Buragadda, S., Alhusaini, A.A., Melam, G.R., & Arora, N. (2015). Effect of complete decongestive therapy and a home program for patients with post mastectomy lymphedema. Journal of Physical Therapy Science, 27, 2743–2748. 

DOI Link

Study Purpose

To compare lymphedema-related outcomes between women receiving complete decongestive therapy (CDT) and a home program versus those receiving manual drainage and compression garments

Intervention Characteristics/Basic Study Process

Patients were divided into two groups. One group received manual drainage, compression garments, glenohumeral mobilization, and deep breathing exercises. The other received CDT including manual drainage, compression garments, and a home self-massage and exercise program. Participants received initial training for the home program to be completed daily. Both groups received treatment from a therapist five days per week for six weeks. Study assessments were done a baseline, week 4, and week 6.

Sample Characteristics

  • N = 60
  • MEAN AGE = 56.2 years
  • FEMALES: 100%
  • KEY DISEASE CHARACTERISTICS: All participants had breast cancer, and 51% received a radical mastectomy.

Setting

  • SITE: Single site  
  • SETTING TYPE: Multiple settings  
  • LOCATION: Saudi Arabia

Phase of Care and Clinical Applications

  • PHASE OF CARE: Late effects and survivorship

Study Design

Pre- and post-test design

Measurement Instruments/Methods

  • Arm circumference measurements
  • Visual Analog Scale (VAS) for pain
  • Disabilities of the Arm Shoulder and Hand (DASH) questionnaire

Results

Subjects in both groups had significant reductions in arm volume, pain, and DASH scores.

Conclusions

Both CDT with a home program of manual drainage and exercise and standard manual lymphatic drainage with compression garments resulted in significant improvements in arm volume, associated pain, and disability scores.

Limitations

  • Small sample (< 100)
  • Risk of bias (no blinding)
  • Risk of bias (no random assignment)
  • Measurement/methods not well described
  • Other limitations/explanation: The type of pain measured was not clear. The results reporting was unclear in the tables provided. It was not clear if patients were randomly assigned to groups.

Nursing Implications

Both the combination of manual lymphatic drainage with compression garment use and CDT with a daily home program were associated with significant improvements in lymphedema symptoms.