A pilot, prospective evaluation of a novel alternative for maintenance therapy of breast cancer-associated lymphedema [ISRCTN76522412]
Identifieur interne : 007A53 ( Main/Exploration ); précédent : 007A52; suivant : 007A54A pilot, prospective evaluation of a novel alternative for maintenance therapy of breast cancer-associated lymphedema [ISRCTN76522412]
Auteurs : Olivia Wilburn [États-Unis] ; Paul Wilburn [États-Unis] ; Stanley G. Rockson [États-Unis]Source :
- BMC Cancer [ 1471-2407 ] ; 2006.
Descripteurs français
- KwdFr :
- MESH :
- diagnostic : Lymphoedème.
- étiologie : Autosoins, Lymphoedème, Techniques de physiothérapie.
- Adulte d'âge moyen, Femelle, Humains, Lymphoedème, Massage, Projets pilotes, Qualité de vie, Résultat thérapeutique, Sujet âgé, Tumeurs du sein.
English descriptors
- KwdEn :
- MESH :
- complications : Breast Neoplasms.
- diagnosis : Lymphedema.
- etiology : Lymphedema.
- instrumentation : Physical Therapy Modalities, Self Care.
- therapy : Lymphedema.
- Aged, Female, Humans, Massage, Middle Aged, Pilot Projects, Quality of Life, Treatment Outcome.
Abstract
Prospective investigations of complete decongestive lymphatic physiotherapy (CDPT), including manual lymphatic drainage (MLD), have validated the efficacy of these interventions for the initial reduction of edema and long-term maintenance of limb volume in lymphedema. However, CDPT demands substantial time and effort from patients to maintain these benefits; the treatments are not always well-accepted, and patients may suffer from a deterioration in quality-of-life or a time-dependent loss of initial treatment benefits. A new device designed for home use by the patient, the Flexitouch™, has been developed to mechanically simulate MLD. We have undertaken a prospective, randomized, crossover study of the efficacy of the Flexitouch™, when compared to massage, in the self-administered maintenance therapy of lymphedema.
A prospective, randomized, crossover study of maintenance therapy was performed in 10 patients with unilateral breast cancer-associated lymphedema of the arm. Each observation phase included self-administered treatment with the Flexitouch™ or massage, 1 hour daily for 14 days, respectively, followed by crossover to the alternate treatment phase. Each treatment phase was preceded by a 1 week treatment washout, with use of garment only. The sequence of treatment was randomly assigned. The potential impact of treatment modality on quality of life was assessed with serial administration of the SF-36.
Statistical analysis disclosed that the order of treatment had no outcome influence, permitting 10 comparisons within each treatment group. Post-treatment arm volume reduced significantly after the Flexitouch™, but not after self-administered massage. The patients' mean weight decreased significantly with Flexitouch™ use, but not with massage. The Flexitouch™ device was apparently well-tolerated and accepted by patients. Serial SF-36 administration showed no deterioration in physical or psychosocial scores compared to baseline measurements; there were no statistical differences in scores when the two treatment modalities were compared.
This short-term prospective evaluation of the Flexitouch™ suggests that the device may provide better maintenance edema control than self-adiminstered massage in breast cancer-associated lymphedema. The apparent ease of use and reliability of response to the device suggest that further broad-scale testing is warranted.
Url:
DOI: 10.1186/1471-2407-6-84
PubMed: 16571129
PubMed Central: 1440867
Affiliations:
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Le document en format XML
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<term>Breast Neoplasms (complications)</term>
<term>Female</term>
<term>Humans</term>
<term>Lymphedema (diagnosis)</term>
<term>Lymphedema (etiology)</term>
<term>Lymphedema (therapy)</term>
<term>Massage</term>
<term>Middle Aged</term>
<term>Physical Therapy Modalities (instrumentation)</term>
<term>Pilot Projects</term>
<term>Quality of Life</term>
<term>Self Care (instrumentation)</term>
<term>Treatment Outcome</term>
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<term>Autosoins (instrumentation)</term>
<term>Femelle</term>
<term>Humains</term>
<term>Lymphoedème ()</term>
<term>Lymphoedème (diagnostic)</term>
<term>Lymphoedème (étiologie)</term>
<term>Massage</term>
<term>Projets pilotes</term>
<term>Qualité de vie</term>
<term>Résultat thérapeutique</term>
<term>Sujet âgé</term>
<term>Techniques de physiothérapie (instrumentation)</term>
<term>Tumeurs du sein ()</term>
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<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Lymphedema</term>
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<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Lymphoedème</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Physical Therapy Modalities</term>
<term>Self Care</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Autosoins</term>
<term>Lymphoedème</term>
<term>Techniques de physiothérapie</term>
</keywords>
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<term>Female</term>
<term>Humans</term>
<term>Massage</term>
<term>Middle Aged</term>
<term>Pilot Projects</term>
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<term>Femelle</term>
<term>Humains</term>
<term>Lymphoedème</term>
<term>Massage</term>
<term>Projets pilotes</term>
<term>Qualité de vie</term>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Prospective investigations of complete decongestive lymphatic physiotherapy (CDPT), including manual lymphatic drainage (MLD), have validated the efficacy of these interventions for the initial reduction of edema and long-term maintenance of limb volume in lymphedema. However, CDPT demands substantial time and effort from patients to maintain these benefits; the treatments are not always well-accepted, and patients may suffer from a deterioration in quality-of-life or a time-dependent loss of initial treatment benefits. A new device designed for home use by the patient, the Flexitouch™, has been developed to mechanically simulate MLD. We have undertaken a prospective, randomized, crossover study of the efficacy of the Flexitouch™, when compared to massage, in the self-administered maintenance therapy of lymphedema.</p>
</sec>
<sec sec-type="methods"><title>Methods</title>
<p>A prospective, randomized, crossover study of maintenance therapy was performed in 10 patients with unilateral breast cancer-associated lymphedema of the arm. Each observation phase included self-administered treatment with the Flexitouch™ or massage, 1 hour daily for 14 days, respectively, followed by crossover to the alternate treatment phase. Each treatment phase was preceded by a 1 week treatment washout, with use of garment only. The sequence of treatment was randomly assigned. The potential impact of treatment modality on quality of life was assessed with serial administration of the SF-36.</p>
</sec>
<sec><title>Results</title>
<p>Statistical analysis disclosed that the order of treatment had no outcome influence, permitting 10 comparisons within each treatment group. Post-treatment arm volume reduced significantly after the Flexitouch™, but not after self-administered massage. The patients' mean weight decreased significantly with Flexitouch™ use, but not with massage. The Flexitouch™ device was apparently well-tolerated and accepted by patients. Serial SF-36 administration showed no deterioration in physical or psychosocial scores compared to baseline measurements; there were no statistical differences in scores when the two treatment modalities were compared.</p>
</sec>
<sec><title>Conclusion</title>
<p>This short-term prospective evaluation of the Flexitouch™ suggests that the device may provide better maintenance edema control than self-adiminstered massage in breast cancer-associated lymphedema. The apparent ease of use and reliability of response to the device suggest that further broad-scale testing is warranted.</p>
</sec>
</div>
</front>
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