Abstract
Objective
To investigate the clinical effect of extracorporeal shock wave therapy (ESWT) in
patients with secondary lymphedema after breast cancer treatment.
Design
Prospective clinical pilot study.
Setting
Education and research hospital.
Participants
Women with a diagnosis of lymphedema secondary to breast cancer (N=11).
Interventions
Patients were treated for 12 sessions of ESWT with 2500 impulses each. The treatment
frequency was 4Hz in multiple shock mode. The energy flow density during treatment
was equal to a working pressure of 2 bar.
Main Outcome Measures
The primary outcome measure was volumetric measurements. The secondary outcome measures
were the short version of the Disabilities of the Arm, Shoulder and Hand Questionnaire
(QuickDASH) and the brief version of the World Health Organization Quality of Life
(WHOQOL-BREF). Assessments were conducted by the same investigator at baseline, posttreatment,
and at 1, 3, and 6 months after treatment for all patients.
Results
Significant reduction was found in the amount of lymphedema with ESWT treatment in
all patients, and this reduction was maintained for 6 months. A statistically significant
reduction was observed in volumetric measurements for the follow-up period (P=.001). The mean volume displacement of the affected upper extremity before treatment
was 870.45±384.19mL at 6 months, and after the treatment it was 604.54±381.74mL. In
addition, improvements were observed in the QuickDASH functional assessment tool and
in the physical health domain of the WHOQOL-BREF questionnaire (P=.002 and P=.007, respectively).
Conclusions
ESWT was shown to provide a reduction in the amount of lymphedema in patients with
lymphedema secondary to breast cancer. Also, a marked improvement was observed in
the functional status and quality of life of study patients. Treatment efficacy was
maintained in the long term. As a noninvasive, novel, and effective method, ESWT is
a promising treatment modality for the treatment of lymphedema, which is a chronic,
progressive, and refractory condition.
Keywords
List of abbreviations:
CDT (complex decongestive therapy), ESWT (extracorporeal shock wave therapy), QOL (quality of life), QuickDASH (short version of the Disabilities of the Arm, Shoulder and Hand Questionnaire), VEGF (vascular endothelial growth factor), WHOQOL-BREF (brief version of the World Health Organization Quality of Life)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 14, 2016
Footnotes
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
