title: A randomized controlled trial comparing two types of pneumatic compression for breast cancer-related lymphedema treatment in the home.
abstract: OBJECTIVE
  Pneumatic compression devices (PCDs) are used in the home setting as adjunctive treatment for lymphedema after acute treatment in a clinical setting. PCDs range in complexity from simple to technologically advanced. The objective of this prospective, randomized study was to determine whether an advanced PCD (APCD) provides better outcomes as measured by arm edema and tissue water reductions compared to a standard PCD (SPCD) in patients with arm lymphedema after breast cancer treatment.
  
  
  METHODS
  Subjects were randomized to an APCD (Flexitouch system, HCPCS E0652) or SPCD (Bio Compression 2004, HCPCS E0651) used for home treatment 1 h/day for 12 weeks. Pressure settings were 30 mmHg for the SPCD and upper extremity treatment program (UE01) with standard pressure for the APCD. Thirty-six subjects (18 per group) with unilateral upper extremity lymphedema with at least 5% arm edema volume at the time of enrollment, completed treatments over the 12-week period. Arm volumes were determined from arm girth measurements and suitable model calculations, and tissue water was determined based on measurements of the arm tissue dielectric constant (TDC).
  
  
  RESULTS
  The APCD-treated group experienced an average of 29% reduction in edema compared to a 16% increase in the SPCD group. Mean changes in TDC values were a 5.8% reduction for the APCD group and a 1.9% increase for the SPCD group.
  
  
  CONCLUSIONS
  This study suggests that for the home maintenance phase of treatment of arm lymphedema secondary to breast cancer therapy, the adjuvant treatment with an APCD provides better outcomes than with a SPCD.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, University of Texas Health Science Center, Memorial Hermann Center for Wound Care and Lymphedema Management, 6431 Fannin, MSB 1.247, Houston, TX 77030, USA. Caroline.E.Fife@uth.tmc.edu
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Fife
authors.forename: Suzanne
authors.initials: S
authors.lastname: Davey
authors.forename: Erik A
authors.initials: EA
authors.lastname: Maus
authors.forename: Renie
authors.initials: R
authors.lastname: Guilliod
authors.forename: Harvey N
authors.initials: HN
authors.lastname: Mayrovitz
mesh_terms: D000368:Aged; D001132:Arm / Q000473:pathology*; D001943:Breast Neoplasms / Q000150:complications*; D058128:Compression Bandages; D005260:Female; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices / Q000706:statistics & numerical data*; D008209:Lymphedema / Q000209:etiology / Q000628:therapy*; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D011446:Prospective Studies; D012648:Self Care / Q000379:methods*; D016896:Treatment Outcome