title: Immediate effects of active exercise with compression therapy on lower-limb lymphedema.
abstract: Active exercise with compression therapy (AECT) is a standard treatment for gynecological cancer-related lower-limb lymphedema (LLL) in clinical situations. However, there is insufficient evidence regarding the immediate effects of the use of AECT on LLL. The purpose of this study was to evaluate the immediate effects of AECT on LLL.
  
  
  
  Participants in this randomized controlled crossover trial comprised 23 women with LLL who completed high-load AECT, low-load AECT, and compression-only therapy (CT). AECT was performed on a bicycle ergometer with short stretch bandages. Each intervention was performed for 15 min, with successive interventions separated by a 1-week washout period. Lower-limb volume was assessed using a Perometer™ sensor (Pero-system, Wuppertal, Germany). General symptoms (pain and heaviness) and skin symptoms (pitting and stiffness) were assessed using a visual analog scale and palpation, respectively. Measurements were taken before and after each intervention. Analysis of variance using linear mixed-effect modeling was used for statistical analyses.
  
  
  
  Volume decrement differed significantly between all three interventions (P < 0.05). Lower-limb volume was significantly reduced after high-load AECT compared to that after CT. General symptoms and skin symptoms were similar across the three interventions, but severity of pre-intervention skin symptoms correlated significantly with volume decrement after high- and low-load AECT. High-load AECT using the bicycle ergometer was more effective than CT for decreasing lower-limb volume.
  
  
  
  These results suggest that high-load AECT has marked effects on severe LLL.
authors.affiliation: Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan.|Department of Locomotive Rehabilitation Science, Unit of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Fukushima
authors.affiliation: Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan. cxa01423@nifty.com.
authors.forename: Tetsuya
authors.identifier: 0000-0002-4728-9409
authors.initials: T
authors.lastname: Tsuji
authors.affiliation: Department of Rehabilitation Medicine, Keio University Hospital, Tokyo, Japan.
authors.forename: Yufuko
authors.initials: Y
authors.lastname: Sano
authors.affiliation: Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Chieko
authors.initials: C
authors.lastname: Miyata
authors.affiliation: Department of Rehabilitation Medicine, Keio University Hospital, Tokyo, Japan.
authors.forename: Michiyo
authors.initials: M
authors.lastname: Kamisako
authors.affiliation: Department of Rehabilitation Medicine, Keio University Hospital, Tokyo, Japan.
authors.forename: Hiroka
authors.initials: H
authors.lastname: Hohri
authors.affiliation: Department of Rehabilitation Medicine, Keio University Hospital, Tokyo, Japan.
authors.forename: Chikako
authors.initials: C
authors.lastname: Yoshimura
authors.affiliation: Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Asakura
authors.affiliation: Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Okitsu
authors.affiliation: Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Muraoka
authors.affiliation: Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Meigen
authors.initials: M
authors.lastname: Liu
mesh_terms: D001458:Bandages; D018592:Cross-Over Studies; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000473:pathology*; D008209:Lymphedema / Q000628:therapy*; D008875:Middle Aged
keywords: Ergometer exercise; Gynecological cancer; Lymphatic system insufficiency; Rehabilitation