1,377 results on '"LYMPHEDEMA treatment"'
Search Results
2. Feasibility of implementing a remote system for lymphoedema conservative therapy: a case study.
- Author
-
Matsumoto, Chisato, Yang, Rui, Okazaki, Mutsumi, Konya, Chizuko, and Dai, Misako
- Subjects
- *
LYMPHEDEMA treatment , *PATIENT education , *CONSERVATIVE treatment , *LYMPHEDEMA , *CELLULITIS , *RISK assessment , *PHYSICAL diagnosis , *SELF-management (Psychology) , *LEG , *SKIN care , *ULTRASONIC imaging , *TELEMEDICINE , *COMMUNICATION , *COMPRESSION therapy , *CLINICS , *PATIENT monitoring , *PATIENT aftercare - Abstract
Background: Poor access to lymphoedema specialists and communication between them and patients prevents appropriate lymphoedema management. Therefore, development and dissemination of remote systems is necessary to improve care in rural areas with limited medical personnel or access to medical coordination. Aims: The authors evaluated the elements required for providing patient education on conservative therapy for lymphoedema, to determine the feasibility of remote management. Methods: The study involved connecting a health professional in a local clinic (point A) treating a patient with lymphoedema, who was present alongside the clinician, with a specialist certified lymphoedema therapist (CLT) located remotely in a university (point B). Findings: The CLT was able to greet, interview and provide guidance to the patient on conservative therapy. Direct contact with the patient was not possible, which limited visualisation, palpation, leg circumference measurement, and lymphatic drainage management. Conclusion: The findings suggest that remote a lymphoedema management approach involving conservative therapy benefits both patients and health professionals, particularly in rural regions. Future studies are needed to confirm the effectiveness of this approach to confirm adequate treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
3. CACA guidelines for holistic integrative management of anticancer treatment - induced cutaneous adverse events.
- Author
-
Zhu, Guannan, Shi, Qiong, Cai, Tao, Gu, Dongcheng, Zhou, Hang, Wang, Lu, Liu, Fang, Wang, Ping, Xiong, Jianxia, Huang, Yujing, Li, Chunying, and Gao, Tianwen
- Subjects
TUMOR treatment ,SKIN disease treatment ,ANTIBIOTICS ,HEMORRHAGE risk factors ,BURNS & scalds -- Risk factors ,STEROID drugs ,LYMPHEDEMA treatment ,SCLERODERMA (Disease) treatment ,INFECTION risk factors ,HOLISTIC medicine ,MEDICAL protocols ,RISK assessment ,HAND-foot syndrome ,VASCULITIS ,ANTI-inflammatory agents ,CHINESE medicine ,WOUND healing ,SOFT tissue infections ,SKIN diseases ,STEVENS-Johnson Syndrome ,PSORIASIS ,ACNEIFORM eruptions ,SKIN tumors ,EXTRAVASATION ,SKIN inflammation ,ULCERS ,MICROSURGERY ,SARCOMA ,ABLATION techniques ,ERYTHEMA ,PHOTOSENSITIVITY disorders ,PROFESSIONAL associations ,MUCOUS membranes ,ENZYME inhibitors ,BALDNESS ,CHEMOEMBOLIZATION ,VITILIGO ,SEVERITY of illness index ,PHARMACEUTICAL gels ,PIGMENTATION disorders ,CHEMORADIOTHERAPY ,HEMATOMA ,SCARS ,FEVER ,CRYOSURGERY ,PHOTOTHERAPY ,ITCHING ,ANALGESICS ,LASER therapy ,MONOCLONAL antibodies ,IMMUNE checkpoint inhibitors ,OPERATIVE surgery ,METASTASIS ,INJECTIONS ,QUALITY of life ,GROWTH factors ,PAIN ,MEDICAL screening ,DRUG eruptions ,KERATOSIS ,RADIODERMATITIS ,IMATINIB ,PHOTODYNAMIC therapy ,GLUCOCORTICOIDS ,SECONDARY primary cancer ,PREVENTIVE health services ,DIET therapy ,CLASSIFICATION ,DISEASE risk factors ,DISEASE complications - Abstract
Purpose: The skin and mucous membrane of cancer patients can be directly or indirectly impaired during the treatment of cancers, bringing about not physical but also psychological damages to cancer patients. A practical guideline is of great significance to improve the quality of life for patients suffered from cutaneous adverse events. Methods: This guideline was generated based on up-to-date evidence and the consensus of experts specialized in dermatology. Results: The current guideline include the baseline screening of skin and mucosal membranes, the manifestations of injuries on skin, mucosa and appendages, along with the treatment of them. The causal anti-tumor management include chemotherapy, radiotherapy, immune therapy and surgery. Conclusion: This guideline can be helpful to reduce the risk of cutaneous adverse events during anti-cancer treatment and improve the quality of life of patients suffered from these adverse events. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
4. Prevention of breast cancer‐related lymphoedema: Quality of clinical practice guidelines and variations in recommendations.
- Author
-
Li, Mingzhen, Liu, Boxuan, Chen, Cheng, Liu, Huan, He, Shaohua, Sun, Weihua, Yan, Qiang, Rao, Xiaohua, Jin, Yinghui, and Tan, Liming
- Subjects
- *
LYMPHEDEMA treatment , *BREAST tumor treatment , *LYMPHEDEMA , *MEDICAL protocols , *MEDICAL information storage & retrieval systems , *RESEARCH funding , *EXERCISE therapy , *DESCRIPTIVE statistics , *DECISION making in clinical medicine , *SYSTEMATIC reviews , *MEDLINE , *MEDICAL databases , *QUALITY assurance , *ONLINE information services , *CONFIDENCE intervals , *HEALTH education , *DISEASE risk factors - Abstract
Aim: We aimed to evaluate the quality of clinical practice guidelines (CPGs) for breast cancer related lymphoedema (BCRL) and compare the similarities and differences in recommendations. Background: Many CPGs of BCRL have been developed; however, their recommendations and quality are controversial. Methods: Relevant papers were retrieved from electronic databases, professional associations and guideline development organizations, from 1 January 2015 to 30 September 2021. The Appraisal of Guidelines Research and Evaluation (AGREE) II instrument was used to evaluate the quality of the guidelines. Intraclass correlation coefficient (ICC) analysis was used to evaluate the overall consistency among evaluators. Results: Eight CPGs were included. The ICC values evaluation for CPGs ranged from 0.76 to 0.95, with good consensus among evaluators. The highest median score was 68.75% (61.46, 72.22%) for clarity, and the lowest was 37.50% (25.78, 51.30%) for applicability. The NICE, ACS/ACSO and APTA CPGs were rated well in most areas. Professional health education, individualized exercise programme and regular surveillance are the main methods to prevent lymphoedema. Conclusion: In the past 6 years, the quality of BCRL guidelines has varied greatly, especially in the domains of rigour and applicability. Interrater agreement was excellent, but recommendation showed some inconsistencies in the details. Summary statement: What is already known about this topic? Providing recommendations based on evidence‐based guidelines for care of cancer treatment‐related lymphoedema will help to improve outcomes for patients with this chronic condition. What this paper adds? The rigour of the guidelines needs to be improved.Guideline‐making organizations have the responsibility to promote the application of guidelines into practice using a variety of methods.Multifactorial reasons were responsible for the differences inguidelines' recommendations The implications of this paper Nurses need to be more aware of guideline recommendations.There are inconsistencies in the details, despite many similarities.The formulation of individual nursing care programmes should be tailored to the local clinical situation and working environment. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
5. The clinical and economic impact of chronic venous insufficiency-associated lymphedema and the prevalence of persistent edema after venous intervention.
- Author
-
Genet, Matthew, Labropoulos, Nicos, Gasparis, Antonios, O'Donnell, Thomas, and Desai, Kush
- Subjects
- *
LYMPHEDEMA treatment , *LYMPHEDEMA , *MEDICAL care use , *ABLATION techniques , *T-test (Statistics) , *SCIENTIFIC observation , *FISHER exact test , *OUTPATIENT medical care , *TREATMENT effectiveness , *RETROSPECTIVE studies , *DESCRIPTIVE statistics , *SURGICAL stents , *CHI-squared test , *CHRONIC diseases , *VENOUS insufficiency , *COMPRESSION garments , *ECONOMIC aspects of diseases , *MEDICAL care costs , *CRITICAL care medicine , *DISEASE risk factors , *DISEASE complications ,LYMPHATIC massage - Abstract
Objectives: To determine the demographics, outcomes, and healthcare utilization of patients with chronic venous insufficiency-associated lymphedema (CVI-LED) and the prevalence of lymphedema-specific therapy use after venous intervention. Methods: The IBM MarketScan Commercial and Medicare Claims Databases were examined for patients with CVI-LED. Patient demographics and the use of lymphedema-specific therapy before and after venous intervention were collected. Results: Of 85,601 LED patients identified, 8,406 also had a diagnosis of CVI. In the CVI-LED group, 1051 underwent endovenous ablation or venous stent placement. The use of lymphedema-specific therapy before and after venous intervention was 52% and 39%, respectively (p <.05). The mean time of initiation of LED-specific therapy following venous intervention was 265 days after ablation and 347 days after stent placement. Conclusion: Treating venous hypertension improves certain venous-related signs and symptoms of CVI. However, a significant proportion of patients have persistent edema which may reflect underlying, sub-optimally treated LED. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
6. The effectiveness and safety of heat/cold therapy in adults with lymphoedema: systematic review.
- Author
-
Hill, J. E., Whitaker, J. C., Sharafi, N., Hamer, O., Chohan, A., Harris, C., and Clegg, A.
- Subjects
- *
LYMPHEDEMA treatment , *MEDICAL information storage & retrieval systems , *AMED (Information retrieval system) , *PATIENT safety , *RESEARCH funding , *THERMOTHERAPY , *CINAHL database , *STATISTICAL sampling , *TREATMENT effectiveness , *COLD therapy , *SYSTEMATIC reviews , *MEDLINE , *MEDICAL databases , *ADVERSE health care events , *EVALUATION , *ADULTS - Abstract
The aim of this review is to assess the efficacy and safety of using heat and cold therapy for adults with lymphoedema. A multi-database search was undertaken. Only studies which included adults with lymphoedema who were treated with heat or cold therapy reporting any outcome were included. Screening, data extraction, and assessment of bias were undertaken by a single reviewer and verified by a second. Due to the substantial heterogeneity, a descriptive synthesis was undertaken. Eighteen studies were included. All nine studies which assessed the effects of heat-therapy on changes in limb circumference reported a point estimate indicating some reduction from baseline to end of study. Similarly, the five studies evaluating the use of heat-therapy on limb volume demonstrated a reduction in limb volume from baseline to end-of-study. Only four studies reported adverse events of which all were deemed to be minor. Only two studies explored the effects of cold therapy on lymphoedema. Tentative evidence suggests heat-therapy may have some benefit in treating lymphoedema with minimal side effects. However, further high-quality randomised controlled trials are required, with a particular focus on moderating factors and assessment of adverse events. This review highlights the potential benefit that heat therapy may have on reducing limb circumference and volume for adults with lymphoedema. There was no evidence that controlled localised heat therapy was unsafe. The current evidence-base is at a point where no specific clinical recommendations can be made. The use of heat therapy should only be applied as part of a methodologically robust study to treat lymphoedema. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
7. Cost impact and outcomes of 50 lymphoedema cases using adjustable compression garments.
- Author
-
Thomas, Melanie, Humphreys, Ioan, Pike, Cheryl, Morgan, Karen, and Noble-Jones, Rhian
- Subjects
LYMPHEDEMA treatment ,T-test (Statistics) ,STATISTICAL significance ,RESEARCH funding ,SCIENTIFIC observation ,VISUAL analog scale ,COST benefit analysis ,DESCRIPTIVE statistics ,COMPRESSION therapy ,COMPRESSION garments ,QUALITY of life ,HEALTH outcome assessment ,CONFIDENCE intervals ,DATA analysis software - Abstract
Increasing pressures on healthcare resources require constant evaluation of the efficiency and effectiveness of provision, particularly for the rising number of vulnerable, elderly and obese patients. Practices regarding compression are arguably often ingrained due to its historical usage, with evidence from managing chronic venous insufficiency (CVI) underpinning its effectiveness. This evaluation explores the clinical benefit, impact, outcomes and cost-efficiencies of using an adjustable compression wrap system instead of previous care. 'Before-after design' observation of 50 patients captured baseline resource use, costs and outcomes (clinical and patient) at the time of assessment and again at a maximum of six-month follow-up. Data after using the adjustable compression wrap showed significantly improved clinician-reported outcomes: presence of wounds/leg ulceration (from 56% to 21%), incidence of cellulitis (halved), and reduced complexity/severity of lymphoedema. Additionally, patientreported outcomes, visual analogue scale (VAS) health score and LYMPROM© scores for pain, heaviness, shopping for shoes and clothes, and body image significantly improved. The mean number of community nurse visits per patient reduced from 11.6. to 9.1, but was not statistically significant (p-value 0.09). However, this evaluation found that over six months there was a mean cost reduction of over £383.70 per patient, which included the purchase price of the adjustable compression wrap system. [ABSTRACT FROM AUTHOR]
- Published
- 2024
8. Primary lymphedema of childhood: Treatment results from a tertiary center.
- Author
-
Cinar, Ece, Ata, Benil Nesli, and Eyigor, Sibel
- Subjects
- *
LYMPHEDEMA treatment , *MEDICAL rehabilitation , *COMPUTER software , *AGE groups , *DATA analysis - Abstract
Primary lymphedema is the most common form of lymphedema presenting in the pediatric age group. Childhood lymphedema is caused by hereditary or congenital malformations in the lymphatic system that can manifest at birth or during childhood or adolescence. Complex decongestive therapy (CDT) is the cornerstone of conservative management of lymphedema in both adult and pediatric lymphedema patients, although pediatric treatment guidelines are still lacking. In this study we aimed to assess the effects of CDT on pediatric patients. Childhood lymphedema patients who presented to the lymphedema rehabilitation unit of our university hospital before the age of 18 and who were treated for lymphedema with CDT were included in the study. Data on patient demographics, disease characteristics, and treatment duration were recorded. Limb volumes were calculated from patient measurements using a spreadsheet software (Limb Volume Calculator) that utilized the geometric formula for volume of a truncated cone. Measurements were taken before treatment and also weekly after initiation of treatment. Percent excess volume (PEV) was used instead of absolute volume difference to define the severity of lymphedema. A total of 34 limbs from 24 patients were included in the study. The mean age of the patients was 10.1 ± 4.9 years and 14 (58.3 %) were female. Most patients had one affected limb but 16 had bilateral lower-extremity lymphedema. The mean duration of treatment with CDT was 153.6 ± 155.8 days. Excess volume percentage change between pre-treatment PEV (602.8 ± 713.8) and post-treatment PEV (514.6 ± 699.1) was found to be statistically significant (p < 0.05). Pediatric lymphedema management is a difficult and less well studied area in lymphedema rehabilitation. Our data support the use of CDT, which is a safe and effective treatment method, for pediatric lymphedema patients. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
9. Effects of complex decongestive therapy and aquatic physiotherapy on markers of the inflammatory process in individuals with lymphedema.
- Author
-
Cristina de Sousa Pedrosa, Barbara, Machado Manhães de Castro, Pedro, Santos, Luiza Vieira Santos e, Lima de Andrade, Danielly, Florencio Vilaça, Adriano, Pinheiro Júnior, José Eudes Gomes, Paula de Lima Ferreira, Ana, Lins, Esdras Marques, Maia, Juliana Netto, do Amparo Andrade, Maria, and de Castro, Célia Maria Machado Barbosa
- Subjects
- *
LEG physiology , *LYMPHEDEMA treatment , *T-test (Statistics) , *DATA analysis , *RESEARCH funding , *STATISTICAL sampling , *HYDROTHERAPY , *TREATMENT effectiveness , *RANDOMIZED controlled trials , *DESCRIPTIVE statistics , *QUANTITATIVE research , *MANN Whitney U Test , *COMPRESSION therapy , *AQUATIC exercises , *RESEARCH methodology , *STATISTICS , *ONE-way analysis of variance , *INFLAMMATION , *CYTOKINES , *COMPARATIVE studies , *DATA analysis software , *BIOMARKERS , *C-reactive protein , *TUMOR necrosis factors - Abstract
Chronic lymphedema is a progressive and inflammatory disease caused by impaired lymphatic transport. This study evaluates the effects of complex decongestive therapy (CDT) and aquatic physiotherapy on markers of the inflammatory process and lower limb volumes in individuals with lymphedema. A randomized controlled clinical trial was carried out with three groups: patients with lymphedema submitted to CDT, patients with lymphedema submitted to aquatic physiotherapy, and control group of individuals without lymphedema. The evaluation was performed through blood count, CRP measurements, C3, C4 complement, measurement of serum levels of cytokines interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukins 4 (IL-4), 6 (IL-6), and 10 (IL-10), and the volume of a lower limb using the volume formula of a truncated cone. The study was registered with the Brazilian Clinical Trials Registry (RBR-4tpkszn). Our work showed a reduction in the TNF-α levels of patients in the CDT group (p =.028). Significant differences were found between the control group and the CDT group for IL-10 (p =.049) and Monocytes (p =.039). No significant reduction in limb volume was found. Our results show that CDT was able to significantly reduce the inflammatory marker TNF-α in patients with lymphedema, suggesting an anti-inflammatory effect of the therapy. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
10. Comparing complex decongestive therapy in patients with lymphedema of different causes by measuring: extremity volume, quality of life, and functionality.
- Author
-
Sahbaz-Pirincci, Cansu, Cihan, Emine, Düzlü-Öztürk, Ülkü, Borman, Pınar, and Dalyan, Meltem
- Subjects
LYMPHEDEMA treatment ,LEG physiology ,QUALITY of life ,TREATMENT effectiveness ,PARAMETER estimation - Abstract
Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2024
- Full Text
- View/download PDF
11. Comparison of Intermittent Pneumatic Compression Pump as Adjunct to Decongestive Lymphatic Therapy against Decongestive Therapy Alone for Upper Limb Lymphedema after Breast Cancer Surgery: A Systematic Review and Meta-Analysis.
- Author
-
Yao, Min, Peng, Puchao, Ding, Xiufang, Sun, Qinfang, and Chen, Lijie
- Subjects
LYMPHEDEMA treatment ,LYMPHATIC massage ,MEDICAL information storage & retrieval systems ,ARM ,SURGERY ,PATIENTS ,RESEARCH funding ,BREAST tumors ,TREATMENT effectiveness ,META-analysis ,CANCER patients ,DESCRIPTIVE statistics ,SURGICAL complications ,SYSTEMATIC reviews ,MEDLINE ,ROTATIONAL motion ,COMPRESSION therapy ,MEDICAL databases ,ONLINE information services ,CONFIDENCE intervals - Abstract
Background: Breast cancer is among the most prevalent malignancies in women worldwide, with substantial morbidity and mortality. Upper limb lymphedema (ULL) is a common complication after breast cancer surgery that affects patients' daily activities and quality of life. Decongestive lymphatic therapy (DLT) and intermittent pneumatic compression (IPC) therapy are 2 primary treatment methods for ULL. Objectives: This study aimed to compare the efficacy of DLT with IPC versus DLT alone in the management of ULL following breast cancer surgery. Method: PubMed Central, SCOPUS, EMBASE, MEDLINE, Cochrane Trial Registry, Google Scholar, and Clinicaltrials.gov databases were comprehensively searched for randomized controlled trials (RCTs) comparing DLT with IPC and DLT alone in patients with breast cancer-related ULL. The risk of bias was evaluated using the RoB 2 tool. Pooled effect sizes were calculated using random-effects models. Results: A total of 1,894 citations were identified by the systematic search. Of them, 9 RCTs were included in the analysis. The pooled standardized mean difference (SMD) for percentage volume reduction was 0.63 (95% confidence interval [CI]: −0.24 to 1.50; I
2 = 90.9%), showing no significant difference between the DLT alone and DLT combined with IPC (p = 0.15). Pain and heaviness scores were also comparable between the groups. However, there was a significant difference in external rotation joint mobility (SMD = 0.62; 95% CI: 0.08–1.16; I2 = 23.8%), favoring DLT with IPC. Conclusions: Our findings suggest that DLT with IPC and DLT alone showed similar findings in managing ULL after breast cancer surgery, with DLT with IPC showing a greater impact on external rotation joint mobility. Healthcare providers should consider patient preferences and individual factors when selecting the most appropriate treatment modality for ULL management. [ABSTRACT FROM AUTHOR]- Published
- 2024
- Full Text
- View/download PDF
12. Lymphoedema specialists embedded into community nurse and wound services: impacts and outcomes.
- Author
-
Thomas, Melanie, Morgan, Karen, and Humphreys, Ioan
- Subjects
- *
INJURY risk factors , *LYMPHEDEMA treatment , *LYMPHEDEMA , *CELLULITIS , *MEDICAL care use , *MEDICAL specialties & specialists , *COMMUNITY health nurses , *COMMUNITY health nursing , *PHILOSOPHY of education , *HUMAN services programs , *T-test (Statistics) , *EVALUATION of human services programs , *SCIENTIFIC observation , *QUESTIONNAIRES , *VISUAL analog scale , *BANDAGES & bandaging , *DESCRIPTIVE statistics , *CONFIDENCE , *PATIENT care , *PRE-tests & post-tests , *PROFESSIONS , *QUALITY of life , *PROFESSIONAL employee training , *WOUND care , *HEALTH outcome assessment , *QUALITY assurance , *COMPARATIVE studies , *SURGICAL dressings , *DATA analysis software , *CONFIDENCE intervals , *MEDICAL care costs , *PROFESSIONAL competence , *HEALTH care rationing , *ECONOMICS , *DISEASE risk factors , *DISEASE complications - Abstract
Background: Lymphoedema is a progressive condition causing significant alterations to life, exerting pressures on unscheduled care from complications including cellulitis and wounds. An on the ground education programme (OGEP) was implemented to raise knowledge, competence and confidence in lymphoedema management in community clinical services. The aim of this study was to explore the impact and outcomes of the OGEP intervention. Methods: Data were captured before and after OGEP on 561 lymphoedema patients in the community setting. Data recorded included resource use, costs and outcomes (EQ-5D-5L and LYMPROM). Results: Data demonstrated statistically significant reductions in resource allocations including staff visits (P<0.001), cellulitis admissions (P<0.001), compression consumables and wound dressing costs (P<0.001). Overall, the total mean per patient cost decreased from £1457.10 to £964.40 (including intervention) with outcomes significantly improved in EQ-5D-5L/LYMPROM scores. Conclusion: The analysis suggests the OGEP intervention may offer reductions in resource costs and improvements in patient outcomes. OGEP may therefore provide an innovative solution in future care delivery. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
13. National Lymphoedema Conference 2024: session summaries.
- Author
-
Hashimi, Samina and Rajagopalan, Upasana
- Subjects
- *
LYMPHEDEMA treatment , *HEAD & neck cancer treatment , *LYMPHEDEMA , *FACE , *LEG , *DIFFERENTIAL diagnosis , *DISEASE management , *CONFERENCES & conventions , *EXPERIENCE , *COMPRESSION garments , *QUALITY of life , *WOUND care , *HEALTH outcome assessment , *CANCER patient psychology , *LIPEDEMA ,LYMPHATIC massage - Abstract
The 11th annual National Lymphoedema Conference, organised by the British Journal of Community Nursing in association with the British Lymphology Society and Lipoedema UK, was hosted at the America Square Conference Centre, London, on 22 February 2024. The conference, which aims to provide new insights into the latests developments in lymphoedema care and management through talks by leading experts in the field, was attended by an impressive number of delegates and exhibitors. The sessions were Chaired by BLS Trustee Rebecca Elwell, and are summarised below. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
14. The assessment and management of foot and toe oedema as part of holistic lower limb care.
- Author
-
Everett, Jeanne, Lawrance, Sue, Cooper, Karen, and Phillips, Natalie
- Subjects
- *
DIAGNOSIS of edema , *LYMPHEDEMA diagnosis , *LYMPHEDEMA treatment , *FOOT care , *HOLISTIC medicine , *LYMPHEDEMA , *MEDICAL protocols , *CELLULITIS , *LEG , *COMMUNITY health nursing , *BEHAVIOR modification , *FOOT , *EDEMA , *BANDAGES & bandaging , *TREATMENT effectiveness , *COMPRESSION garments , *COMPRESSION therapy , *HEALTH behavior , *QUALITY of life , *SURGICAL dressings , *GLOVES , *TOES , *DISEASE complications , *EQUIPMENT & supplies - Abstract
Toe and foot swelling can manifest as lymphoedema or chronic oedema but can also be a complication of the treatment of these conditions. In this article, the authors discuss the assessment and treatment options for toe and foot swelling, highlighting the importance of prevention in the first instance. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
15. Outcomes from a proof-of-concept specialist lymphoedema clinic in the community.
- Author
-
Morris, Kay, Colgan, Mary Paula, McMahon, Noelle, and Slattery, Sinead
- Subjects
- *
LYMPHEDEMA treatment , *COMMUNITY health services , *COST control , *PRIMARY health care , *VALUE-based healthcare , *QUESTIONNAIRES , *DESCRIPTIVE statistics , *TREATMENT effectiveness , *EVIDENCE-based medicine , *HEALTH outcome assessment , *MEDICAL care costs , *OBESITY - Abstract
The Health and Safety Execultive lymphoedema model of care was published in 2018 highlighting the lack of dedicated lymphoedema services in Ireland. This led to the introduction of a proof-of-concept primary care specialist lymphoedema clinic. The clinic was responsible for all patients from their county. A comprehensive dataset was gathered which included the patient's history for 1 year prior to their presentation at clinic and then 6 monthly. A quality of life tool (LymQoL) and a patient satisfaction survey were completed. Completed 1-year data showed a significant reduction in GP and public health nurse visits as well as a reduction in the occurrence of cellulitis and associated hospital admissions. All areas of quality of life were improved and patient satisfaction was either excellent (89%) or very good (11%). The 1-year findings strongly support the roll-out of specialist clinics to all regional health areas. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
16. Integrated lymphoedema and tissue viability service: improving patient and wound outcomes.
- Author
-
Stanton, Julie, Knowles, Aaron, Russell, Laura, and Bevis, Claire
- Subjects
- *
LYMPHEDEMA diagnosis , *LYMPHEDEMA treatment , *LYMPHEDEMA , *WOUND healing , *NURSES , *ANTIMICROBIAL bandages , *TAPING & strapping , *SKIN care , *TREATMENT effectiveness , *PATIENT-centered care , *TISSUE viability , *COMPRESSION therapy , *WOUND care , *CASE studies , *HEALTH equity , *CURETTAGE , *MEDICAL care costs , *INTEGRATED health care delivery , *EMPLOYEES' workload , *PRESSURE ulcers ,LEG ulcers - Abstract
This article will focus on the integration of tissue viability and lymphoedema services to improve outcomes for patients with leg ulceration. It will highlight why there is a need for lymphoedema specialist knowledge within the care of patients with leg ulceration and how the services are closely aligned. Lymphoedema can adversely affect wound healing and the article will provide case studies that highlight how developing a hybrid tissue viability and lymphoedema clinician or integration of the specialists can provide effective patient-centred care at reduced cost. The article offers potential strategies and suggestions on how to address inequalities in care and how to improve service provision. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
17. The Effect of Exercise on Reducing Lymphedema Severity in Breast Cancer Survivors.
- Author
-
Lian, Yanxue, Sandhu, Simran, Asefa, Yamikani, and Gupta, Ananya
- Subjects
- *
LYMPHEDEMA treatment , *LYMPHEDEMA , *EXERCISE physiology , *EXERCISE , *EXERCISE therapy , *BREAST tumors , *CANCER patients , *YOGA , *QUALITY of life , *MEDICAL care costs , *PHYSICAL activity - Abstract
Simple Summary: Some cancer survivors, especially breast cancer survivors, may face the issue of lymphedema. Although it tends to be incurable, there are some methods to manage lymphedema. Exercise was thought to aggravate lymphedema severity in cancer survivors until a completely opposite view was proposed in 1998. Since then, an increasing number of studies have been carried out to investigate the effects of exercise on cancer survivors with lymphedema. Currently, exercise is widely considered safe and beneficial. However, the formulation of exercise prescriptions for patients with lymphedema has been under exploration. The aim of this literature review is to extract information from existing studies to provide some advice for the design of exercise prescriptions in terms of reducing lymphedema severity. The findings of this literature may help patients reduce the severity of lymphedema and improve their quality of life. It may also help reduce healthcare costs and improve affordability. Exercise has been repeatedly shown to be safe and beneficial for cancer survivors. However, there is no normative guideline for exercise prescription, and it is still under exploration. Therefore, this literature review aims to provide some advice for the formulation of exercise prescriptions for patients with breast cancer-related lymphedema (BCRL) from the perspective of reducing lymphedema severity. A review of relevant studies published before November 2023 was conducted using three scientific databases: PubMed, Embase, and Scopus. A total of 2696 articles were found. Eventually, 13 studies fulfilled the inclusion criteria and were included in this literature review. We concluded that daily, or nearly daily, exercise at home can be recommended. Moreover, reduced lymphedema severity may not be maintained after ceasing the exercise program, so exercise should be a lifelong practice. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
18. Prevention, Surveillance, and Treatment of Breast Cancer--Related Lymphedema: The Role of the Advanced Practice Provider.
- Author
-
McGrath, Leslie A. and Bloomfield, Emily
- Subjects
- *
LYMPHEDEMA treatment , *LYMPHEDEMA , *PUBLIC health surveillance , *RISK assessment , *CONTINUING education units , *DISEASE exacerbation , *LYMPHATICS , *CELLULITIS , *THERAPEUTIC complications , *PATIENT education , *OCCUPATIONAL roles , *EARLY medical intervention , *INTERPROFESSIONAL relations , *HUMAN services programs , *BREAST tumors , *AXILLARY lymph node dissection , *DISEASE management , *NURSE practitioners , *QUALITY of life , *DUCTAL carcinoma , *PROFESSIONAL employee training , *HEALTH outcome assessment , *MEDICAL screening , *LYMPHANGIOGRAPHY , *DISEASE risk factors , *DISEASE complications - Abstract
Breast cancer--related lymphedema is a lifelong disease associated with decreased quality of life and increased healthcare costs. Evidence supports early detection and prompt treatment through prospective surveillance models as standard of care. Additional research on risk stratification and predictive modeling may lead to patient-centered treatments. Advanced practice providers are uniquely positioned to develop and implement comprehensive lymphedema programs focused on treatment and prevention pathways. AT A GLANCE * Lymphedema is the result of progressive, inflammation-induced fibrosis and responds more favorably to early intervention as compared to late-stage disease. * Best practice and national clinical guidelines recommend prospective lymphedema surveillance models as standard of care. * Investigating mechanisms behind individual susceptibility can aid in the development of riskdriven and personalized treatment pathways. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
19. Lymphoedema: a journey taken together.
- Author
-
Cooper, Garry
- Subjects
INFLAMMATION prevention ,LYMPHEDEMA treatment ,LYMPHATIC massage ,HEALTH self-care ,HOLISTIC medicine ,LYMPHATICS ,DISEASE management ,SKIN care ,EXERCISE therapy ,GLOBAL burden of disease ,PATIENT-centered care ,COMPRESSION therapy - Abstract
Lymphoedema is a long-term condition which is incurable at the present time. Due to the nature of the condition, being both long-term and manifesting in physical changes (swelling), its impact on the person and their lives can be hard to quantify. Management options need to be considered within a person-centred approach, with the four cornerstones of treatment being skin care, exercise, compression therapy and manual lymphatic drainage (MLD). Evidence for each is varied and practitioners need to determine their therapeutic benefit. Beyond the cornerstones of treatment, future developments are ongoing within the areas of surgery, such as venous anastomosis and pharmacological interventions, which may reduce the effects of continual inflammation. In the future, these developments may become part of the care delivered to those affected by lymphoedema. However currently, skin care, exercise, and compression therapy remain fundamental, with MLD included if therapeutically indicated, as well as educating and empowering those involved in self-management with the support of practitioners. [ABSTRACT FROM AUTHOR]
- Published
- 2024
20. An innovative flat-knit compression garment for lymphoedema patients led to better outcomes: a multicentre study.
- Author
-
Hirsch, Tobias, Arns, Helene, Schleinitz, Jörg, and Fiedler, Hans-Walter
- Subjects
LYMPHEDEMA treatment ,COMPRESSION bandages ,DIFFUSION of innovations ,ARM ,LEG ,T-test (Statistics) ,DATA analysis ,SCIENTIFIC observation ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,LONGITUDINAL method ,LEISURE ,CLINICAL competence ,QUALITY of life ,RESEARCH ,STATISTICS ,PATIENT satisfaction ,WELL-being ,JOB performance - Abstract
Objective: To evaluate the clinical performance, quality of life (QoL) and patient satisfaction with an innovative flat-knit compression garment for the daytime treatment of lymphoedema patients in daily routine. Method: In a prospective multicentre observational study, patients with leg or arm lymphoedema (stage I-II, International Society of Lymphology (ISL) standards, 2016) received a made-to-measure flat-knit compression class 2 JOBST Confidence (BSN-JOBST GmbH, Germany) thigh-high stocking or arm sleeve. Primary endpoint was the oedema status as determined by the mean sum of the circumferences at the beginning and the end of the wearing period. Secondary endpoints included QoL-related parameters and patient satisfaction with product features assessed through questionnaires. The observation period lasted three weeks. Results: A total of 97 patients (87 females, 10 males), of which 65 had leg lymphoedema and 32 had arm lymphoedema, received the study device. The oedema status was effectively maintained (slight reduction in mean sum of circumferences by –3.1±7.3cm; p=0.0001). For QoL-related parameters, the patients reported fewer limitations in work, leisure and psychological wellbeing after wearing the stocking or arm sleeve (all p-values <0.0001). They also experienced less limitations in function and movement, feeling of tension and heaviness, and fewer difficulties wearing clothes, shoes, jewellery or watches at study end (all p-values <0.0001). In terms of pleasant feeling on the skin, moisture management, softness of material, range of motion, overall wearing comfort and heat build-up under the garment, patients were more satisfied with the tested compression garment than with previously worn compression garments (all p-values <0.001). Conclusion: In this study, the tested innovative compression product increased patient satisfaction with the improved product features while the lymphoedema status was successfully maintained. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
21. Reply to Bourgeois, P. Comment on "Devoogdt et al. The Effectiveness of Fluoroscopy-Guided Manual Lymph Drainage as Part of Decongestive Lymphatic Therapy on the Superficial Lymphatic Architecture in Patients with Breast Cancer-Related Lymphoedema: A Randomised Controlled Trial. Cancers 2023, 15 , 1545"
- Author
-
Tjalma, Wiebren A. A., Belgrado, Jean-Paul, Thomis, Sarah, Nevelsteen, Ines, Gebruers, Nick, Monten, Chris, Hanssens, Marianne, De Vrieze, Tessa, and Devoogdt, Nele
- Subjects
- *
LYMPHEDEMA treatment , *LYMPHATICS , *FLUORESCENT dyes , *BREAST tumors , *TREATMENT effectiveness , *CANCER patients , *SEVERITY of illness index , *MEDICAL drainage , *FLUOROSCOPY , *DISEASE complications - Published
- 2024
- Full Text
- View/download PDF
22. Lymphedema Surveillance and Prevention.
- Author
-
Martone, Patrick, Kline-Quiroz, Cristina, Alpert, Elisa, Lee, Krystal, and Marshall, Genevieve
- Subjects
- *
LYMPHEDEMA treatment , *LYMPHEDEMA , *PUBLIC health surveillance , *OCCUPATIONAL roles , *SENTINEL lymph node biopsy , *ULTRASONIC imaging , *FUNCTIONAL status , *PHYSICAL medicine , *LYMPHANGIOGRAPHY , *CANCER patients , *QUALITY of life , *PATIENT education , *CANCER patient medical care , *HEALTH self-care , *DISEASE risk factors - Abstract
Lymphedema is a chronic condition, which can impact a person's quality of life and function. Identifying lymphedema at an early stage is key to preventing a person from developing chronic lymphedema. Physiatry can play an important role in education, identification of risk factors, performing prospective lymphedema surveillance programs, and prevention/treatment of lymphedema. Incorporating lymphedema surveillance programs into routine cancer care provides physiatry with the opportunity to assess additional rehabilitation and functional needs of a cancer patient. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
23. A multidisciplinary approach to managing lymphorroea in primary lymphoedema: a case study.
- Author
-
Dai, Misako, Yamashita, Shuji, Yang, Rui, Okazaki, Mutsumi, Sugama, Junko, and Sanada, Hiromi
- Subjects
- *
ANKLE radiography , *LYMPHEDEMA treatment , *CELLULITIS treatment , *FOOT radiography , *LYMPHEDEMA , *LYMPH , *SURGICAL anastomosis , *PHYSICAL therapy , *LYMPHANGIOGRAPHY , *SKIN care , *KLIPPEL-Trenaunay-Weber Syndrome , *COMPRESSION garments , *REINFECTION , *LYMPHATIC diseases , *TREATMENT effectiveness , *HEALTH care teams , *COMPRESSION therapy , *EPIDERMOLYSIS bullosa , *HEALTH self-care , *DISEASE complications ,LYMPHATIC surgery ,LEG radiography - Abstract
This case study describes the successful management of a patient with primary lymphoedema, who was experiencing lymphorrhoea and epidermolysis, using a multidisciplinary approach. The patient had Klippel–Trenaunay syndrome. The multidisciplinary team, in an outpatient clinic in Japan, included a certified lymphoedema therapist, plastic surgeons, and a wound, ostomy and continence nurse. The team performed complex physical therapy and lymphaticovenular anastomosis, which promoted the resolution of the lymphorrhoea. This resulted in improvements in skin condition, the prevention of recurrent cellulitis, and no increase in limb circumferences during the 1-year follow-up period. This report highlights the importance of a multidisciplinary approach to lymphoedema management, including lymphorrhoea control that fitted in with the patient's daily life. It is hoped that this article will contribute to the improvement of the quality of life of patients with lymphoedema. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
24. Use of simple lymphatic drainage on truncal lymphoedema for a patient with diabetes and peripheral arterial disease.
- Author
-
Yates, Jennifer
- Subjects
- *
LYMPHEDEMA treatment , *ISCHEMIA , *WOUND healing , *WELL-being , *PERIPHERAL vascular diseases , *DIABETIC foot , *DIABETES , *NECROSIS , *WOUND care ,LYMPHATIC massage - Abstract
Lymphoedema is the gradual, abnormal build-up of lymph fluid in the tissues resulting from a failure of the lymphatic system. The swelling impedes movement and is painful. Compression garments are contraindicated and not tolerated by patients with extensive peripheral arterial disease. In this case study, simple lymphatic drainage was therefore considered a safer treatment option to reduce oedema and to encourage proactive self-management for a patient with bilateral amputations, diabetes and peripheral arterial disease. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
25. A simple approach to treating lower limb oedema and lymphorrhoea.
- Author
-
Price, Katie Gillam
- Subjects
LYMPHEDEMA treatment ,LYMPHEDEMA diagnosis ,CHRONIC disease treatment ,LYMPHEDEMA ,PHYSICAL diagnosis ,WOUND healing ,CHRONIC wounds & injuries ,PROFESSIONS ,VENOUS insufficiency ,CONTINUING education units ,MEDICAL care costs ,COST control ,LEG ,MEDICAL protocols ,DISEASE relapse ,CYTOCHEMISTRY ,SELF-efficacy ,COMPRESSION therapy ,DRUG prescribing ,QUALITY of life ,PATIENT education ,HOLISTIC nursing ,WOUND care ,COMMUNITY health nursing ,NURSING assessment ,HEALTH self-care ,SYMPTOMS ,DISEASE complications - Abstract
The vast majority of wound care is undertaken by community nurses (Dhoonmoon, 2023), with £941 million attributed to venous leg ulcer care and a further £836 million spent on unspecified leg ulcer management (Guest et al, 2017). If signs and symptoms can be recognised and a diagnosis made, a plan of care can be drawn up and treatment implemented quickly and efficiently to reduce costs escalating further. More important though, the patient's condition will improve quickly and deterioration in quality of life can be avoided. Nursing staff are currently encouraging patients to take a more active role in their own care, guiding them in how to look after their own long-term conditions, which can promote long lasting healing and independence [ABSTRACT FROM AUTHOR]
- Published
- 2024
26. Work-Related Musculoskeletal Disorders Risk Assessment during Manual Lymphatic Drainage with Compressive Bands among Physiotherapists.
- Author
-
Jacquier-Bret, Julien and Gorce, Philippe
- Subjects
LYMPHEDEMA treatment ,MUSCULOSKELETAL system diseases ,COMPUTER software ,KRUSKAL-Wallis Test ,RANGE of motion of joints ,WORK ,TORSO ,RISK assessment ,COMPRESSION bandages ,ERGONOMICS ,COMPRESSION therapy ,POSTURE ,DESCRIPTIVE statistics ,ABDUCTION (Kinesiology) ,PHOTOGRAPHY ,RESEARCH funding ,LYMPHATIC massage ,BIOMECHANICS ,CLUSTER analysis (Statistics) ,NECK ,DATA analysis software ,VIDEO recording ,SHOULDER ,DISEASE risk factors - Abstract
Background: Complete decongestive therapy is the standard treatment for lymphedema. Manual lymphatic drainage and short-stretch multilayer compression bandaging are two daily stages of complete decongestive therapy during which physiotherapists work with patients. Objective: The aim of this study was to assess the risks of musculoskeletal disorders to which physiotherapists are exposed during these two phases. Method: Five physiotherapists performed five 20 min manual lymphatic drainages, followed by the compression bandaging phase. From the video recordings, 8477 postures defined by 13 joint angles were grouped into clusters using hierarchical cluster analysis. The risk of musculoskeletal disorders in physiotherapists' postures was assessed using ergonomic tools. Results: Seven clusters, called generic postures (GP), were identified and defined throughout the mean joint angle values and standard deviation. Four seated GPs were found for the drainage phase, and three standing GPs were identified for the bandaging phase. This phase corresponded to a quarter of the total duration. The GP's ergonomic scores ranged from 4.51 to 5.63 and from 5.08 to 7.12, respectively, for the Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA). GP1, GP3, and GP4 presented the highest ergonomic scores (RULA scores: 5.27 to 5.63; REBA scores: 6.25 to 7.12). The most affected areas were the neck (flexion > 20° for all GPs), trunk (flexion between 25 and 30° for GP2, and GP7 during the bandaging phase and GP4 during the drainage phase), and shoulder (flexion and abduction >20° for all GPs except GP5). Conclusions: These results highlighted that the two complete decongestive therapy phases could be described as a combination of GP. Ergonomic assessment showed that compression bandaging as well as drainage phases expose physiotherapists to moderate musculoskeletal disorder risks that require "further investigation and change soon". [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
27. Lymphatic insufficiency and stiff compression in venous leg ulceration.
- Author
-
Stanton, Julie
- Subjects
LYMPHEDEMA treatment ,WOUND healing ,COMPRESSION garments ,LYMPHATIC diseases ,COMPRESSION therapy ,BLOOD circulation ,LEG ulcers ,PATIENT compliance ,LYMPHATICS ,HEALTH self-care - Abstract
The article provides information on lymphatic insufficiency and stiff compression in venous leg ulceration.
- Published
- 2024
- Full Text
- View/download PDF
28. Comparing easywrap with six other adjustable wraps for compression therapy in venous and lymphatic disease by variation in pressure, stiffness and elasticity.
- Author
-
Phillips, Natalie and Wright, Tom
- Subjects
LYMPHEDEMA treatment ,RESEARCH ,IN vivo studies ,VENOUS insufficiency ,LIPEDEMA ,COMPRESSION bandages ,LYMPHATIC diseases ,COMMERCIAL product evaluation ,COMPRESSION therapy ,DESCRIPTIVE statistics ,LEG ulcers ,STATISTICAL sampling - Abstract
Background: There is no clear guidance or comprehensive comparative evidence to help clinicians select between adjustable wraps for compression therapy. However, adjustable wraps could be compared with three metrics used for compression bandages: variation in pressure, stiffness and elasticity. Aims: To determine whether easywrap (Haddenham Healthcare) had lower standard deviation (SD) in lying pressure, greater static stiffness index (SSI) and/or a greater mean elongation ratio than six other adjustable wraps. Methods: In this preliminary exploratory study, seven adjustable wraps were tested in vivo 20 times each (140 tests in total), on 20 people (with a variable number of readings per participant), to give the SD in lying pressure and mean SSI. The same wraps were tested in vitro five times each to give the mean elongation ratio. Findings: Of all seven adjustable wraps, easywrap had the second lowest SD in lying pressure at 5.9 mmHg, compared with 8.9 mmHg overall; the highest mean SSI at 13.2 mmHg, compared with 9.5 mmHg overall; and the highest mean elongation ratio at 137.0%, compared with 107.1% overall. Conclusions: These metrics suggest that easywrap has clinical advantages over other adjustable wraps. A lower variation in lying pressure suggests more consistent application of pressures within intended therapeutic levels. Higher SSI indicates greater resistance to stretching, which is linked to improved venous function and oedema reduction. Higher elongation ratio demonstrates greater tensile strength, which should maintain therapeutic pressure for longer without readjustment. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
29. Management of Lymphoedema and Lymphorrhoea with Wrap around Compression in Breast Secondary to Carcinoma Breast: A Case Report.
- Author
-
Shukla, Aradhana, Gonnade, Nitesh, and Kamal, Manoj
- Subjects
LYMPHATIC disease diagnosis ,BREAST disease diagnosis ,LYMPHEDEMA diagnosis ,LYMPHEDEMA treatment ,BREAST diseases ,LYMPHEDEMA ,COMPRESSION bandages ,PALLIATIVE treatment ,DISEASE management ,BREAST tumors ,TERTIARY care ,COMPRESSION therapy ,LYMPHATIC diseases ,DISEASE complications - Abstract
Lymphoedema secondary to breast cancer is one of the most unfortunate outcomes, and lymphoedema secondary to breast cancer in the ipsilateral upper extremity and its management, has been described in the literature. We are reporting a case of lymphoedema and lymphorrhoea in the breast itself, managed by compression bandaging with limited resources and the use of active pharmacological agents in the palliative care unit of a tertiary care hospital. Lymphoedema and lymphorrhoea in the breast are not very common to see in clinics, but management of this case even though no protocol available, was done by modification of bandaging techniques available for limb lymphoedema management. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
30. Managing Lymphedema Through Movement.
- Author
-
Spencer, Jenny
- Subjects
LYMPHEDEMA treatment ,BREAST tumors ,DISEASE management ,EXERCISE therapy ,AXILLARY lymph node dissection ,SEVERITY of illness index ,YOGA ,MUSCLE strength ,QUALITY of life ,COMPRESSION garments ,ACTIVITIES of daily living ,DISEASE complications - Published
- 2024
31. Compression therapy in a patient with Klippel- Trénaunay syndrome.
- Author
-
Hyvönen, Hanna, Salminen, Päivi, Kallio, Milla, Lagus, Heli, and Isoherranen, Kirsi
- Subjects
LYMPHEDEMA treatment ,LYMPHEDEMA ,OPERATIVE surgery ,KLIPPEL-Trenaunay-Weber Syndrome ,VENOUS insufficiency ,COMPRESSION garments ,LEG ,TREATMENT effectiveness ,COMPRESSION therapy ,QUALITY of life ,SCLEROTHERAPY ,COMBINED modality therapy ,DISEASE complications ,ADOLESCENCE - Abstract
Background Klippel-Trénaunay syndrome (KTS) is a rare congenital vascular malformation syndrome defined as capillary and venous malformations, and hypertrophy of the limb with or without lymphatic malformation. Currently there is no cure for KTS but the majority of patients are advised to wear compression garments on the affected limb to control swelling and discomfort. Aim To describe used compression therapy methods and their results in a paediatric patient with KTS. Methods The patient records were assessed for the used treatment methods for KTS. Our patient was treated with multimodal treatments to alleviate symptoms, and compression therapy was used specially to control lymphoedema and venous insufficiency. Results A 13-year-old boy with KTS had lymphoedema and venous insufficiency of the right lower extremity since birth. Compression therapy was started at the age of 2 months with a custom-made, single-leg compression pantyhose with gradual compression from distal to proximal regions. Furthermore, a manual lymphatic drainage and intermittent pneumatic compression were added on the regimen respectively. Other treatment methods included sclerotherapy, surgery and medication. None of treatment methods was sufficient alone to reduce limb oedema but the patient reported improved performance when using compression garments and a positive impact after enhanced compression therapy. Conclusion This report shows the importance of continuous and individualised compression therapy in the treatment of lymphoedema associated to KTS. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
32. Lymphedema Surgical Treatment Using BioBridgeTM: A Preliminary Experience.
- Author
-
Cè, Maurizio, Menozzi, Andrea, Soresina, Massimo, Giardini, Denisa, Martinenghi, Carlo, and Cellina, Michaela
- Subjects
LYMPHEDEMA ,MAGNETIC resonance imaging ,MAGNETIC resonance ,PATIENT experience ,LYMPHANGIOGRAPHY ,ARACHNOID cysts ,SURGICAL meshes ,ARTIFICIAL implants - Abstract
Lymphedema treatment has traditionally been based on conservative therapies. In recent years, the introduction of two microsurgical techniques—venolymphatic anastomoses and lymph-node transplantation—have revolutionized the therapeutic approach to this disease. However, these surgical techniques only provide a partial volume reduction, and thus, they require further improvement. A new device called BioBridgeTM, an implantable biocompatible and biodegradable mesh, made up of aligned nanofibrillar collagen scaffolds that mimic the collagen matrix, could significantly improve the benefits of these surgical strategies, favoring lymphatic regeneration. In this article, we describe our experience with three patients affected by primary lymphedema, two treated with a lymph-node transplant, and one with venolymphatic anastomosis. All interventions involved the placement of nanocollagen scaffolds. With each patient, non-contrast magnetic resonance lymphography was performed for surgical planning and there was an imaging and a clinical follow-up at 1 year. All patients showed a significant reduction in the affected areas with the demonstration of new lymphatic vessels at MR imaging follow-up. This was a preliminary experience, and it showed the potential benefit of positioning nonfibrillar scaffolds in combination with other microsurgical therapies for lymphedema. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
33. Assessment and management of upper limb lymphoedema in advanced disease: a case study.
- Author
-
Duffield, Amy
- Subjects
- *
LYMPHEDEMA treatment , *VENA cava superior , *METASTASIS , *DIFFERENTIAL diagnosis , *ARM , *HOLISTIC medicine , *TREATMENT effectiveness , *MEDICAL referrals , *BREAST tumors , *DISEASE management , *PALLIATIVE treatment - Abstract
Lymphoedema is thought to affect around 200 000 people in the UK (NHS England, 2023). Secondary lymphoedema is a relatively common complication of cancer and cancer treatment, and in advanced disease it may present a challenging issue for community nursing staff caring for patients approaching the end of their lives. In this article, a case study considers the assessment and treatment of upper limb lymphoedema in a patient with advanced metastatic breast cancer. Management of this complex and distressing condition requires holistic assessment and collaborative care planning with the patient and their wider care team, including onward referral to specialist lymphoedema and palliative care services. The case study considers the typical presentation of lymphoedema in an upper limb, exclusion of reversible causes for oedema, awareness of palliative care emergencies such as superior vena cava obstruction, and the provision of supportive therapeutic interventions in context of the patient's expressed wishes for her ongoing care. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
34. Cupping for Lymphatic Drainage: An Exploration of Fast, Flash & Massage Cupping Techniques.
- Author
-
Kohlmeier, Paul
- Subjects
LYMPHEDEMA treatment ,CUPPING ,MASSAGE therapy ,TRADITIONAL medicine ,LYMPHATIC diseases ,NEGATIVE-pressure wound therapy ,LYMPHATIC massage ,LYMPHATICS - Abstract
The article discusses the fast, flash and massage cupping strategies for lymphatic drainage and promotion of good lymphatic fluid flow. Also cited are a brief history of cupping therapy as remedy for illnesses like respiratory diseases, the conditions that can be treated with cupping like lipedema, lymphedema, and swelling from injury, as well as the contraindications and safety considerations for cupping therapy.
- Published
- 2023
35. The efficacy of Kinesio taping on lymphedema following head and neck cancer therapy: a randomized, double blind, sham-controlled trial.
- Author
-
Atar, Sevgi, Atar, Yavuz, Uygan, Ugur, Karaketir, Seyma Görcin, Kumral, Tolgar Lütfi, Sari, Hüseyin, Karaketir, Semih, and Kuru, Ömer
- Subjects
- *
HEAD & neck cancer diagnosis , *LYMPHEDEMA treatment , *LYMPHEDEMA , *RANGE of motion of joints , *TAPING & strapping , *HOME care services , *HEAD & neck cancer , *TREATMENT effectiveness , *RANDOMIZED controlled trials , *QUALITY of life , *DESCRIPTIVE statistics , *BLIND experiment , *DATA analysis software , *KINESIOLOGY , *EXERCISE therapy , *DISEASE complications , *EVALUATION ,LYMPHATIC massage - Abstract
The aim was to investigate the effectiveness of Kinesio taping for lymphedema following head and neck cancer therapy and its effect on patient compliance and quality of life. A total of 66 patients with lymphedema following head and neck cancer therapy were randomly allocated to the therapeutic Kinesio taping group (n = 33) and the sham Kinesio taping group (n = 33). All participants received manual lymphatic drainage, Kinesio taping, and home exercises for the first four weeks, and only home exercises for the second four weeks. The tape measurements, a scale of external lymphedema, a scale of the internal lymphedema, and quality of life were evaluated in both groups. The perceived discomfort consisting of limitation of daily living activities, pain, tightness, stiffness, and heaviness were also recorded. When the group x time effect was evaluated, it was observed that external lymphedema was significantly reduced in both groups according to neck and face composite measurements (p <.001). However, in these measurements, a significant difference was found between the groups in favor of the KT group (p =.001, p =.032, respectively). At the end of the study, there was no significant difference in terms of internal lymphedema in both groups (p =.860). The quality of life parameters such as global health status and swallowing were significantly better in the Kinesio taping group (p <.001). There was no significant difference in the parameters of perceived discomfort between the two groups (p =.282, p =.225, p =.090, p =.155, p =.183, respectively). Kinesio taping is effective in tape measurements and positively affects the quality of life in lymphedema following head and neck cancer therapy. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
36. Multi-segment bioimpedance in the evaluation of treatment for secondary lower limb lymphedema: Gynecological cancer.
- Author
-
de Godoy, Henrique Jose Pereira, de Godoy, Ana Carolina Pereira, de Godoy, Jose Maria Pereira, and de Fatima Guerreiro Godoy, Maria
- Subjects
- *
LYMPHEDEMA treatment , *BODY fluids , *MANN Whitney U Test , *DESCRIPTIVE statistics , *CROSSOVER trials , *FEMALE reproductive organ tumors , *WOMEN'S health - Abstract
Aim: The present aimed study was to report the mobilization of body fluids after five days of intensive treatment for secondary lower limb lymphedema. Materials and methods: A crossover clinical trial was conducted involving the analysis of changes in intracellular and extracellular fluids in all extremities and the trunk in women with lower limb lymphedema secondary to treatment for gynecological cancer. Evaluations were performed with multi-segment bio impedance analysis before and after intensive treatment using Godoy Method® eight hours per day for five days. Comparisons were made using Wilcoxon signed-ranks test. Results: Significant changes in intracellular and extracellular fluids were found in all extremities and the trunk (p<0.0001 for all comparisons). Conclusion: Intensive Godoy Method® leads to important changes in the distribution of body fluids in the treatment of lower limb lymphedema following treatment for gynecological cancer, with a significant increase in fluids in the upper limbs and trunk as well as significant reductions in the lower limb and in intracellular and extracellular water. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
37. Lower Limb Lymphedema Treatment after Gynecological Cancer.
- Author
-
Dhamija, Deepika and Chahal, Aksh
- Subjects
GYNECOLOGIC cancer ,LYMPHEDEMA treatment ,FEMALE reproductive organ diseases ,QUALITY of life ,SLEEP quality - Abstract
In both developing toddlers and adults, the staggering number of proteins contained in the extracellular matrix interact dynamically with the whole nervous system circuitry. Edema develops when lymphatic drainage is restricted, leading to the accumulation of toxic wastes and the possibility for systemic dysregulation of the neuronal synapses. It is imperative that extra proteins and wastes are removed from the interstitial space. Therefore, to promote complete health, including hormonal health in women, the lymphatic system must be addressed. Our observations demonstrate the numerous advantages of decongestive physical therapy for female lymphedema patients. The objective of this research is to see how effective decongestive physiotherapy approaches are in lymphedema patients. The diseased limb’s area was greatly lowered, which improved the sleep quality and quality of life (QOL) score that had been confirmed using the Cronbach’s alpha value for the total color energy-physiological medi taping (CEPMT). The main goals of CEPMT are to enhance lymphatic circulation and avoid lymphatic stasis, which enhances QOL and sleep. The patient’s recovery was significantly aided by patient education, counseling, and a home bandaging routine, which was verified using the questionnaire approach. In gynecological cancer patients, CEPMT is crucial for lowering lymphoedema, enhancing sleep quality, and improving CEPMT. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
38. Comment on Devoogdt et al. The Effectiveness of Fluoroscopy-Guided Manual Lymph Drainage as Part of Decongestive Lymphatic Therapy on the Superficial Lymphatic Architecture in Patients with Breast Cancer-Related Lymphoedema: A Randomised Controlled Trial. Cancers 2023, 15 , 1545
- Author
-
Bourgeois, Pierre
- Subjects
- *
LYMPHATIC physiology , *LYMPHEDEMA treatment , *LYMPH nodes , *HETEROCYCLIC compounds , *DRUG toxicity , *BREAST tumors , *TREATMENT effectiveness , *MEDICAL drainage , *FLUOROSCOPY , *DISEASE complications ,LYMPHATIC massage - Published
- 2024
- Full Text
- View/download PDF
39. Community nurses can empower people living with lymphoedema.
- Author
-
Mendes, Aysha
- Subjects
- *
LYMPHEDEMA treatment , *LYMPHEDEMA , *COMMUNITY health nurses , *OCCUPATIONAL roles , *SOCIAL support , *SELF-management (Psychology) , *COMPRESSION garments , *SELF-efficacy , *NURSE-patient relationships , *NURSES , *QUALITY of life , *COMPRESSION therapy , *PATIENT education , *COMMUNITY health nursing - Abstract
In the article, the author discusses how community nurses in the United Kingdom (UK) can empower people with lymphoedema based on the concept of patient accountability and empowerment. Also cited are the features of lymphoedema like chronic swelling, pain and heaviness in the tissues, and the focus of treatment like lymphatic drainage, exercise, and skincare.
- Published
- 2023
- Full Text
- View/download PDF
40. Phlebological insole: Can it help in the lymphoedema treatment? A scoping review.
- Author
-
De Michele, Manuela, Mastrullo, Monica, Melotto, Gianluca, and Tedeschi, Roberto
- Subjects
- *
LYMPHEDEMA treatment , *CONSERVATIVE treatment , *ONLINE information services , *MEDICAL databases , *CINAHL database , *SYSTEMATIC reviews , *PHYSICAL therapy , *LYMPHATIC diseases , *TREATMENT effectiveness , *HEALTH care teams , *VASCULAR diseases , *LITERATURE reviews , *MEDLINE , *FOOT orthoses , *GREY literature , *EVALUATION - Abstract
Background: The treatment of lymphoedema requires a multi-professional and interdisciplinary approach. Despite being prescribed in the management of lymphatic disorders, the effectiveness of the phlebological insoles is still under investigation. Aim: This scoping review aims to identify and analyse evidence regarding the efficacy of phlebological insoles as a conservative intervention for lower limb lymphoedema. Method: The following databases were searched up to November 2022: PubMed, Cochrane Library, CINAHL Complete, PEDro and Scopus. Preventive and conservative interventions were considered. Studies considering people with lower limb oedema, of any age and type of oedema, were eligible for inclusion. No restrictions in terms of language, year of publication, study design and type of publication were applied. Additional studies were sought through grey literature. Results: From 117 initial records, 3 studies met the inclusion criteria. Two quasi-experimental studies and one randomised cross-over study were included. The results of the examined studies confirmed the positive effects of insoles usage and foot and ankle mobility on the venous return. Conclusion: This scoping review provided an overview of the topic. The studies analysed in this scoping review have shown that insoles seem to be beneficial in reducing the lower limb oedema in healthy individuals. However, there are still no comprehensive trials confirming this evidence on people with lymphoedema. The small number of identified articles, the selection of participants not affected by lymphoedema, the use of heterogeneous devices in terms of modifications and materials highlight the need of further investigations. Future trails should include people affected by lymphoedema, address the choice of materials in manufacturing the insoles and take in consideration the patients' adherence to the device and concordance to the treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
41. Subcutaneous cannula drainage for symptomatic lower limb oedema in advanced cancer: a case study.
- Author
-
Priest, Lauren, Allcroft, Peter, Thomson, Margaret, and Lambrakis, Anthea
- Subjects
LYMPHEDEMA treatment ,METASTASIS ,MAGNETIC resonance imaging ,LEG ,ANAL tumors ,TREATMENT effectiveness ,MEDICAL drainage ,CATHETERIZATION ,PALLIATIVE treatment ,SQUAMOUS cell carcinoma ,CATHETERS ,DISEASE complications - Abstract
Secondary lymphoedema is a troubling and complex symptom in people with advanced metastatic cancer. Currently there is no standardised approach to managing secondary lymphoedema in the palliative care population. This case study of lower limb lymphoedema utilises subcutaneous drainage with specific cannula placement. The hope is that this insight may allow for future standardisation of this procedure.. [ABSTRACT FROM AUTHOR]
- Published
- 2023
42. Is manual lymphatic drainage with bio-electric massage therapy a good treatment combination for lymphoedema and lipoedema? A case study.
- Author
-
Pluck, Andrea
- Subjects
LYMPHEDEMA treatment ,MOTIVATION (Psychology) ,LIPEDEMA ,TREATMENT effectiveness ,PHYSICAL activity ,QUALITY of life ,LYMPHATIC massage ,COMBINED modality therapy ,TRANSCUTANEOUS electrical nerve stimulation - Abstract
Manual lymphatic drainage (MLD) massage is widely accepted as a conservative treatment for lymphoedema. This case study examines the effectiveness ofMLD in combination with bio-electric massage therapy (BMT)/transcutaneous electrical nerve stimulation (TENS) for those living with lymphoedema and lipoedema. The use of non-invasive multi-modal treatment methods such as these in the treatment/management oflymphoedema and lipoedema can be useful reducing limb volume and improving quality oflife for people living with this condition. Results obtained in this case study showed reduction in volume oflimbs, as well as texture changes and positive effects in symptom-related outcomes. During the case study, the client became more optimistic about her condition and motivated to try more physical activities. This case study highlights the need for further experimental studies on the effectiveness ofMLD with BMT in lymphoedema and lipoedema. [ABSTRACT FROM AUTHOR]
- Published
- 2023
43. The use of eHeath and digital health technology for lymphoedema care.
- Author
-
Mangion, Andrea and Piller, Neil
- Subjects
LYMPHEDEMA treatment ,HEALTH services accessibility ,DIGITAL health ,MEDICAL technology ,PATIENT-centered care ,TREATMENT effectiveness ,TELEMEDICINE - Abstract
While electronic health (eHealth) has been gaining in popularity in recent years, its adoption was accelerated by the COVID-19 pandemic, when restrictions on in-person consultations compelled healthcare practitioners to turn to modalities such as telehealth for patient management. There are numerous potential benefits of using eHealth in lymphoedema management, including improved access to care, better tracking of symptoms and enhanced options for patient engagement and empowerment. As healthcare practitioners continue to prioritise patient-centred care, with an emphasis on putting the patient's needs first and making treatment as accessible as possible, eHealth offers a promising opportunity to improve lymphoedema care. This article provides an overview of eHealth, explores a classification system for the various forms of eHealth, discusses the rationale for using eHealth, and proposes future research directions in lymphoedema care. [ABSTRACT FROM AUTHOR]
- Published
- 2023
44. Lymphatic drainage patterns in head and neck lymphoedema: A preliminary imaging study with indocyanine green lymphography.
- Author
-
Pigott, Amanda, Suami, Hiroo, McCann, Andrew, and Trevethan, Megan
- Subjects
HEAD & neck cancer diagnosis ,LYMPHEDEMA treatment ,LYMPHEDEMA diagnosis ,NECK radiography ,CRANIAL radiography ,HEAD & neck cancer treatment ,LYMPHATIC physiology ,CONSERVATIVE treatment ,LYMPHEDEMA ,AUDITING ,INDOLE compounds ,INJECTIONS ,LYMPHANGIOGRAPHY ,CANCER patients ,LYMPHATIC massage - Abstract
Head and neck lymphoedema occurs frequently after head and neck cancer treatment and causes physical and psychosocial disability Imaging is not routinely used to diagnose or inform its conservative treatment. Indocyanine green (ICG) lymphography is used for these purposes in upper and lower limb lymphoedema. Aim: The study aimed to explore the clinical potential of ICG lymphography in diagnosis and conservative management ofhead and neck lymphoedema. Methods: Participants underwent a single examination with ICG lymphography The tracer injection sites were determined by anatomic lymphatic territories. Presence of dermal backflow was used to diagnose lymphoedema. Imaging data were recorded using a bespoke audit tool to document lymphatic movement features and manual lymphatic drainage observations. Results: Six participants underwent head and neck ICG lymphography Lymphatic vessels and dermal backflow were visualised in all participants. Manual lymphatic drainage observations suggested all participants required very firm pressure to move the ICG dye through areas of dermal backflow whereas only light pressure was required in areas with linear lymphatic vessel flow: Conclusion: ICG lymphography can identify lymphatic structures and drainage patterns in the head and neck region and is considered a potential tool for diagnosis and conservative treatment planning for head and neck lymphoedema. [ABSTRACT FROM AUTHOR]
- Published
- 2023
45. Resistance training in patients with secondary lymphoedema: does it have any effect on functional and quality of life measures?
- Author
-
Damato, Andrea, Rovnaya, Aleksandra, and McGuigan, Polly
- Subjects
LYMPHEDEMA treatment ,RESISTANCE training ,CLINICAL trials ,FUNCTIONAL status ,EXERCISE physiology ,COMPRESSION garments ,CANCER patients ,SEVERITY of illness index ,PHYSICAL activity ,QUALITY of life ,MUSCLE strength ,EXERCISE intensity ,QUESTIONNAIRES ,HIGH-intensity interval training ,PATIENT safety ,BREAST tumors ,ARM circumference ,COMORBIDITY - Abstract
The inclusion of resistance training in the care of patients with upper limb lymphoedema is an understudied developing concept. The study investigated the safety and effectiveness ofadding a moderate/high intensity resisted exercise (RE) programme for 6 weeks on arm circumference, muscular strength and quality oflife (QoL) measure in patients with breast cancer-related lymphoedema. This study included 35 patients with a history ofbreast cancer who were in phase two of their lymphoedema rehabilitation. They were assigned to either the intervention (n=18) or control (n=17) groups. The intervention consisted ofresistance band exercises four times a week for 6 weeks. Limb circumference measurements, muscular strength, Disabilities ofArm, Shoulder, and Hand (DASH), Lower Extremity Functional Scale (LEFS) and Lymphoedema Quality of Life (LYMQOL) questionnaires were administered at baseline and at 6 weeks. After 6 weeks, the intervention group demonstrated statistically significant differences (p<0.01) in the DASH and LYMQOL scores. There was a significant change in UL and LL strength between both groups (p<0.05). Unexpectedly, there was a significant decrease in UL measurements in the hand, forearm, elbow and proximal arm in the intervention group (p<0.05). The results indicate that RE demonstrates a positive effect on arm function, symptoms and QoL without increasing arm volume in breast cancer-related lymphoedema. [ABSTRACT FROM AUTHOR]
- Published
- 2023
46. Transcutaneous Electrical Acupoint Stimulation Combined with Warm Acupuncture for Breast Cancer Related Upper Limb Lymphedema: A Retrospective Cohort Study.
- Author
-
Lu, Chao, Li, Guang-liang, Deng, De-hou, Bao, Wen-long, Wang, Yan, and Zhang, Ai-qin
- Subjects
LYMPHEDEMA treatment ,LYMPHEDEMA ,ACUPUNCTURE ,RETROSPECTIVE studies ,ARM ,RISK assessment ,TREATMENT effectiveness ,COMPARATIVE studies ,ACUPUNCTURE points ,TRANSCUTANEOUS electrical nerve stimulation ,BREAST tumors ,LONGITUDINAL method ,DISEASE risk factors ,DISEASE complications - Abstract
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. (Registration No. ChiCTR2200062075) [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
47. Breast cancer‐related lymphoedema and resistance exercise: An evidence‐based review of guidelines, consensus statements and systematic reviews.
- Author
-
Wang, Ling, Shi, Yue Xian, Wang, Ting Ting, Chen, Ke Xin, and Shang, Shao Mei
- Subjects
- *
LYMPHEDEMA treatment , *RESISTANCE training , *ONLINE information services , *CINAHL database , *MEDICAL information storage & retrieval systems , *SYSTEMATIC reviews , *CANCER patients , *MEDICAL protocols , *QUALITY assurance , *RESEARCH funding , *MEDLINE , *BREAST tumors , *DISEASE complications - Abstract
Aims and Objectives: Breast cancer‐related lymphoedema (BCRL) is a side effect of cancer treatment and can be alleviated by resistance exercise. This systematic, evidence‐based review examined the existing best evidence on resistance exercise for BCRL to accurately describe the current status of the field and offer recommendations for clinicians. Methods: This review adheres to the PRISMA guidelines. Clinical practice guidelines, consensus documents, systematic reviews and other related evidence‐based resources about resistance exercise for BCRL were retrieved through the English databases and guideline websites. The publication data limit was set to December 2020. The following search terms were used: 'breast cancer/breast neoplasm/breast carcinoma/breast tumor/breast malignancy, lymphedema/swelling/edema/lymphoedema, resistance/weight/strength training, best practice/clinical practice/guideline/consensus documents'. The quality of the included studies was evaluated by two authors independently using AGREE II and AMSTAR II tools. Evidence‐based recommendations on resistance exercise relevant for BCRL were synthesised and categorised. Results: Twenty two articles (seven guidelines, four consensus documents and eleven systematic reviews) were included. The overall quality of the eleven eligible guidelines and consensus documents was moderate to high according to the AGREE II criteria. The quality of the eleven systematic reviews was critically low to high according to the AMSTAR criteria. Six clinical topics involving 43 recommendations were identified. Recommendations were categorised by safety of resistance training, effectiveness of resistance training, evaluation prior to resistance exercise, resistance exercise prescription, resistance training outcome index and points for attention. Conclusions: This study summarises 43 recommendations for resistance training for BCRL and provides guidance for clinicians. Based on randomised trials and systematic reviews published in recent years, there is an urgent need to update the guidelines and consensus documents in terms of topics, for example effectiveness of resistance training and resistance training outcome index. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
48. Impact on Health-Related quality of life after wearing compression garment or not for six months in women with mild breast cancer-related arm lymphedema. A cross-sectional study.
- Author
-
Blom, Katarina Y., Johansson, Karin I., Nilsson-Wikmar, Lena B., Klernäs, Pia E., and Brogårdh, Christina B.
- Subjects
- *
LYMPHEDEMA treatment , *LYMPHEDEMA , *CANCER patient psychology , *EMBARRASSMENT , *CROSS-sectional method , *COMPRESSION garments , *SEVERITY of illness index , *ARM , *COMPARATIVE studies , *QUALITY of life , *DESCRIPTIVE statistics , *RESEARCH funding , *BREAST tumors , *DISEASE complications - Abstract
Women with mild breast cancer-related arm lymphedema (BCRAL) mostly receive treatment with compression garments and instructions in self-care to prevent the progression of lymphedema. However, wearing a compression garment may be experienced as negative and may affect health-related quality of life (HRQOL) more than the lymphedema itself. The aim of this study was to investigate if there is a difference in lymphedema-specific HRQOL, between women with mild BCRAL wearing compression garments or not for 6 months. Participants with mild BCRAL (Lymphedema relative volume <10%) rated their HRQOL by the Lymphedema Quality of Life Inventory (LyQLI), 6 months after diagnosis and being randomized to compression group (CG) or non-compression group (NCG). Both groups received self-care instructions, and the CG was treated with a standard compression garment, compression class 1. Data from 51 women (30 in the CG and 21 in the NCG), were analyzed. Both the CG and the NCG experienced a low negative impact on HRQOL in physical, psychosocial, and practical domains (score <1). However, the CG experienced a higher negative impact on median HRQOL in the practical domain compared to the NCG, 0.23/0.08 respectively, (p = 0.026). In the specific items, more participants in the CG reported a negative impact on HRQOL compared to the NCG in employment activities 23%/0%, (p = 0.032), embarrassment by lymphedema/compression garments 33%/5%, (p = 0.017), feeling discomfort/embarrassment while doing sports and hobbies 30%/5%, (p = 0.034) and having to answer questions about the lymphedema 27%/0% (p = 0.015). Overall, the lymphedema-specific HRQOL was high after 6 months in women with mild lymphedema, with only a minor difference between the groups. Some women may however perceive practical and emotional issues with the compression garment. These aspects should be considered in patient education and when planning/evaluating treatment. Trial registration: ISRCTN51918431 [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
49. A spotlight on lymphoedema Did Not Attends: Demographics and workforce costs.
- Author
-
Thomas, Melanie Jane, Humphreys, Ioan, and Noble‐Jones, Rhian Wyn
- Subjects
LYMPHEDEMA treatment ,AUDITING ,SCIENTIFIC observation ,MEDICAL care ,MEDICAL care costs ,POPULATION geography ,MEDICAL care use ,DESCRIPTIVE statistics ,MEDICAL appointments ,PATIENT compliance ,WORKING hours ,TECHNOLOGY ,COMORBIDITY ,WOUND care ,ECONOMICS - Abstract
This unique evaluation aimed to estimate, the financial impact of non‐attendance on a nation‐wide hospital lymphoedema service. Along with gaining some understanding of patient characteristics of those who Did Not Attend (DNA) and were subsequently discharged. The evaluation design interrogated existing performance data from 2012 to 2022. This information was used to estimate the costs incurred based on national published sources and pay scales. Staffing costs of over £1.1 m in one decade related to the financial impact of over 23 000 unattended lymphoedema appointments. The characteristics of 870 patients from 2019/2020 were also evaluated suggesting that those with a wound alongside complex lymphoedema were less likely to DNA appointments. Two‐thirds of patients were managing two or more comorbidities—obesity, cardiac conditions and diabetes being the most common. It seems likely that some DNAs are avoidable by adapting appointment administrative processes and greater understanding of patients' perception of value. However, the reasons for DNA are likely to be varied and nuanced so potentially a small proportion are unavoidable. Modernising appointment processes and identifying patient value may help minimise DNA costs in the future. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
50. The Geriatric Amputee: The Role of Prosthetic Training In The Home Setting.
- Author
-
Alicea, Noelle
- Subjects
DIABETES complications ,LYMPHEDEMA treatment ,ARTIFICIAL limbs ,WOUND healing ,PHYSICAL therapy assessment ,PROSTHETICS ,PERIPHERAL vascular diseases ,PHYSICAL therapy ,HOME care services ,FUNCTIONAL status ,GERIATRIC assessment ,GAIT disorders ,TREATMENT effectiveness ,ACCESSIBLE design ,HOME remodeling ,WALKING ,ACCIDENTAL falls ,LEG amputation ,PATIENT education ,EXERCISE therapy ,REHABILITATION ,OLD age - Published
- 2023
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.