Belmonte, R., Tejero, M., Ferrer, M., Muniesa, J.M., Duarte, E., Cunillera, O., & Escalada, F. (2011). Efficacy of low-frequency low-intensity electrotherapy in the treatment of breast cancer-related lymphoedema: A cross-over randomized trial. Clinical Rehabilitation, 26(7), 607–618.

To compare efficacy of low-frequency, low-intensity electrotherapy and manual lymphatic drainage in treatment of upper-limb lymphedema

Patients were randomized to two groups. Group A underwent electrotherapy therapy for 10 sessions followed by 10 sessions of manual drainage. Group B underwent manual drainage first and then received electrotherapy. There was a month washout period between treatments. Patients were assessed after every 10 treatment sessions. Electrotherapy was delivered with a system that provides massage with low-frequency electrical stimulation.

• The study sample (N = 30) was comprised of female patients with breast cancer.
• Mean age was 68 years.
• All patients had unilateral arm lymphedema.
• Seventy-eight percent of patients had had both chemotherpy and radiation therapy.
• Average duration of lymphedema was 73 months.
• Eighty-eight percent used compression garments.

The study took place in an outpatient setting in Spain.

The study has clinical applicability for late effects and survivorship.

The study used a randomized crossover trial design.

• Limb volume was calculated using six circumference measurements.
• Patients completed the Functional Assessment of Cancer Therapy Questionnaire for Breast Cancer Version 4 (FACT-B4).
   

 There were no significant differences in outcomes between the two treatments.

There was no difference in benefits from manual lymphatic drainage and low-frequency, low-intensity electrotherapy.

• The study had a small sample size, with less than 100 participants.
• The study has a risk of bias because it had no blinding.

 Findings suggest there is no difference in efficacy of these two treatment approaches for management of arm lymphedema in patients with breast cancer.