PHYSIOTHERAPY IN UPPER LIMB LYMPHEDEMA AFTER BREAST CANCER TREATMENT: A RANDOMIZED STUDY

Abstract

Our aim was to compare the responses ofphysical treatment with or without manuallymphatic drainage (MLD) in lymphedemaafter breast cancer treatment in a Brazilianpopulation. This was a controlled clinical trialwith lymphedema secondary to breast cancertreatment patients that were randomized intoeither: Group 1 consisting of MLD, skin care,bandaging and remedial exercises; or Group 2using skin care, bandaging and remedialexercises. Sixty-six patients were randomizedand 9 were excluded during the first phase,resulting in a total of 57 patients eligible foranalyzes with 28 in Group 1 and 29 in Group2. The first phase of treatment had an averageduration of 24 days (±12.38) and final volumeexcess average (VE) between limbs was494.51ml, corresponding to 29.18% of theinitial volume. Volume reduction was highlysignificant, independent of the intervention(p<0.001), and both treatments led to anaverage of percentage volume excess reduction(PVER) of 15.02%. Patients with incompleterange of motion and lymphatic-related fibrotictissues showed a statistically significantreduction in the percentage of volume excess(p=0.010; p=0.009). The presence of armparesthesia was associated with the lowesttherapeutic response (p=0.024). Bothtreatment groups demonstrated absolute andrelative reductions of excess limb volume,and the addition of MLD did not significantlyincrease the therapeutic response in womenwith lymphedema after breast cancer.