Complex decongestive physiotherapy for patients with chronic cancer-associated lymphedema.
OBJECTIVE
Lymphedema of the limbs after cancer therapy is the most common cause of lymphedema in developed countries. There is no cure for chronic cancer-associated lymphedema. Multidisciplinary complex decongestive physiotherapy (CDP) is commonly used as a primary treatment. This prospective study assessed the efficacy of intensive CDP treatment in chronic cancer-associated lymphedema.


METHODS
Thirty women who had unilateral upper or lower limb chronic lymphedema after breast or pelvic cancer therapy were enrolled in the study. All patients received CDP once per day, in consecutive full treatment sessions, which took place between 4 and 21 times. Assessment of the results of therapy included measuring the circumference, calculated volume, and edema ratio (excess volume/unaffected side volume) of the limb volume. The main outcome measure was the percentage reduction in excess limb volume.


RESULTS
The pretreatment edema ratio demonstrated a high correlation with the patient's age (r = 0.508, p = 0.004) and the duration of the lymphedema (r = 0.634, p < 0.000). After the intensive CDP, the limb circumference, calculated volume, and edema ratio were significantly reduced compared with their pretreatment values (p < 0.000). The mean percentage reduction of excess volume was 67.8 +/- 33.2% in all patients.


CONCLUSIONS
Intensive CDP was effectively able to reduce the limb volume of patients with chronic cancer-associated lymphedema. Further follow-up study is needed to confirm the effectiveness of CDP in the maintenance phase, and its long-term effectiveness in Taiwanese.
Liao
Su-Fen
SF
Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua 500, Taiwan.
Huang
Mu-Shen
MS
Li
Shu-Hua
SH
Chen
I-Ru
IR
Wei
Ta-Sen
TS
Kuo
Shou-Jen
SJ
Chen
Shou-Tung
ST
Hsu
Jui-Chang
JC
D000328:Adult; D000368:Aged; D001132:Arm; D001943:Breast Neoplasms / Q000150:complications*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007866:Leg; D008209:Lymphedema / Q000209:etiology / Q000534:rehabilitation*; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000150:complications*; D026741:Physical Therapy Modalities / Q000379:methods*; D011446:Prospective Studies