Positive Health Online

Abstract

WILBURN and colleagues, Stanford Center for Lymphatic and Venous Disorders, Stanford University School of Medicine, Falk Cardiovascular Research Center, Stanford, California 94305, USA, have conducted a pilot study of a novel device for manual lymphatic drainage in the care of breast-cancer-related lymphoedema.   

Background

Complete decongestive lymphatic physiotherapy which includes manual lymphatic drainage is a proven treatment for the reduction of oedema and long-term maintenance of limb volume in lymphoedema. However, the therapy demands substantial time and effort from patients to maintain these benefits; the treatments are not always well-accepted; and patients may suffer from a deterioration in quality-of-life or a time-dependent loss of initial treatment benefits. A new device designed for home use by the patient, the Flexitouch, has been developed to mechanically simulate manual lymphatic drainage. The aim of this study was to test the efficacy of the Flexitouch, when compared to massage, in the self-administered maintenance therapy of lymphedema.

Methodology

A prospective, randomized, crossover study of maintenance therapy was performed in 10 patients with unilateral breast cancer-associated lymphoedema of the arm. Each observation phase included self-administered treatment with the Flexitouch or massage, 1 hour daily for 14 days, respectively, followed by crossover to the alternate treatment phase. Each treatment phase was preceded by a 1-week washout, with use of garment only. The sequence of treatment was randomly assigned. The potential impact of treatment modality on quality of life was assessed with serial administration of the SF-36.

Results

Post-treatment arm volume reduced significantly after the Flexitouch, but not after self-administered massage. The patients’ mean weight decreased significantly with Flexitouch use, but not with massage. The Flexitouch device was apparently well-tolerated and accepted by patients. Serial SF-36 administration showed no deterioration in physical or psychosocial scores compared to baseline measurements; there were no statistical differences in scores when the two treatment modalities were compared.

Conclusion

This short-term prospective evaluation of the Flexitouch suggests that the device may provide better maintenance than self-administered massage in breast cancer-associated lymphoedema.

References

Wilburn O, Wilburn P, Rockson SG. A pilot, prospective evaluation of a novel alternative for maintenance therapy of breast cancer-associated lymphedema. BMC Cancer 6 : 84, 2006.