Additional effects of the pneumatic compression treatment to the complete decongestive therapy on breast cancer treatment related lymphedema

Aim and Hypothesis: Contemporarily, accepted therapy in the treatment of lymphedema today is known as complete or complex decongestive therapy. There is not a certain opinion regarding pneumatic compression therapy on the treatment of lymphedema. The purpose of this study is to examine the effects of adding pneumatic compression therapy to complex / complete decongestive therapy on female patients who developed lymphedema after breast cancer treatment.Method: Among 42 patients, who applied to Dokuz Eylul University Physical Medicine and Rehabilitation Department Outpatient Clinic between February 2009 and January 2010, 15 patients, who satisfied the study criteria enrolled in the study. The patients were randomized into two groups. Decongestive therapy was performed to all patients during 20 sessions. In addition to the decongestive therapy one of these groups were treated with also pneumatic compression. The patients? shoulder range of motion and circumference and volume of both upper extremities are measured at the beginning of treatment, on the 10th and 20th days (end of treatment) and one month and three months after treatment. Arm edema of the patients was assessed by total difference of arm-hand circumference and arm-hand volume percentage difference.Results: Complete Decongestive Therapy (CDT) group (n = 8) and Complete Decongestive Therapy combining with intermittent pneumatic compression (CDT + IPC) group (n = 7) were similar in demographic characteristics and baseline data. Significant reduction has been realized on total difference of arm-hand circumference and arm-hand volume percentage difference on the 10th & 20th days and 1st & 3rd months versus the beginning of treatment. For all measurement times, there was no significant difference between two groups in terms of response to the treatment. Regardless of groups, significant increase have noted on shoulder range of motion on 10th, 20th days and 1st and 3rd months versus the beginning of treatment.Conclusion: In the treatment of breast cancer treatment related lymphedema in woman, complete decongestive therapy alone or with pneumatic compression therapy was found to be an effective method. Findings on adding intermittent pneumatic compression therapy to complete decongestive therapy provides no additional significant benefit. This may be related to the small number of patients, who participated in the study. Further studies are required with greater number of patients.Key words: Breast cancer, lymphedema, complete decongestive therapy, intermittent pneumatic compression