Related Experiment Video
Updated: May 22, 2025
Ultrasonographic Evaluation of Breast Cancer-related Lymphedema
Published on: January 12, 2017
Self-administered versus lymphedema therapist-administered complex decongestive therapy protocol in breast
Sukriye Cansu Gultekin1, Didem Karadibak2, Ahmet Burak Cakir3
1Faculty of Physiotherapy and Rehabilitation, Graduate School of Health Sciences, Dokuz Eylul University, Izmir, Turkey. cnsgultekin@gmail.com.
Purpose:
The aim of this study was to demonstrate that a self-administered complex decongestive therapy (CDT) protocol is not inferior to certified lymphedema therapist (CLT)-administered CDT in the management of lymphedema and health-related outcomes in patients with breast cancer-related lymphedema (BCRL).
Methods:
Fifty patients with BCRL were randomly assigned to two experimental groups: (1) a CLT-administered CDT group (n = 25) or a self-administered CDT group (n = 25). CDT was a multimodal approach in two experimental conditions consisting of patient education, manual lymph drainage, multi-layer bandaging, therapeutic exercises and skin/nail care. Lymphedema severity was assessed using circumference measurement, and BCRL-related symptoms were assessed using a numerical rating scale. The following measurement methods were used to assess health-related outcomes: universal goniometer for range of motion (ROMs), hand grip dynamometer for peripheral muscle strength, disabilities of the arm, shoulder and hand (DASH) questionnaire for disability level, International Physical Activity Questionnaire-Short Form (IPAQ-SF) for physical activity level, the checklist for individual strength (CIS) for fatigue and upper limb lymphedema quality of life questionnaire (ULL-27) for quality of life.
Results:
Following CDT, there was a significant decrease in lymphedema severity and lymphedema-related symptoms in both groups (p < 0.001). There was no significant difference between the groups regarding the mean difference in health-related outcomes following CDT (post-treatment-baseline) (p < 0.05). Lymphedema severity and symptoms remained stable during the 3-month follow-up periods in the CLT-administered CDT group (p > 0.05). There was a decrease in the severity of lymphedema, stiffness, heaviness and fatigue in the self-administered CDT group at 3-month follow-up (p < 0.05), while pain and tingling remained unchanged (p > 0.05).
Conclusion:
The present findings demonstrated self-administered CDT protocol is not inferior to CLT-administered CDT in the management of lymphedema and reduction of lymphedema-related disabilities.
