Efficacy of self-administered complex decongestive therapy on breast cancer-related lymphedema

a single-blind randomized controlled trial

M. B. Ligabue, I. Campanini, P. Veroni, A. Cepelli, M. Lusuardi, A. Merlo

Research output: Contribution to journalArticle

Abstract

Purpose: After surgery, breast cancer-related lymphedema (BCRL) is a frequent chronic condition. The complex decongestive therapy (CDT) delivered by physiotherapists at hospitals is the state-of-the-art treatment choice. As lymphedema requires continuous management, we designed a 1-month-long course to train women to professionally carry out a self-administered CDT (saCDT) and tested its efficacy while keeping the benefits of CDT. Methods: Consecutive patients treated with CDT over a 1-year period at an Italian facility were randomly assigned to either experimental (EXP, saCDT course) or control (CTRL, usual care) group. Women were assessed before, at 1, and 6 months from enrolment. Pain assessed by the numerical pain rating scale (NPRS) was the primary outcome. Arm asymmetry assessed by the excess limb volume (ELV) was the secondary outcome. Outcome variations were compared to their MCID to classify women as improved, stable, or worsened. Results: Forty-one women were included. The proportion of stable or improved women was significantly different between EXP and CTRL groups at 6 months after enrolment for both arm pain (p = 0.01) and asymmetry (p < 0.01). Noteworthy, only one EXP woman had worsened after 6 months. NPRS significantly decreased in the EXP group only, with a median variation of 2 points. Arm ELV significantly decreased with respect to the baseline value in the EXP group only, with a median reduction of 8%. Conclusions: Teaching saCDT to women with BCRL is effective in maintaining or improving the benefits of CDT and can be used as a self-care tool in the management of BCRL.

Original languageEnglish
Pages (from-to)191-201
Number of pages11
JournalBreast Cancer Research and Treatment
Volume175
Issue number1
DOIs
Publication statusPublished - May 15 2019
Externally publishedYes

Fingerprint

Randomized Controlled Trials
Pain
Arm
Therapeutics
Extremities
Lymphedema
Physical Therapists
Self Care
Breast Cancer Lymphedema
Teaching

Keywords

  • Breast cancer
  • Complex decongestive therapy
  • Lymphedema
  • Self-care

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Efficacy of self-administered complex decongestive therapy on breast cancer-related lymphedema : a single-blind randomized controlled trial. / Ligabue, M. B.; Campanini, I.; Veroni, P.; Cepelli, A.; Lusuardi, M.; Merlo, A.

In: Breast Cancer Research and Treatment, Vol. 175, No. 1, 15.05.2019, p. 191-201.

Research output: Contribution to journalArticle

Ligabue, M. B. ; Campanini, I. ; Veroni, P. ; Cepelli, A. ; Lusuardi, M. ; Merlo, A. / Efficacy of self-administered complex decongestive therapy on breast cancer-related lymphedema : a single-blind randomized controlled trial. In: Breast Cancer Research and Treatment. 2019 ; Vol. 175, No. 1. pp. 191-201.
@article{12e63f624f504270b15fcfb9cc0899d9,
title = "Efficacy of self-administered complex decongestive therapy on breast cancer-related lymphedema: a single-blind randomized controlled trial",
abstract = "Purpose: After surgery, breast cancer-related lymphedema (BCRL) is a frequent chronic condition. The complex decongestive therapy (CDT) delivered by physiotherapists at hospitals is the state-of-the-art treatment choice. As lymphedema requires continuous management, we designed a 1-month-long course to train women to professionally carry out a self-administered CDT (saCDT) and tested its efficacy while keeping the benefits of CDT. Methods: Consecutive patients treated with CDT over a 1-year period at an Italian facility were randomly assigned to either experimental (EXP, saCDT course) or control (CTRL, usual care) group. Women were assessed before, at 1, and 6 months from enrolment. Pain assessed by the numerical pain rating scale (NPRS) was the primary outcome. Arm asymmetry assessed by the excess limb volume (ELV) was the secondary outcome. Outcome variations were compared to their MCID to classify women as improved, stable, or worsened. Results: Forty-one women were included. The proportion of stable or improved women was significantly different between EXP and CTRL groups at 6 months after enrolment for both arm pain (p = 0.01) and asymmetry (p < 0.01). Noteworthy, only one EXP woman had worsened after 6 months. NPRS significantly decreased in the EXP group only, with a median variation of 2 points. Arm ELV significantly decreased with respect to the baseline value in the EXP group only, with a median reduction of 8{\%}. Conclusions: Teaching saCDT to women with BCRL is effective in maintaining or improving the benefits of CDT and can be used as a self-care tool in the management of BCRL.",
keywords = "Breast cancer, Complex decongestive therapy, Lymphedema, Self-care",
author = "Ligabue, {M. B.} and I. Campanini and P. Veroni and A. Cepelli and M. Lusuardi and A. Merlo",
year = "2019",
month = "5",
day = "15",
doi = "10.1007/s10549-019-05136-9",
language = "English",
volume = "175",
pages = "191--201",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York LLC",
number = "1",

}

TY - JOUR

T1 - Efficacy of self-administered complex decongestive therapy on breast cancer-related lymphedema

T2 - a single-blind randomized controlled trial

AU - Ligabue, M. B.

AU - Campanini, I.

AU - Veroni, P.

AU - Cepelli, A.

AU - Lusuardi, M.

AU - Merlo, A.

PY - 2019/5/15

Y1 - 2019/5/15

N2 - Purpose: After surgery, breast cancer-related lymphedema (BCRL) is a frequent chronic condition. The complex decongestive therapy (CDT) delivered by physiotherapists at hospitals is the state-of-the-art treatment choice. As lymphedema requires continuous management, we designed a 1-month-long course to train women to professionally carry out a self-administered CDT (saCDT) and tested its efficacy while keeping the benefits of CDT. Methods: Consecutive patients treated with CDT over a 1-year period at an Italian facility were randomly assigned to either experimental (EXP, saCDT course) or control (CTRL, usual care) group. Women were assessed before, at 1, and 6 months from enrolment. Pain assessed by the numerical pain rating scale (NPRS) was the primary outcome. Arm asymmetry assessed by the excess limb volume (ELV) was the secondary outcome. Outcome variations were compared to their MCID to classify women as improved, stable, or worsened. Results: Forty-one women were included. The proportion of stable or improved women was significantly different between EXP and CTRL groups at 6 months after enrolment for both arm pain (p = 0.01) and asymmetry (p < 0.01). Noteworthy, only one EXP woman had worsened after 6 months. NPRS significantly decreased in the EXP group only, with a median variation of 2 points. Arm ELV significantly decreased with respect to the baseline value in the EXP group only, with a median reduction of 8%. Conclusions: Teaching saCDT to women with BCRL is effective in maintaining or improving the benefits of CDT and can be used as a self-care tool in the management of BCRL.

AB - Purpose: After surgery, breast cancer-related lymphedema (BCRL) is a frequent chronic condition. The complex decongestive therapy (CDT) delivered by physiotherapists at hospitals is the state-of-the-art treatment choice. As lymphedema requires continuous management, we designed a 1-month-long course to train women to professionally carry out a self-administered CDT (saCDT) and tested its efficacy while keeping the benefits of CDT. Methods: Consecutive patients treated with CDT over a 1-year period at an Italian facility were randomly assigned to either experimental (EXP, saCDT course) or control (CTRL, usual care) group. Women were assessed before, at 1, and 6 months from enrolment. Pain assessed by the numerical pain rating scale (NPRS) was the primary outcome. Arm asymmetry assessed by the excess limb volume (ELV) was the secondary outcome. Outcome variations were compared to their MCID to classify women as improved, stable, or worsened. Results: Forty-one women were included. The proportion of stable or improved women was significantly different between EXP and CTRL groups at 6 months after enrolment for both arm pain (p = 0.01) and asymmetry (p < 0.01). Noteworthy, only one EXP woman had worsened after 6 months. NPRS significantly decreased in the EXP group only, with a median variation of 2 points. Arm ELV significantly decreased with respect to the baseline value in the EXP group only, with a median reduction of 8%. Conclusions: Teaching saCDT to women with BCRL is effective in maintaining or improving the benefits of CDT and can be used as a self-care tool in the management of BCRL.

KW - Breast cancer

KW - Complex decongestive therapy

KW - Lymphedema

KW - Self-care

UR - http://www.scopus.com/inward/record.url?scp=85061029966&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061029966&partnerID=8YFLogxK

U2 - 10.1007/s10549-019-05136-9

DO - 10.1007/s10549-019-05136-9

M3 - Article

VL - 175

SP - 191

EP - 201

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 1

ER -