The physical treatment of upper limb edema.
BACKGROUND
Edema of the upper limb, without any doubt, constitutes the most invalidating complication of breast carcinoma treatment. The swelling of the limb results from decreased liquid evacuation by surgical intervention at the axillary level and also by the eventual treatment by cobaltotherapy.


METHODS
The physical treatment for edema of the limb consists of a combination of therapies that were tested for their effectiveness in laboratories on healthy students and also on patients who underwent surgery for breast carcinoma. The treatment consists of the application of manual lymphatic drainage (type Leduc), the use of multilayered bandages, and the use of intermittent pneumatic compression. The population studied was represented by 220 patients who underwent breast surgery. The authors followed their evolution during the first 2 weeks of treatment. Patients were not hospitalized. The edema was measured by using marks tattooed on the skin.


RESULTS
The limb that developed edema was compared with the healthy limb. The most important reduction was obtained in the first week. The decrease was equivalent to 50% of the average of the difference between both upper limbs. During the second week, the results obtained stabilized; however, there was a slight decrease at the end of the second week.


CONCLUSIONS
The physical treatment of edema represents the preferred therapeutic approach. However, it must answer to well-defined criteria to be efficient and for long-lasting effects. The physical treatment is used to treat outpatients, allowing them to follow a normal lifestyle.
Leduc
O
O
Academic Department, Physical Therapy, University of Brussels, Belgium.
Leduc
A
A
Bourgeois
P
P
Belgrado
J P
JP
D000328:Adult; D000368:Aged; D001132:Arm; D001458:Bandages; D001943:Breast Neoplasms / Q000628:therapy*; D018567:Breast Neoplasms, Male / Q000628:therapy; D004322:Drainage; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000209:etiology* / Q000473:pathology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000379:methods; D011312:Pressure; D016896:Treatment Outcome