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综合消肿治疗对乳腺癌相关淋巴水肿患者手部动觉、上肢功能及生活质量的影响。

The effects of complex decongestive therapy on kinesthetic sense of hands, upper extremity function, and quality of life in patients with breast cancer-related lymphedema.

作者信息

Yeşil Hilal, Eyigör Sibel, İnbat Menekşe, Bulut Ferah

机构信息

Department of Physical Medicine and Rehabilitation, Afyon Kocatepe University, Faculty of Medicine, Afyonkarahisar, Turkey.

Department of Physical Medicine and Rehabilitation, Ege University, Faculty of Medicine, Izmir, Turkey.

出版信息

Turk J Phys Med Rehabil. 2021 May 25;67(2):211-217. doi: 10.5606/tftrd.2021.5191. eCollection 2021 Jun.

Abstract

OBJECTIVES

This study aims to investigate the effect of complex decongestive therapy (CDT) on the kinesthetic sense of hands, upper extremity function, and the quality of life in patients with breast cancer-related lymphedema (BCRL).

PATIENTS AND METHODS

Between August 2018 and August 2019, total of 50 women with BCRL (mean age: 56.5±9.6 years; range, 36 to 71 years) were included in the study. Kinesthetic sense of the hand, upper extremity function (Disabilities of the Arm, Shoulder and Hand [DASH]), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire [EORTC QLQ-C30]), and arm volume of all patients were evaluated before and after the treatment. All patients received CDT for 20 sessions for 1 h over a total of four weeks.

RESULTS

A statistically significant decrease in the volume of the involved extremity was observed after the treatment (p<0.001). There was a significant decrease in the symptom score (p<0.001) and a significant improvement in the general health status and functional scales of the EORTC QLQ-C30 (p<0.001 and p=0.012, respectively). The DASH scores and visual and kinesthetic sense scores of the patients significantly improved after the treatment (p=0.016, p=0.008, and p<0.001, respectively).

CONCLUSION

Our study results show that BCRL is a serious complication which may lead to impairment in the kinesthetic sense of hand and upper extremity function with the increased arm volume. The CDT is an effective and safe method not only to achieve significant volume reduction in the extremities, but also to achieve favorable results in managing these problems.

摘要

目的

本研究旨在探讨综合消肿治疗(CDT)对乳腺癌相关淋巴水肿(BCRL)患者手部本体感觉、上肢功能及生活质量的影响。

患者与方法

2018年8月至2019年8月,共有50例BCRL女性患者(平均年龄:56.5±9.6岁;范围36至71岁)纳入本研究。在治疗前后对所有患者的手部本体感觉、上肢功能(手臂、肩部和手部功能障碍量表[DASH])、生活质量(欧洲癌症研究与治疗组织生活质量核心问卷[EORTC QLQ-C30])及手臂体积进行评估。所有患者接受为期四周、共20次、每次1小时的CDT治疗。

结果

治疗后受累肢体体积有统计学意义的下降(p<0.001)。症状评分显著下降(p<0.001),EORTC QLQ-C30的总体健康状况和功能量表有显著改善(分别为p<0.001和p=0.012)。治疗后患者的DASH评分、视觉和本体感觉评分显著改善(分别为p=0.016、p=0.008和p<0.001)。

结论

我们的研究结果表明,BCRL是一种严重并发症,可能导致手部本体感觉和上肢功能受损以及手臂体积增加。CDT不仅是一种有效且安全的方法,可使肢体体积显著减小,而且在处理这些问题方面也能取得良好效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33ac/8343150/8174cb55544e/TJPMR-2021-67-2-211-217-F1.jpg

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