Ann Rehabil Med.  2015 Jun;39(3):347-359. 10.5535/arm.2015.39.3.347.

Limb Differences in the Therapeutic Effects of Complex Decongestive Therapy on Edema, Quality of Life, and Satisfaction in Lymphedema Patients

• Noh S
• Hwang JH
• Yoon TH
• Chang HJ
• Chu IH
• Kim JH

• KMID: 2165637
• DOI: http://doi.org/10.5535/arm.2015.39.3.347

Abstract

OBJECTIVE
To investigate the changing patterns of edema, quality of life (QOL), and patient-satisfaction after complex decongestive therapy (CDT) in three trajectories: arm lymphedema (AL), secondary leg lymphedema (LL) and primary leg lymphedema (PL).
METHODS
Candidates for AL (n=35), LL (n=35) and PL (n=14) were identified from prospective databases. The patients were treated with CDT for 2 weeks, and lymphedema volume was measured before and immediately following the therapy. Patients then self-administered home therapy for 3 months and presented for a follow-up visit. The Korean version of Short Form-36 (SF-36) was used to assess QOL, and we administered a study-specific satisfaction survey.
RESULTS
There was no significant difference in the volume reductions between the 3 groups. There were no significant differences in all of the measures between PL and LL. Overall initial QOL was significantly lower in patients with LL than in patients with AL. SF-36 scores post-CDT did not differ significantly between AL and LL. Clinically significant differences were noted between AL and LL in the mean values of the satisfaction survey.
CONCLUSION
AL, LL, and PL may have different longitudinal courses. We suggest that lower extremity lymphedema patients present more favorable outcomes after CDT with respect to QOL and satisfaction than upper extremity lymphedema patients. Clinicians should approach patients with different therapeutic considerations specific to each type or region of lymphedema before using CDT in clinical practice.

Keyword

Lymphedema; Therapy; Quality of life; Personal satisfaction

MeSH Terms

Arm
Edema*
Extremities*
Follow-Up Studies
Humans
Leg
Lower Extremity
Lymphedema*
Personal Satisfaction
Prospective Studies
Quality of Life*
Upper Extremity

Figure

• 

  Fig. 1 Recruitment and retention of patients with lymphedema. CDT, complex decongestive therapy.

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  Fig. 2 Changes in quality of life, based on the Short Form-36, in patients with lymphedema who underwent complex decongestive therapy (CDT). (A) Average SF-36 score, (B) physical component summary, and (C) mental component summary. *p<0.05, **p<0.01, ***p<0.001, a)p-values were derived from independent t-tests, b)p-values were derived from repeated measured ANOVAs for the effect of time for the within subject factor (3 levels: pre-CDT, post-CDT, and 12 weeks after post-CDT), c)p-values were derived from repeated measured ANOVAs for the effect of time for the between subjects factor (2 levels: AL and LL, PL and LL).

• 

  Fig. 3 Satisfaction with complex decongestive therapy in patients with lymphedema, based on the study-specific satisfaction survey. **p<0.01, ***p<0.001, p-values were derived from independent t-tests.

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  Fig. 4 Changes in limb volume in patients with lymphedema, based on complex decongestive therapy (CDT). PCEV, percent excess volume. ***p<0.001, a)p-values were derived from paired t-tests.

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