Abstract
Objective
To evaluate the efficacy of negative pressure massage treatment (NPMT) compared with
manual lymphatic drainage (MLD) in women with chronic breast cancer–related lymphedema
(LE). We hypothesized that NPMT would result in greater improvements in LE and upper
limb function.
Design
Pilot single-blinded randomized controlled trial.
Setting
Health sciences university.
Participants
Of 64 women screened, 28 met eligibility requirements (ie, >18y of age; completed
active treatment for breast cancer; had unilateral arm LE for ≥1y; were not receiving
LE care; had stable LE) and were randomized to the NPMT (n=15) and control groups
(n=13).
Interventions
The intervention group received NPMT and the control group received MLD; both received
twelve 60-minute sessions over 4-6 weeks.
Main Outcome Measures
Bioimpedance (lymphedema index [L-Dex] units]), limb volume (mL) calculated from limb
circumference, and Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH)
score.
Results
Outcomes were analyzed for 28 women. Compared to the MLD group, the NPMT group demonstrated
greater improvement with a large effect size in L-Dex scores (P=.001; standardized mean difference [SMD]=−1.15; 95% confidence interval, −1.96 to
−0.35) and interlimb volume differences (P=.038; SMD=−0.83; 95% confidence interval, −1.60 to −0.05). Differences in DASH scores
were not statistically significant (P=.067).
Conclusions
Compared to MLD, treatment with NPMT resulted in greater improvement in L-Dex scores
and interlimb volume differences in women with a duration of unilateral upper limb
LE of >1 year. Our findings need to be confirmed in a larger randomized controlled
trial.
Keywords
List of abbreviations:
BC (breast cancer), BIS (bioelectrical impedance spectroscopy), DASH (Disabilities of the Arm, Shoulder, and Hand questionnaire), ECF (extracellular fluid), ES (effect size), L-Dex (lymphedema index), LE (lymphedema), MLD (manual lymphatic drainage), NPMT (negative pressure massage therapy), PI (principal investigator), RCT (randomized controlled trial), SMD (standardized mean difference)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 16, 2021
Accepted:
March 23,
2021
Received in revised form:
March 19,
2021
Received:
February 14,
2021
Footnotes
Presented to the American Physical Therapy Association Tri-State Chapter Physical Therapy Conference, October 2019, Las Vegas, NV; American Physical Therapy Association, February 2020, Denver, CO.
Supported by a Magistro Family Foundation Research Grant from the Foundation for Physical Therapy Research.
Clinical Trial Registration No.: NCT03252145.
Disclosure: None.
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
