Participating in regular physical activity is encouraged following breast cancer (BC) treatment, except for those who have subsequently developed lymphoedema We designed a randomised controlled trial to investigate the effect of participating in a supervised, mixed-type, moderate-intensity exercise program among women with lymphoedema following breast cancer Women <76 years who had completed BC treatment at least six months prior and subsequently developed unilateral, upper-limb lymphoedema were randomly allocated to an intervention (n=16) or control (n=16) group The intervention group (IG) participated in 20 supervised group exercise sessions over 12 weeks, while the control group (CG) was instructed to continue habitual activities Lymphoedema status was assessed by bioimpedance spectroscopy (impedance ratio between limbs) and perometry (volume difference between limbs) Mean baseline measures were similar for the IG (113+015 and 337+307ml, respectively) and CG (113+015 and 377+416ml, respectively) and no changes were observed over time However, 2 women in the IG no longer had evidence of lymphoedema by study end Average attendance was over 70% of supervised sessions, and there were no withdrawals The results indicate that, at worst, exercise does not exacerbate secondary lymphoedema Women with secondary lymphoedema should be encouraged to be physically active, optimising their physical and psychosocial recovery

Exercise and secondary lymphedema : safety, potential benefits, and research issues

Patients with cancer-related lymphoedema (CRL) commonly refuse treatment with bandaging or hosiery because of hot and humid weather conditions. This review aims to determine the effectiveness and safety of kinesiotaping (KT) in the management of CRL compared to compression bandaging or hosiery. A systematic search of the literature was conducted until July 2015. The primary outcomes were reduction in body part volume or circumference and adverse effects of the interventions. The secondary outcomes were subjective experience of the treatment, severity of lymphoedema-related symptoms and patients' quality of life (QoL). Six randomised controlled trials (RCTs) were included in this review. Five were included in the meta-analysis of the primary outcome limb volume (n = 203, KTn = 91, compression n = 112). It revealed no significant difference between the interventions [WMD -205.33 mL CI (-454.69 to 44.04) P = 0.11]. An increased risk of skin complications with KT was reported in five studies affecting between 10% and 21% of patients. Where lymphoedema-related symptoms were reported KT was found to be superior to compression. Paradoxically, patients receiving bandaging reported a higher QoL. KT was not found to be more comfortable than bandaging. KT should only be used with great caution where bandaging cannot be used.

A meta-analysis of the effectiveness and safety of kinesiology taping in the management of cancer-related lymphoedema

Objective:To determine the effectiveness of Kinesio taping compared to compression garments during maintenance phase of complex decongestive therapy for breast cancer–related lymphedema.Design:Rand...

Kinesio taping versus compression garments for treating breast cancer-related lymphedema: a randomized, cross-over, controlled trial.

Ziel der Untersuchung war die Evaluation der Wirkung von elastischem Tape bei Lymphodemen in der Erhaltungsphase der Komplexen Physikalischen Entstauungstherapie. Es wurde eine prospektive, randomisiert-kontrollierte, 3-armige Studie mit einem Interventionszeitraum von 12 Wochen geplant. Wahrend in der Kontrollgruppe die regulare KPE der Phase II fortgefuhrt wurde, wurde die Interventionsgruppe A additiv mit elastischem Tape, welches unter der vorhandenen Kompression getragen wurde, behandelt. Die Interventionsgruppe B erhielt das elastische Tape anstelle der Kompression. Das Odemvolumen wurde nach einer, 2 und 12 Wochen optoelektronisch vermessen, sowie der odembedingter Spannungsschmerz mittels VAS erfasst. Elastisches Tape als additive Masnahme (n=29) zeigte im Vergleich mit der Kontrolle (n=30) keinen signifikanten Einfluss auf die Entwicklung des Odemvolumens und den odembedingten Spannungsschmerz. Studienarm B (Tape anstelle der Kompression) musste abgebrochen werden, da in mehreren Fallen eine Exazerbation des Odemvolumens auftrat. Die gemessenen Veranderungen des Odemvolumens in der Interventionsgruppe A blieben im Bereich der normalen Schwankungsbreite von Lymphodemen in der Erhaltungsphase. Der Einsatz von elastischem Tape anstelle der Kompressionstherapie kann in der Erhaltungsphase der KPE bei Lymphodemen nicht empfohlen werden. Die Bedeutung der Kompressionstherapie wird durch dieses Ergebnis unterstrichen. Elastisches Tape als additive Therapiemasnahme unter dem Kompressionsstrumpf reduziert Odemvolumen und odembedingten Spannungsschmerz nicht.

Elastisches Tape als therapeutische Intervention in der Erhaltungsphase der Komplexen Physikalischen Entstauungstherapie (KPE Phase II) von Lymphödemen

Lymphodeme sind erst seit den 1960er-Jahren ein Thema in der Medizin. Bis heute herrscht weitgehend Unkenntnis zur Pathologie/Pathophysiologie sowie zum Verlauf und der Charakteristik der dabei auftretenden Befunde. Auch die Behandlungsmoglichkeiten sind haufig unklar. Das Kapitel erlautert all dies mit zahlreichen Beispielen und Quellen und gibt so einen Uberblick uber dieses Grundlagenthema.

Pathophysiologische und entstauungstherapeutische Besonderheiten der Lymphödeme

The average annual incidence of lymphedema following breast carcinoma treatment is approximately 16.200 cases in women and men, however only eleven studies of high quality on effective short-term or long-term therapy are currently available. Recent meta-analyses which address this topic are clearly deficient with regard to the evidence base for manual lymphatic drainage. The aim of this study was to review the efficacy of manual lymphatic drainage (MLD) in maintenance-phase complex decongestive physiotherapy (CDP) over a period of three months. 76 female patients were randomly assigned to one of four treatment groups (comparison of MLD, CDP, compression sleeve and Kinesio Taping (KT) method). The data were acquired in four measurements. The analysis of variance revealed a significant difference of 0,042 (p < 0,05) in the comparison of the four groups. A review of the variables within the four groups (Friedman test) showed a significant reduction (0,001) in the compression sleeve group. No significant differences were found in the pre-post comparison (Friedman test) in the MLD, KT und CDP group. In light of the absence of a significant difference, the results of the CDP, MLD and KT groups indicate a potential equivalence. The compression sleeve group showed significant superiority.

/pdf/effektivitat-der-manuellen-lymphdrainage-in-der-1v32etqvgh.pdf

Effektivität der Manuellen Lymphdrainage in der Erhaltungsphase einseitiger, sekundärer Armlymphödeme – Eine Pilotstudie

Hintergrund: Erste Studienergebnisse zeigen einen positiven Effekt der Elastische-Tape-Technik auf akute und chronische Lymphodeme. Die einzige chronische Lymphodeme betrachtende Studie kombiniert die Elastische-Tape-Technik jedoch sowohl mit Manueller Lymphdrainage als auch mit apparativer intermittierender Kompression, deren Wirkungen auf Lymphodeme derzeit noch kontrovers diskutiert werden. Ziel: Ziel dieser Pilotstudie mit randomisiertem kontrollierten Design war es, die Wirksamkeit der Elastische-Tape-Technik auf sekundare, einseitige Armlymphodeme zu prufen und diese mit der Wirksamkeit anderer Behandlungstechniken zu vergleichen. Methode: In die multizentrische Studie wurden 76 Frauen in 1 von 4 moglichen Behandlungsgruppen (Komplexe Physikalische Entstauungstherapie, Elastisches Tape, Manuelle Lymphdrainage, Kompressionsbestrumpfung) uber einen Zeitraum von 3 Monaten randomisiert. Insgesamt wurden 4 (U0 – U3) Armumfangmessungen nach Kuhnkes 4-cm-Methode durchgefuhrt. Ergebnisse: Die ANOVA wies einen signifikanten Unterschied zwischen den Gruppen (p < 0,042) auf. Der Pra-post-Vergleich (Friedman-Test) zeigte nur in der Kompressionsgruppe (p < 0,001) eine signifikante Reduktion. Schlussfolgerung: Die Elastische-Tape-Technik erzielt keine signifikante Volumenreduktion. Background: Initial studies indicate that the elastic taping method has a positive effect on acute and chronic lymphedema. However, the only study concerning chronic lymphedema combines the elastic taping method with both manual lymphatic drainage and intermittent pneumatic compression, the effects of which on chronic lymphedema are still the subject of controversial debate. Objective: The major aim of this pilot study was to determine the efficacy of the elastic taping method in the treatment of secondary one-sided arm lymphedema. Method: For this multicentric study, 76 women were randomly assigned to one of 4 possible treatment groups (i. e. complex decongestive therapy, elastic tape, manual lymphatic drainage, compression sleeve) over a 3 month intervention period. Arm circumference according to Kuhnke was assessed 4 times during the course of the study. Results: ANOVA revealed a significant difference (p < 0.042) between the 4 groups. Friedman test yielded a significant volume reduction in the compression sleeve group (p < 0.001), while the other 3 treatments did not result in significant volume reductions. Conclusion: It was assumed that elastic taping exerts a beneficial effect on arm circumference. However, the present data do not confirm this hypothesis.

Effektivität der Elastische-Tape-Technik in der Erhaltungsphase einseitiger, sekundärer Armlymphödeme

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Effektivität der Manuellen Lymphdrainage in der Erhaltungsphase einseitiger, sekundärer Armlymphödeme – Eine Pilotstudie

Effektivität der Elastische-Tape-Technik in der Erhaltungsphase einseitiger, sekundärer Armlymphödeme