Article

OBJECTIVE: To compare the efficacy of low-frequency low-intensity electrotherapy
and manual lymphatic drainage in the treatment of chronic upper limb breast
cancer-related lymphoedema. DESIGN: Cross-over single-blind random clinical
trial. SETTING: Rehabilitation service. PARTICIPANTS:
Thirty-six women with
chronic upper limb breast cancer-related lymphoedema. METHODS: Patients were
randomized to undergo 10 sessions of manual lymphatic drainage followed by 10
sessions of low-frequency low-intensity electrotherapy or to undergo first
low-frequency low-intensity electrotherapy followed by manual lymphatic drainage.
There was a month of washout time between treatments.
Each patient was examined
just before and after each treatment. Researchers and outcome assessors were
blinded for assigned treatment. MEASURES: Outcomes were lymphoedema volume, pain,
heaviness and tightness, and health-related quality of life measured with the
Functional Assessment of Cancer Therapy Questionnaire for Breast Cancer version 4
(FACT-B+4). Carry-over, period and treatment effects were analysed. Treatment
effect was assessed using paired t-test. RESULTS:
Thirty patients finalized
treatment. Comparing the changes in low-frequency low-intensity electrotherapy
with manual lymphatic drainage changes, there were no significant differences.
Low-frequency low-intensity electrotherapy did not reduce lymphoedema volume
(mean of change = 19.77 mL,
P = 0.36), but significant reductions were observed
in pain, heaviness and tightness (mean of change = 13.1, 16.2 and 6.4 mm,
respectively), and FACT-B+4 summaries improved significantly (Trial Outcome Index
mean of change = 5.4, P = 0.015). Manual lymphatic drainage showed no significant
changes in any of the outcomes CONCLUSION: Although there are no significant
differences between treatment changes, the observed trend towards a better
health-related quality of life is remarkable in low-frequency low-intensity electrotherapy.

Langue : ANGLAIS