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, owilburn@gmail.com, have evaluated a new way of performing lymphatic drainage for breast cancer-associated lymphoedema.

Background

Prospective investigations of complete decongestive lymphatic physiotherapy, including manual lymphatic drainage, have validated the efficacy of these interventions for the initial reduction of oedema and long-term maintenance of limb volume in lymphoedema. However, the technique has significant drawbacks. A new device designed for home use by the patient, the Flexitouch, has been developed to mechanically simulate lymphatic drainage. The aim of this study was to evaluate the efficacy of the Flexitouch device as compared to massage.

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. The sequence of treatment was randomly assigned. The potential impact of treatment modality on quality of life was assessed with the SF-36.

Results

Statistical analysis disclosed that the order of treatment had no outcome influence, permitting 10 comparisons within each treatment group. 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 well-tolerated and accepted by patients. SF-36 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 oedema control 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.