. Setting University hospital in Alcalá de Henares, Madrid, Spain. Participants 120 women who had breast surgery involving dissection of axillary lymph nodes between May 2005 and June 2007. Intervention The early physiotherapy group was treated by a physiotherapist with a physiotherapy programme including manual lymph drainage, massage of scar tissue, and progressive active and action assisted shoulder exercises. This group also received an educational strategy. The control group received the educational strategy only. Main outcome measure Incidence of clinically significant secondary lymphoedema (>2 cm increase in arm circumference measured at two adjacent points compared with the non-affected arm). Results 116 women completed the one year follow-up. Of these, 18 developed secondary lymphoedema (16%): 14 in the control group (25%) and four in the intervention group (7%). The difference was significant (P=0.01); risk ratio 0.28 (95% confidence interval 0.10 to 0.79). A survival analysis showed a significant difference, with secondary lymphoedema being diagnosed four times earlier in the control group than in the intervention group (intervention/control, hazard ratio 0.26, 95% confidence interval 0.09 to 0.79). Conclusion Early physiotherapy could be an effective intervention in the prevention of secondary lymphoedema in women for at least one year after surgery for breast cancer involving dissection of axillary lymph nodes. Trial registration Current controlled trials ISRCTN95870846.</div></front></TEI><affiliations><list><country><li>Espagne</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Communauté de Madrid</li><li>Grand Londres</li></region><settlement><li>Londres</li><li>Madrid</li></settlement></list><tree><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Torres Lacomba, Maria" sort="Torres Lacomba, Maria" uniqKey="Torres Lacomba M" first="María" last="Torres Lacomba">María Torres Lacomba</name></region><name sortKey="Cerezo Tellez, Ester" sort="Cerezo Tellez, Ester" uniqKey="Cerezo Tellez E" first="Ester" last="Cerezo Téllez">Ester Cerezo Téllez</name><name sortKey="Mayoral Del Moral, Orlando" sort="Mayoral Del Moral, Orlando" uniqKey="Mayoral Del Moral O" first="Orlando" last="Mayoral Del Moral">Orlando Mayoral Del Moral</name><name sortKey="Minayo Mogoll N, Elena" sort="Minayo Mogoll N, Elena" uniqKey="Minayo Mogoll N E" first="Elena" last="Minayo Mogoll N">Elena Minayo Mogoll N</name><name sortKey="Torres Lacomba, Maria" sort="Torres Lacomba, Maria" uniqKey="Torres Lacomba M" first="María" last="Torres Lacomba">María Torres Lacomba</name><name sortKey="Yuste Sanchez, Maria Jose" sort="Yuste Sanchez, Maria Jose" uniqKey="Yuste Sanchez M" first="María José" last="Yuste Sánchez">María José Yuste Sánchez</name><name sortKey="Zapico Go I, Alvaro" sort="Zapico Go I, Alvaro" uniqKey="Zapico Go I A" first="Álvaro" last="Zapico Go I">Álvaro Zapico Go I</name><name sortKey="Zapico Go I, Alvaro" sort="Zapico Go I, Alvaro" uniqKey="Zapico Go I A" first="Álvaro" last="Zapico Go I">Álvaro Zapico Go I</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Prieto Merino, David" sort="Prieto Merino, David" uniqKey="Prieto Merino D" first="David" last="Prieto Merino">David Prieto Merino</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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