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Manual lymphatic drainage treatment for lymphedema: a systematic review of the literature

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Abstract

Purpose

Manual lymphatic drainage (MLD) massage is widely accepted as a conservative treatment for lymphedema. This systematic review aims to examine the methodologies used in recent research and evaluate the effectiveness of MLD for those at-risk of or living with lymphedema.

Methods

The electronic databases Embase, PubMed, CINAHL Complete and Cochrane Central Register of Controlled Trials were searched using relevant terms. Studies comparing MLD with another intervention or control in patients at-risk of or with lymphedema were included. Studies were critically appraised with the PEDro scale.

Results

Seventeen studies with a total of 867 female and two male participants were included. Only studies examining breast cancer-related lymphedema were identified. Some studies reported positive effects of MLD on volume reduction, quality of life and symptom-related outcomes compared with other treatments, while other studies reported no additional benefit of MLD as a component of complex decongestive therapy. In patients at-risk, MLD was reported to reduce incidence of lymphedema in some studies, while others reported no such benefits.

Conclusions

The reviewed articles reported conflicting findings and were often limited by methodological issues. This review highlights the need for further experimental studies on the effectiveness of MLD in lymphedema.

Implications for Cancer Survivors

There is some evidence that MLD in early stages following breast cancer surgery may help prevent progression to clinical lymphedema. MLD may also provide additional benefits in volume reduction for mild lymphedema. However, in moderate to severe lymphedema, MLD may not provide additional benefit when combined with complex decongestive therapy.

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Data availability

All data generated for this review are included in the manuscript and/or the supplementary files.

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Authors and Affiliations

  1. Australian Lymphoedema Education, Research & Treatment (ALERT) Program, Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 1, 75 Talavera Road, Sydney, NSW, 2109, Australia

    Belinda Thompson, Katrina Gaitatzis, Robbie Blackwell & Louise A. Koelmeyer

  2. School of Environmental & Life Sciences, Faculty of Science, The University of Newcastle, Ourimbah, NSW, Australia

    Xanne Janse de Jonge

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  1. Belinda Thompson
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  2. Katrina Gaitatzis
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  3. Xanne Janse de Jonge
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  4. Robbie Blackwell
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  5. Louise A. Koelmeyer
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Contributions

All authors contributed to the conception and design of the systematic review. The literature search, data extraction and data synthesis were performed by Belinda Thompson and Katrina Gaitatzis. The first draft of the manuscript was written by Belinda Thompson, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Belinda Thompson.

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Thompson, B., Gaitatzis, K., Janse de Jonge, X. et al. Manual lymphatic drainage treatment for lymphedema: a systematic review of the literature. J Cancer Surviv 15, 244–258 (2021). https://doi.org/10.1007/s11764-020-00928-1

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