Efficacy of manual lymphatic drainage and intermittent pneumatic compression pump use in the treatment of lymphedema after mastectomy: a randomized controlled trial.
BACKGROUND
This study has two aims. The first was to investigate the efficacy and contribution of an intermittent pneumatic compression pump in the management of lymphedema, and the second was to evaluate the correlation of our measurement methods.


METHODS
This study was designed as a controlled clinical trial at the Physical Medicine and Rehabilitation Department of Ataturk University Faculty of Medicine. Thirty-one patients with upper extremity lymphedema following mastectomy participated in the study. The patients were divided into two groups. The complex decongestive physical therapy (CDT) group (group 1, n = 15) received allocated treatment, including skin care, manual lymphatic drainage, compression bandages, compression garments, and exercises. The other group had CDT combined with an intermittent pneumatic compression pump (group 2, n = 16). Both groups were treated five times a week for 3 weeks (for a total of 15 sessions). Patients were assessed according to circumference measurements of landmarks, limb volume difference, dermal thickness with ultrasonography (USG), and pain.


RESULTS
We observed significant difference in both groups when comparing them before and after therapy. The baseline median volume difference of group 1 was 630 (180-1,820), and after therapy it was 480 (0-1,410). In group 2, the beginning median volume difference was 840 (220-3,460), and after therapy it was 500 (60-2,160). However, no significant differences were observed between the two groups in terms of the above-mentioned parameters.


CONCLUSIONS
We concluded that the pneumatic compression pump did not contribute to the reduction of lymphedema. In addition, gauging dermal thickness using USG may prove to be a useful measurement method in the evaluation of lymphedema.
Department of Physical Medicine and Rehabilitation, Medical Faculty, Ataturk University, 25240, Erzurum, Turkey, drhulyauzkeser@hotmail.com.
Hulya
H
Uzkeser
Saliha
S
Karatay
Burak
B
Erdemci
Mehmet
M
Koc
Kazım
K
Senel
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D004322:Drainage; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices / Q000706:statistics & numerical data*; D008209:Lymphedema / Q000209:etiology / Q000628:therapy*; D008408:Mastectomy / Q000009:adverse effects*; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D011788:Quality of Life