Ann Rehabil Med.  2013 Apr;37(2):229-234. 10.5535/arm.2013.37.2.229.

Clinical Outcomes of Extracorporeal Shock Wave Therapy in Patients With Secondary Lymphedema: A Pilot Study

• Bae H
• Kim HJ

• KMID: 2165775
• DOI: http://doi.org/10.5535/arm.2013.37.2.229

Abstract

OBJECTIVE
To investigate the clinical effect of extracorporeal shock wave therapy (ESWT) in patients with secondary lymphedema after breast cancer treatment.
METHODS
In a prospective clinical trial, ESWT was performed consecutively 4 times over two weeks in 7 patients who were diagnosed with stage 3 secondary lymphedema after breast cancer treatment. Each patient was treated with four sessions of ESWT (0.056-0.068 mJ/mm2, 2,000 impulses). The parameters were the circumference of the arm, thickness of the skin and volume of the arm. We measured these parameters with baseline values before ESWT and repeated the evaluation after each ESWT treatment. Subjective data on skin thickness, edema and sensory impairment were obtained using a visual analogue scale (VAS).
RESULTS
The mean volume of the affected arm after four consecutive ESWT was significantly reduced from 2,332 to 2,144 mL (p<0.05). The circumference and thickness of the skin fold of the affected arm were significantly decreased after the fourth ESWT (p<0.05). The three VAS scores were significantly improved after the fourth ESWT. Almost all patients were satisfied with this treatment and felt softer texture in their affected arm after treatment.
CONCLUSION
ESWT is an effective modality in the treatment of stage 3 lymphedema after breast cancer treatment. ESWT reduced the circumference and the thickness of arms with lymphedema and satisfied almost all patients with lymphedema. Therefore, this treatment provides clinically favorable outcome to patients with breast cancer-related lymphedema.

Keyword

Lymphedema; Breast neoplasms; High-energy shock waves; Physiotherapy

MeSH Terms

Arm
Breast
Breast Neoplasms
Edema
High-Energy Shock Waves
Humans
Lymphedema
Pilot Projects
Prospective Studies
Shock
Skin

Figure

• 

  Fig. 1 The volume of the affected upper extremity after four consecutive extracorporeal shock wave therapy (ESWT) was reduced significantly (p<0.05). After ESWT, the mean of volume drop was 37.23%.

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  Fig. 2 Circumference and thickness of the skin fold of the affected upper extremity were significantly decreased after four extracorporeal shock wave therapy (p<0.05). All the circumferences and skin folds below the axilla, above elbow, below elbow, and above the wrist were significantly reduced.

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  Fig. 3 Visual analogue scales (VASs) of skin hardness, edema, and sensory loss were significantly improved after the fourth extracorporeal shock wave therapy (p<0.05).

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