Abstract
Objective
What are the immediate, short-term, and long-term effects of complex physical therapy
and multimodal approaches on lymphedema secondary to breast cancer?
Data Sources
Four electronic databases (MEDLINE, Embase, Cochrane Library, Physiotherapy Evidence
Database) were searched from inception up to August 2020.
Study Selection
Randomized controlled trials comparing complex physical therapy and multimodal approaches
to the conservative treatment of lymphedema secondary to breast cancer.
Data Extraction
Two independent researchers performed data extraction and assessed the risk of bias,
respectively, using the predefined form and Cochrane Collaboration of Risk of Bias.
The determination of evidence quality was carried out using the Grading of Recommendations
Assessment, Development, and Evaluation tools.
Data Synthesis
Fourteen studies were identified for the systematic review and 11 studies for the
meta-analysis with standardized mean difference (SMD), 95% CI, and random-effect model.
The common outcomes involved total volume, pain, and physical function of the upper
limb. Complex physical therapy has shown a favorable tendency to control outcomes
in the short- and long-term. The meta-analysis indicated a small effect for volume
reduction (SMD, −0.18; 95% confidence interval [CI], −0.35 to 0.00) and a moderate
effect for short-term pain reduction (SMD, −0.61; 95% CI, −1.19 to –0.02).
Conclusions
High-quality evidence suggests a more significant effect of complex physical therapy
on multimodal approaches to the control of the upper limb total volume, substantiating
the absence of changes in the current clinical practice in the management of lymphedema
secondary to breast cancer. Future research should aim to identify concrete effect
of therapeutic modalities in the immediate-, short-, and long-term.
Keywords
List of abbreviations:
CI (Confidence interval), 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: August 15, 2021
Accepted:
June 7,
2021
Received in revised form:
May 26,
2021
Received:
April 5,
2021
Footnotes
Disclosures: none
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
