Intermittent Pneumatic Compression in Patients with Postmastectomy Lymphedema: A Randomized Controlled Trial

Lymphedema as a result of curative surgery for breast cancer can lead to long term morbidity. Lymphedema following post-radical mastectomy causes family and social problem of young individual. Manual-lymphatic-drainage (MLD), IPC (Intermittent pneumatic Compression), MLB (Multi-layered-bandage) and compression sleeves are main treatment stream along with medication and modification of Activities of Daily Living (ADL). The aim of this study was to evaluate the effects of intermittent pneumatic compression (IPC) alone or in combination with exercises on upper limbs circumference and hand function. Subjects were required to have mild to moderate unilateral upper limb lymphedema acquired as a result of curative cancer surgery. The study population consisted of 21 patients with breast cancer-related lymphedema. One group received IPC for 45 minutes per session at 50-60mmHg, 5 sessions per week for 3 weeks (15 sessions in total), combined with physical exercise, and the other group received physical exercise only. Before and after arm circumference measurement done at six sites on affected limb. Hand function was assessed at six months with the DASH (Disabilities of Arm Shoulder and Hand) clinical questionnaire. Both groups exhibited a reduction in upper limb circumferences after the therapy in comparison to the initial values. The reduction reached statistical significance at most measurement levels in the group that received combined IPC and exercise. Intermittent pneumatic compression is an effective method of reducing post-mastectomy lymphedema. The exercises did not have a significant effect on function of hand.