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Limb Differences in the Therapeutic Effects of Complex Decongestive Therapy on Edema, Quality of Life, and Satisfaction in Lymphedema Patients.

Noh S, Hwang JH, Yoon TH, Chang HJ, Chu IH, Kim JH - Ann Rehabil Med (2015)

Bottom Line: There was no significant difference in the volume reductions between the 3 groups.There were no significant differences in all of the measures between PL and LL.SF-36 scores post-CDT did not differ significantly between AL and LL.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Objective: To investigate the changing patterns of edema, quality of life (QOL), and patient-satisfaction after complex decongestive therapy (CDT) in three trajectories: arm lymphedema (AL), secondary leg lymphedema (LL) and primary leg lymphedema (PL).

Methods: Candidates for AL (n=35), LL (n=35) and PL (n=14) were identified from prospective databases. The patients were treated with CDT for 2 weeks, and lymphedema volume was measured before and immediately following the therapy. Patients then self-administered home therapy for 3 months and presented for a follow-up visit. The Korean version of Short Form-36 (SF-36) was used to assess QOL, and we administered a study-specific satisfaction survey.

Results: There was no significant difference in the volume reductions between the 3 groups. There were no significant differences in all of the measures between PL and LL. Overall initial QOL was significantly lower in patients with LL than in patients with AL. SF-36 scores post-CDT did not differ significantly between AL and LL. Clinically significant differences were noted between AL and LL in the mean values of the satisfaction survey.

Conclusion: AL, LL, and PL may have different longitudinal courses. We suggest that lower extremity lymphedema patients present more favorable outcomes after CDT with respect to QOL and satisfaction than upper extremity lymphedema patients. Clinicians should approach patients with different therapeutic considerations specific to each type or region of lymphedema before using CDT in clinical practice.

No MeSH data available.


Related in: MedlinePlus

Changes in quality of life, based on the Short Form-36, in patients with lymphedema who underwent complex decongestive therapy (CDT). (A) Average SF-36 score, (B) physical component summary, and (C) mental component summary. *p<0.05, **p<0.01, ***p<0.001, a)p-values were derived from independent t-tests, b)p-values were derived from repeated measured ANOVAs for the effect of time for the within subject factor (3 levels: pre-CDT, post-CDT, and 12 weeks after post-CDT), c)p-values were derived from repeated measured ANOVAs for the effect of time for the between subjects factor (2 levels: AL and LL, PL and LL).
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Figure 2: Changes in quality of life, based on the Short Form-36, in patients with lymphedema who underwent complex decongestive therapy (CDT). (A) Average SF-36 score, (B) physical component summary, and (C) mental component summary. *p<0.05, **p<0.01, ***p<0.001, a)p-values were derived from independent t-tests, b)p-values were derived from repeated measured ANOVAs for the effect of time for the within subject factor (3 levels: pre-CDT, post-CDT, and 12 weeks after post-CDT), c)p-values were derived from repeated measured ANOVAs for the effect of time for the between subjects factor (2 levels: AL and LL, PL and LL).

Mentions: In all groups, SF-36 scores were significantly lower than that of the Korean population means in almost all domains [2428]. There were no significant differences in the SF-36 scores for any of the time points between the PL and LL patients (p=0.69), but there were significant differences in the mean pre-CDT SF-36 scores between the AL and LL patients (p=0.01). The subjects reported a mean increase, from pre-CDT, of 10.23 points at post-CDT and 16.42 points at 12 weeks after post-CDT. Patients with LL showed more improved SF-36 scores than patients with AL (Table 3, Fig. 2).


Limb Differences in the Therapeutic Effects of Complex Decongestive Therapy on Edema, Quality of Life, and Satisfaction in Lymphedema Patients.

Noh S, Hwang JH, Yoon TH, Chang HJ, Chu IH, Kim JH - Ann Rehabil Med (2015)

Changes in quality of life, based on the Short Form-36, in patients with lymphedema who underwent complex decongestive therapy (CDT). (A) Average SF-36 score, (B) physical component summary, and (C) mental component summary. *p<0.05, **p<0.01, ***p<0.001, a)p-values were derived from independent t-tests, b)p-values were derived from repeated measured ANOVAs for the effect of time for the within subject factor (3 levels: pre-CDT, post-CDT, and 12 weeks after post-CDT), c)p-values were derived from repeated measured ANOVAs for the effect of time for the between subjects factor (2 levels: AL and LL, PL and LL).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496505&req=5

Figure 2: Changes in quality of life, based on the Short Form-36, in patients with lymphedema who underwent complex decongestive therapy (CDT). (A) Average SF-36 score, (B) physical component summary, and (C) mental component summary. *p<0.05, **p<0.01, ***p<0.001, a)p-values were derived from independent t-tests, b)p-values were derived from repeated measured ANOVAs for the effect of time for the within subject factor (3 levels: pre-CDT, post-CDT, and 12 weeks after post-CDT), c)p-values were derived from repeated measured ANOVAs for the effect of time for the between subjects factor (2 levels: AL and LL, PL and LL).
Mentions: In all groups, SF-36 scores were significantly lower than that of the Korean population means in almost all domains [2428]. There were no significant differences in the SF-36 scores for any of the time points between the PL and LL patients (p=0.69), but there were significant differences in the mean pre-CDT SF-36 scores between the AL and LL patients (p=0.01). The subjects reported a mean increase, from pre-CDT, of 10.23 points at post-CDT and 16.42 points at 12 weeks after post-CDT. Patients with LL showed more improved SF-36 scores than patients with AL (Table 3, Fig. 2).

Bottom Line: There was no significant difference in the volume reductions between the 3 groups.There were no significant differences in all of the measures between PL and LL.SF-36 scores post-CDT did not differ significantly between AL and LL.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Objective: To investigate the changing patterns of edema, quality of life (QOL), and patient-satisfaction after complex decongestive therapy (CDT) in three trajectories: arm lymphedema (AL), secondary leg lymphedema (LL) and primary leg lymphedema (PL).

Methods: Candidates for AL (n=35), LL (n=35) and PL (n=14) were identified from prospective databases. The patients were treated with CDT for 2 weeks, and lymphedema volume was measured before and immediately following the therapy. Patients then self-administered home therapy for 3 months and presented for a follow-up visit. The Korean version of Short Form-36 (SF-36) was used to assess QOL, and we administered a study-specific satisfaction survey.

Results: There was no significant difference in the volume reductions between the 3 groups. There were no significant differences in all of the measures between PL and LL. Overall initial QOL was significantly lower in patients with LL than in patients with AL. SF-36 scores post-CDT did not differ significantly between AL and LL. Clinically significant differences were noted between AL and LL in the mean values of the satisfaction survey.

Conclusion: AL, LL, and PL may have different longitudinal courses. We suggest that lower extremity lymphedema patients present more favorable outcomes after CDT with respect to QOL and satisfaction than upper extremity lymphedema patients. Clinicians should approach patients with different therapeutic considerations specific to each type or region of lymphedema before using CDT in clinical practice.

No MeSH data available.


Related in: MedlinePlus