BACKGROUND Complex decongestive therapy(CDT)is currently recommended as the standard treatment for lymphedema.CDT is a four-step detumescence therapy that can effectively treat upper limb lymphedema after breast cance...BACKGROUND Complex decongestive therapy(CDT)is currently recommended as the standard treatment for lymphedema.CDT is a four-step detumescence therapy that can effectively treat upper limb lymphedema after breast cancer surgery,and is considered non-invasive,painless and without side effects.AIM To determine the effectiveness of a six-step CDT involving a foam granule bandage for the treatment of upper extremity lymphedema pressure after breast cancer surgical intervention.METHODS The study included 100 patients with upper extremity lymphedema after breast cancer surgery.The surgical methods were mastectomy plus axillary lymph node dissection and breast preservation plus sentinel lymph node biopsy.The study population was further divided into the experimental group and control group with 50 cases in each group.The control group was given conventional CDT(four-step method),which included skin care,freehand lymphatic drainage,foam granule pressurized bandage,and functional exercise.In the experimental group,a six-step CDT method was applied that involved a foam particle bandage combined with air wave pressure therapy in addition to the four steps of conventional CDT.Patients in both groups were given one course of treatment daily(20 times),and the changes in body moisture and subjective symptoms were measured before and after treatment,preoperatively and 20 times after treatment.RESULTS No statistically significant differences in 50-Hz bioelectrical impedance and extracellular moisture ratio were observed between the two groups before treatment,suggesting comparability of the baseline data.After treatment,the 50-Hz bioelectrical impedance of the experimental group was significantly higher than that in the control group,and the extracellular moisture ratio was significantly lower than that in the control group.A comparison of the differences between the two groups before and after treatment indicated that the treatment effect in the experimental group was better than that in the control group.After 20 treatments,according to subjective evaluations,the tightness and swelling of the limbs in the experimental group were significantly reduced as compared with those in the control group.CONCLUSION The six-step CDT method can effectively reduce lymphedema,promote lymphatic circulation,and alleviate the subjective symptoms of patients,and thereby improve the quality of life and treatment compliance among patients.展开更多
<strong>Aim: </strong>We devised a self-care supporting program targeting patients with early stages of secondary lower-limb lymphedema. The program incorporates “Simple exercises to replace lymphatic dra...<strong>Aim: </strong>We devised a self-care supporting program targeting patients with early stages of secondary lower-limb lymphedema. The program incorporates “Simple exercises to replace lymphatic drainage” based on lymphatic flow. The purpose of this study was to consider the feasibility of continuing this program. <strong>Methods:</strong> The participants were patients in the early stages of secondary lower-limb lymphedema after gynecological cancer surgery and lymphedema therapists with more than five years of experience. Patients continued self-care at home after being briefed on the program, and they were analyzed on their self-care continuity status one month later based on a self-administered questionnaire survey and self-care notes. We interviewed the lymphedema therapists about this program to discuss the feasibility of continuing it and obtain feedback. <strong>Results:</strong> The patients who participated in the study were six women who underwent surgery with lymph node dissection for gynecological cancer. The therapists were five nurses and one occupational therapist. The patient understood the importance of all items in the self-care. “Observation,” “Touching,” and “Skin care” were relatively easy to continue. “Lymph drainage” and “Exercise” were continued with “Simple exercises to replace lymphatic drainage”. “Other exercises” were able to continue by adding distance and time to daily activities. Furthermore, “Measurement” and “Recording” became a burden and were difficult to continue. Nonetheless, this program was generally approved by the lymphedema therapists. They also pointed out the content and format of the self-care notes as improvements. <strong>Conclusions: </strong>We found that the self-care supporting program that incorporated “Simple exercises to replace lymphatic drainage” might be feasible to continue self-care for patients with early stages of secondary lower-limb lymphedema. Furthermore, we found that we needed to improve the “Measurement” and “Recording” sections of this program.展开更多
Objective To observe the clinical efficacy of transcutaneous electrical acupoint stimulation(TEAS)combined with warm acupuncture in treating breast cancer associated with upper limb lymphedema(BCRL).Methods This was a...Objective To observe the clinical efficacy of transcutaneous electrical acupoint stimulation(TEAS)combined with warm acupuncture in treating breast cancer associated with upper limb lymphedema(BCRL).Methods This was a retrospective cohort study using a paired control design.Fifty-two BCRL patients were assigned to the control group(27 cases)and the treatment group(25 cases).The patients in the control group were treated with lymphedema comprehensive detumescence treatment(CDT)for 4 weeks,including systematic therapy composed of manual lymphatic drainage,compression bandage,skincare,and functional exercise.The patients in the treatment group were treated with TEAS combined with warm acupuncture based on the control group methods.Each treatment lasted for 30 min and was applied twice a week for 4 weeks.The arm circumference(AC)of different positions of the affected limb and the degree of swelling of the affected limb were evaluated before the first treatment and after the last treatment.The clinical efficacy was evaluated according to the degree of edema before and after treatment.All adverse events during treatment were recorded.Results The patients’AC and the swelling feeling of the affected limb in the treatment group and the control group were both reduced compared with those before treatment.Compared with the control group,AC of the wrist joint transverse stria,the midpoint between the wrist joint transverse stria and the elbow joint transverse stria in the treatment group were significantly reduced(P<0.05).The decrease in AC diameter at the midpoint between the elbow joint transverse stria and the axillary transverse stria was the most significant(P<0.01).The swelling degree of the affected limbs in the treatment group was significantly lower than before treatment,and was significantly lower compared with the control group after treatment(P<0.01).The total effective rate was 72%in the treatment group,significantly higher than that in the control group(55.56%,P<0.05).No serious adverse events occured in either group.Conclusions TEAS combined with warm acupuncture can effectively reduce AC and swelling feeling of the affected limb in patients with BCRL.The effect is better than that of CDT therapy alone.展开更多
目的:系统评价三种运动疗法对乳腺癌术后患肢淋巴水肿患者上肢功能的康复效果。方法:计算机检索CNKI、万方、维普、Web of Science、PubMed、The Cochran library、Medline、Embase等数据库,搜集2005年1月-2024年5月有关三种运动疗法干...目的:系统评价三种运动疗法对乳腺癌术后患肢淋巴水肿患者上肢功能的康复效果。方法:计算机检索CNKI、万方、维普、Web of Science、PubMed、The Cochran library、Medline、Embase等数据库,搜集2005年1月-2024年5月有关三种运动疗法干预乳腺癌术后患肢淋巴水肿患者上肢功能的随机对照试验(RCT)。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用R软件与Addis软件进行网状Meta分析。结果:共纳入20项RCT,包括1736例乳腺癌术后患肢淋巴水肿患者。网状Meta分析结果显示,在乳腺癌术后患肢淋巴水肿患者手臂周径差康复方面,三种运动疗法均优于对照组(P>0.05);在乳腺癌术后患肢淋巴水肿患者上肢前屈康复方面,有氧训练干预治疗[MD=20.05(11.17,28.69),P<0.05]、抗阻训练干预治疗[MD=11.51(1.04,22.11),P<0.05]显著优于对照组的无干预治疗;在乳腺癌术后患肢淋巴水肿患者上肢后伸康复方面,有氧训练干预治疗[MD=7.72(3.67,11.54),P<0.05]、等速肌力训练干预治疗[MD=10.79(1.65,19.64),P<0.05]显著优于对照组的无干预治疗;在改善乳腺癌术后患肢淋巴水肿患者DASH评分方面,有氧训练干预治疗[MD=22.14(6.80,35.95),P<0.05]、等速肌力训练干预治疗[MD=11.48(1.16,22.34),P<0.05]显著优于对照组的无干预治疗。结论:根据定量合并证据显示,三种运动疗法均可有效改善乳腺癌术后患肢淋巴水肿患者上肢功能。等速肌力训练在干预乳腺癌术后患肢淋巴水肿患者手臂周径差,上肢前屈,上肢后伸,有氧训练在降低DASH方面更具优势。展开更多
文摘BACKGROUND Complex decongestive therapy(CDT)is currently recommended as the standard treatment for lymphedema.CDT is a four-step detumescence therapy that can effectively treat upper limb lymphedema after breast cancer surgery,and is considered non-invasive,painless and without side effects.AIM To determine the effectiveness of a six-step CDT involving a foam granule bandage for the treatment of upper extremity lymphedema pressure after breast cancer surgical intervention.METHODS The study included 100 patients with upper extremity lymphedema after breast cancer surgery.The surgical methods were mastectomy plus axillary lymph node dissection and breast preservation plus sentinel lymph node biopsy.The study population was further divided into the experimental group and control group with 50 cases in each group.The control group was given conventional CDT(four-step method),which included skin care,freehand lymphatic drainage,foam granule pressurized bandage,and functional exercise.In the experimental group,a six-step CDT method was applied that involved a foam particle bandage combined with air wave pressure therapy in addition to the four steps of conventional CDT.Patients in both groups were given one course of treatment daily(20 times),and the changes in body moisture and subjective symptoms were measured before and after treatment,preoperatively and 20 times after treatment.RESULTS No statistically significant differences in 50-Hz bioelectrical impedance and extracellular moisture ratio were observed between the two groups before treatment,suggesting comparability of the baseline data.After treatment,the 50-Hz bioelectrical impedance of the experimental group was significantly higher than that in the control group,and the extracellular moisture ratio was significantly lower than that in the control group.A comparison of the differences between the two groups before and after treatment indicated that the treatment effect in the experimental group was better than that in the control group.After 20 treatments,according to subjective evaluations,the tightness and swelling of the limbs in the experimental group were significantly reduced as compared with those in the control group.CONCLUSION The six-step CDT method can effectively reduce lymphedema,promote lymphatic circulation,and alleviate the subjective symptoms of patients,and thereby improve the quality of life and treatment compliance among patients.
文摘<strong>Aim: </strong>We devised a self-care supporting program targeting patients with early stages of secondary lower-limb lymphedema. The program incorporates “Simple exercises to replace lymphatic drainage” based on lymphatic flow. The purpose of this study was to consider the feasibility of continuing this program. <strong>Methods:</strong> The participants were patients in the early stages of secondary lower-limb lymphedema after gynecological cancer surgery and lymphedema therapists with more than five years of experience. Patients continued self-care at home after being briefed on the program, and they were analyzed on their self-care continuity status one month later based on a self-administered questionnaire survey and self-care notes. We interviewed the lymphedema therapists about this program to discuss the feasibility of continuing it and obtain feedback. <strong>Results:</strong> The patients who participated in the study were six women who underwent surgery with lymph node dissection for gynecological cancer. The therapists were five nurses and one occupational therapist. The patient understood the importance of all items in the self-care. “Observation,” “Touching,” and “Skin care” were relatively easy to continue. “Lymph drainage” and “Exercise” were continued with “Simple exercises to replace lymphatic drainage”. “Other exercises” were able to continue by adding distance and time to daily activities. Furthermore, “Measurement” and “Recording” became a burden and were difficult to continue. Nonetheless, this program was generally approved by the lymphedema therapists. They also pointed out the content and format of the self-care notes as improvements. <strong>Conclusions: </strong>We found that the self-care supporting program that incorporated “Simple exercises to replace lymphatic drainage” might be feasible to continue self-care for patients with early stages of secondary lower-limb lymphedema. Furthermore, we found that we needed to improve the “Measurement” and “Recording” sections of this program.
基金Supported by the Program of Science Research Foundation of Zhejiang Provincial TCM Administration(No.2022ZB058)。
文摘Objective To observe the clinical efficacy of transcutaneous electrical acupoint stimulation(TEAS)combined with warm acupuncture in treating breast cancer associated with upper limb lymphedema(BCRL).Methods This was a retrospective cohort study using a paired control design.Fifty-two BCRL patients were assigned to the control group(27 cases)and the treatment group(25 cases).The patients in the control group were treated with lymphedema comprehensive detumescence treatment(CDT)for 4 weeks,including systematic therapy composed of manual lymphatic drainage,compression bandage,skincare,and functional exercise.The patients in the treatment group were treated with TEAS combined with warm acupuncture based on the control group methods.Each treatment lasted for 30 min and was applied twice a week for 4 weeks.The arm circumference(AC)of different positions of the affected limb and the degree of swelling of the affected limb were evaluated before the first treatment and after the last treatment.The clinical efficacy was evaluated according to the degree of edema before and after treatment.All adverse events during treatment were recorded.Results The patients’AC and the swelling feeling of the affected limb in the treatment group and the control group were both reduced compared with those before treatment.Compared with the control group,AC of the wrist joint transverse stria,the midpoint between the wrist joint transverse stria and the elbow joint transverse stria in the treatment group were significantly reduced(P<0.05).The decrease in AC diameter at the midpoint between the elbow joint transverse stria and the axillary transverse stria was the most significant(P<0.01).The swelling degree of the affected limbs in the treatment group was significantly lower than before treatment,and was significantly lower compared with the control group after treatment(P<0.01).The total effective rate was 72%in the treatment group,significantly higher than that in the control group(55.56%,P<0.05).No serious adverse events occured in either group.Conclusions TEAS combined with warm acupuncture can effectively reduce AC and swelling feeling of the affected limb in patients with BCRL.The effect is better than that of CDT therapy alone.
文摘目的:系统评价三种运动疗法对乳腺癌术后患肢淋巴水肿患者上肢功能的康复效果。方法:计算机检索CNKI、万方、维普、Web of Science、PubMed、The Cochran library、Medline、Embase等数据库,搜集2005年1月-2024年5月有关三种运动疗法干预乳腺癌术后患肢淋巴水肿患者上肢功能的随机对照试验(RCT)。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用R软件与Addis软件进行网状Meta分析。结果:共纳入20项RCT,包括1736例乳腺癌术后患肢淋巴水肿患者。网状Meta分析结果显示,在乳腺癌术后患肢淋巴水肿患者手臂周径差康复方面,三种运动疗法均优于对照组(P>0.05);在乳腺癌术后患肢淋巴水肿患者上肢前屈康复方面,有氧训练干预治疗[MD=20.05(11.17,28.69),P<0.05]、抗阻训练干预治疗[MD=11.51(1.04,22.11),P<0.05]显著优于对照组的无干预治疗;在乳腺癌术后患肢淋巴水肿患者上肢后伸康复方面,有氧训练干预治疗[MD=7.72(3.67,11.54),P<0.05]、等速肌力训练干预治疗[MD=10.79(1.65,19.64),P<0.05]显著优于对照组的无干预治疗;在改善乳腺癌术后患肢淋巴水肿患者DASH评分方面,有氧训练干预治疗[MD=22.14(6.80,35.95),P<0.05]、等速肌力训练干预治疗[MD=11.48(1.16,22.34),P<0.05]显著优于对照组的无干预治疗。结论:根据定量合并证据显示,三种运动疗法均可有效改善乳腺癌术后患肢淋巴水肿患者上肢功能。等速肌力训练在干预乳腺癌术后患肢淋巴水肿患者手臂周径差,上肢前屈,上肢后伸,有氧训练在降低DASH方面更具优势。
