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Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial.

Torres Lacomba M, Yuste Sánchez MJ, Zapico Goñi A, Prieto Merino D, Mayoral del Moral O, Cerezo Téllez E, Minayo Mogollón E - BMJ (2010)

Bottom Line: This group also received an educational strategy.Incidence of clinically significant secondary lymphoedema (>2 cm increase in arm circumference measured at two adjacent points compared with the non-affected arm). 116 women completed the one year follow-up.The difference was significant (P=0.01); risk ratio 0.28 (95% confidence interval 0.10 to 0.79).

View Article: PubMed Central - PubMed

Affiliation: Physiotherapy Department, School of Physiotherapy, Alcalá de Henares University, E-28871 Alcalá de Henares, Madrid, Spain. maria.torres@uah.es

ABSTRACT

Objective: To determine the effectiveness of early physiotherapy in reducing the risk of secondary lymphoedema after surgery for breast cancer.

Design: Randomised, single blinded, clinical trial.

Setting: University hospital in Alcalá de Henares, Madrid, Spain.

Participants: 120 women who had breast surgery involving dissection of axillary lymph nodes between May 2005 and June 2007.

Intervention: The early physiotherapy group was treated by a physiotherapist with a physiotherapy programme including manual lymph drainage, massage of scar tissue, and progressive active and action assisted shoulder exercises. This group also received an educational strategy. The control group received the educational strategy only.

Main outcome measure: Incidence of clinically significant secondary lymphoedema (>2 cm increase in arm circumference measured at two adjacent points compared with the non-affected arm).

Results: 116 women completed the one year follow-up. Of these, 18 developed secondary lymphoedema (16%): 14 in the control group (25%) and four in the intervention group (7%). The difference was significant (P=0.01); risk ratio 0.28 (95% confidence interval 0.10 to 0.79). A survival analysis showed a significant difference, with secondary lymphoedema being diagnosed four times earlier in the control group than in the intervention group (intervention/control, hazard ratio 0.26, 95% confidence interval 0.09 to 0.79).

Conclusion: Early physiotherapy could be an effective intervention in the prevention of secondary lymphoedema in women for at least one year after surgery for breast cancer involving dissection of axillary lymph nodes.

Trial registration: Current controlled trials ISRCTN95870846.

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Related in: MedlinePlus

Fig 1 Progress of participants through study
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fig1: Fig 1 Progress of participants through study

Mentions: Of 120 women recruited, 60 were assigned to early physiotherapy and an educational strategy and 60 to the educational strategy only (fig 1). All variables were similarly distributed between the groups at randomisation (preoperative visit; table 1). The volume ratios were around 1 in both groups. This was expected as no lymphoedema was present at the preoperative assessment. Overall, 116 women completed the follow-up assessments; 59 in the intervention group and 57 in the control group.


Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial.

Torres Lacomba M, Yuste Sánchez MJ, Zapico Goñi A, Prieto Merino D, Mayoral del Moral O, Cerezo Téllez E, Minayo Mogollón E - BMJ (2010)

Fig 1 Progress of participants through study
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC2806631&req=5

fig1: Fig 1 Progress of participants through study
Mentions: Of 120 women recruited, 60 were assigned to early physiotherapy and an educational strategy and 60 to the educational strategy only (fig 1). All variables were similarly distributed between the groups at randomisation (preoperative visit; table 1). The volume ratios were around 1 in both groups. This was expected as no lymphoedema was present at the preoperative assessment. Overall, 116 women completed the follow-up assessments; 59 in the intervention group and 57 in the control group.

Bottom Line: This group also received an educational strategy.Incidence of clinically significant secondary lymphoedema (>2 cm increase in arm circumference measured at two adjacent points compared with the non-affected arm). 116 women completed the one year follow-up.The difference was significant (P=0.01); risk ratio 0.28 (95% confidence interval 0.10 to 0.79).

View Article: PubMed Central - PubMed

Affiliation: Physiotherapy Department, School of Physiotherapy, Alcalá de Henares University, E-28871 Alcalá de Henares, Madrid, Spain. maria.torres@uah.es

ABSTRACT

Objective: To determine the effectiveness of early physiotherapy in reducing the risk of secondary lymphoedema after surgery for breast cancer.

Design: Randomised, single blinded, clinical trial.

Setting: University hospital in Alcalá de Henares, Madrid, Spain.

Participants: 120 women who had breast surgery involving dissection of axillary lymph nodes between May 2005 and June 2007.

Intervention: The early physiotherapy group was treated by a physiotherapist with a physiotherapy programme including manual lymph drainage, massage of scar tissue, and progressive active and action assisted shoulder exercises. This group also received an educational strategy. The control group received the educational strategy only.

Main outcome measure: Incidence of clinically significant secondary lymphoedema (>2 cm increase in arm circumference measured at two adjacent points compared with the non-affected arm).

Results: 116 women completed the one year follow-up. Of these, 18 developed secondary lymphoedema (16%): 14 in the control group (25%) and four in the intervention group (7%). The difference was significant (P=0.01); risk ratio 0.28 (95% confidence interval 0.10 to 0.79). A survival analysis showed a significant difference, with secondary lymphoedema being diagnosed four times earlier in the control group than in the intervention group (intervention/control, hazard ratio 0.26, 95% confidence interval 0.09 to 0.79).

Conclusion: Early physiotherapy could be an effective intervention in the prevention of secondary lymphoedema in women for at least one year after surgery for breast cancer involving dissection of axillary lymph nodes.

Trial registration: Current controlled trials ISRCTN95870846.

Show MeSH
Related in: MedlinePlus