Arinaga Y, Sato F, Piller N, Kakamu T, Kikuchi K, Ohtake T, Sakuyama A, Yotsumoto F, Hori T, Sato N
Lymphology. 2016 Jun;49(2):93-106.
Patients with breast cancer-related lymphedema (BCRL) need a life-long self-care program that they can adhere to enable them to manage their lymphedema. The objective of this study was to assess the effectiveness of a holistic BCRL self-care program that patients could easily adhere to and comply with. A prospective, longitudinal, comparative study between affected arms and unaffected arms in unilateral breast cancer patients was implemented over a six-month period. Both the lymphedematous and unaffected arms of 23 patients with unilateral BCRL were followed and measured. The daily 10-minute holistic BCRL self-care program consisted of modified Japanese rajio taiso (Japanese radio calisthenics), a gentle arm exercise combined with deep breathing, skin moisturizing care using a traditional lymphatic drainage technique, and basic self-care education. Arm and edema volume, relative volume change, resistance of the skin to compression (fibrosis), lymphedema-related symptoms, skin condition, and self-care were assessed. At the end of six-months the volume of all limb segments and resistance of the tissues to compression at all measurement points of the affected arm were significantly reduced. On the unaffected side, only the volume of the forearm and the whole arm was significantly reduced and fibrosis significantly reduced only in the forearm. There was no significant difference in edema volume and relative volume change. Lymphedema-related symptoms significantly improved. Perceived adherence, effectiveness, burden, score and average time for self-care significantly increased. Our results demonstrate that this 10-minute self-care program may improve BCRL and its self-care.
患有乳腺癌相关淋巴水肿(BCRL)的患者需要一个他们能够坚持的终身自我护理计划,以使他们能够管理自己的淋巴水肿。本研究的目的是评估一种患者能够轻松坚持并遵守的整体BCRL自我护理计划的有效性。在六个月的时间里,对单侧乳腺癌患者的患侧手臂和未患侧手臂进行了一项前瞻性、纵向、对比研究。对23例单侧BCRL患者的淋巴水肿手臂和未受影响的手臂都进行了跟踪和测量。每日10分钟的整体BCRL自我护理计划包括改良的日本广播体操、一种结合深呼吸的轻柔手臂运动、使用传统淋巴引流技术的皮肤保湿护理以及基本的自我护理教育。评估了手臂和水肿体积、相对体积变化、皮肤对压迫的抵抗力(纤维化)、与淋巴水肿相关的症状、皮肤状况和自我护理情况。在六个月结束时,患侧手臂所有测量点的所有肢体节段的体积和组织对压迫的抵抗力均显著降低。在未受影响的一侧,只有前臂和整个手臂的体积显著减小,且仅在前臂纤维化显著减轻。水肿体积和相对体积变化没有显著差异。与淋巴水肿相关的症状显著改善。自我护理的感知依从性、有效性、负担、评分和平均时间显著增加。我们的结果表明,这个10分钟的自我护理计划可能会改善BCRL及其自我护理情况。