Abstract
The purpose of this article is to provide a systematic review of Combined Physical
Therapy, Intermittent Pneumatic Compression and arm elevation for the treatment of
lymphoedema secondary to an axillary dissection for breast cancer. Combined Physical
Therapy starts with an intensive phase consisting of skin care, Manual Lymphatic Drainage,
exercises and bandaging and continues with a maintenance phase consisting of skin
care, exercises, wearing a compression sleeve and Manual Lymphatic Drainage if needed.
We have searched the following databases: PubMed/MEDLINE, CINAHL, EMBASE, PEDro and
Cochrane. Only (pseudo-) randomised controlled trials and non-randomised experimental
trials investigating the effectiveness of Combined Physical Therapy and its different
parts, of Intermittent Pneumatic Compression and of arm elevation were included. These
physical treatments had to be applied to patients with arm lymphoedema which developed
after axillary dissection for breast cancer.
Ten randomised controlled trials, one pseudo-randomised controlled trial and four
non-randomised experimental trials were found and analysed. Combined Physical Therapy
can be considered as an effective treatment modality for lymphoedema. Bandaging the
arm is effective, whether its effectiveness is investigated on a heterogeneous group
consisting of patients with upper and lower limb lymphoedema from different causes.
There is no consensus on the effectiveness of Manual Lymphatic Drainage. The effectiveness
of skin care, exercises, wearing a compression sleeve and arm elevation is not investigated
by a controlled trial. Intermittent Pneumatic Compression is effective, but once the
treatment is interrupted, the lymphoedema volume increases.
In conclusion, Combined Physical Therapy is an effective therapy for lymphoedema.
However, the effectiveness of its different components remains uncertain. Furthermore,
high-quality studies are warranted. The long-term effect of Intermittent Pneumatic
Compression and the effect of elevation on lymphoedema are not yet proven.
Keywords
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Article info
Publication history
Published online: December 07, 2009
Accepted:
November 19,
2009
Received in revised form:
November 18,
2009
Received:
February 8,
2009
Identification
Copyright
© 2009 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
