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A randomized clinical trial comparing advanced pneumatic truncal, chest, and arm treatment to arm treatment only in self-care of arm lymphedema

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Abstract

Treatment of the truncal lymphatics prior to treatment of the lymphedematous arm is an accepted, although not empirically tested, therapeutic intervention delivered during decongestive lymphatic therapy (DLT). Breast cancer survivors with arm lymphedema are encouraged to use these techniques when performing simple lymphatic drainage as part of their life-long lymphedema self-care. Self-massage is at times difficult and pneumatic compression devices are used by many patients to assist with self-care. One such device, the Flexitouch® System, replicates the techniques used during DLT; however, the need for application of pneumatic compression in unaffected truncal areas to improve self-care outcomes in arm only lymphedema is not established. The objective of this study was to compare the therapeutic benefit of truncal/chest/arm advanced pneumatic compression therapy (experimental group) verses arm only pneumatic compression (control group) in self-care for arm lymphedema without truncal involvement using the Flexitouch® System. Outcomes of interest were self-reported symptoms, function, arm impedance ratios, circumference, volume, and trunk circumference. Forty-two breast cancer survivors, (21 per group), with Stage II lymphedema completed 30 days of home self-care using the Flexitouch® System. Findings revealed a statistically significant reduction in both the number of symptoms and overall symptom burden within each group; however, there were no statistically significant differences in these outcomes between the groups. There was no statistically significant overall change or differential pattern of change between the groups in function. A statistically significant reduction in bioelectrical impedance and arm circumference within both of the groups was achieved; however, there was no statistically significant difference in reduction between groups. These findings indicate that both configurations are effective, but that there may be no added benefit to advanced pneumatic treatment of the truncal lymphatics prior to arm massage when the trunk is not also affected. Further research is indicated in a larger sample.

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Acknowledgment

The authors wish to thank the breast cancer survivors with lymphedema who participated in the study and to acknowledge Joey O’Dell for her assistance in preparation of this manuscript. This study was funded by a grant from Tactile Systems Technology, Inc.

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Authors and Affiliations

  1. Vanderbilt University School of Nursing, 461 21st Avenue South, Godchaux Hall, Nashville, TN, 37240, USA

    Sheila H. Ridner, Jie Deng, Nancy Kidd, Emily Galford, Candace Bonner, Stewart M. Bond & Mary S. Dietrich

  2. Division of Medical Oncology, Vanderbilt University School of Medicine, 777, Preston Research Building, Nashville, TN, 37232-6307, USA

    Barbara Murphy

  3. Vanderbilt-Ingram Cancer Center, 2220 Pierce Avenue, Nashville, TN, 37232, USA

    Barbara Murphy & Mary S. Dietrich

Authors
  1. Sheila H. Ridner
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  2. Barbara Murphy
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  3. Jie Deng
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  4. Nancy Kidd
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  5. Emily Galford
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  6. Candace Bonner
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  7. Stewart M. Bond
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  8. Mary S. Dietrich
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Correspondence to Sheila H. Ridner.

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Ridner, S.H., Murphy, B., Deng, J. et al. A randomized clinical trial comparing advanced pneumatic truncal, chest, and arm treatment to arm treatment only in self-care of arm lymphedema. Breast Cancer Res Treat 131, 147–158 (2012). https://doi.org/10.1007/s10549-011-1795-5

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  • DOI: https://doi.org/10.1007/s10549-011-1795-5

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