title: Complex decongestive physiotherapy for patients with chronic cancer-associated lymphedema.
abstract: 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.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua 500, Taiwan.
authors.forename: Su-Fen
authors.initials: SF
authors.lastname: Liao
authors.forename: Mu-Shen
authors.initials: MS
authors.lastname: Huang
authors.forename: Shu-Hua
authors.initials: SH
authors.lastname: Li
authors.forename: I-Ru
authors.initials: IR
authors.lastname: Chen
authors.forename: Ta-Sen
authors.initials: TS
authors.lastname: Wei
authors.forename: Shou-Jen
authors.initials: SJ
authors.lastname: Kuo
authors.forename: Shou-Tung
authors.initials: ST
authors.lastname: Chen
authors.forename: Jui-Chang
authors.initials: JC
authors.lastname: Hsu
mesh_terms: 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