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有/无压力的康复锻炼对乳腺癌相关淋巴水肿的急性影响

Acute Effects of Remedial Exercises with and without Compression on Breast-Cancer-Related Lymphedema.

作者信息

Gülören Gülbala, Doğan Yahya, Özgül Serap, Gürşen Ceren, Çinar Gamze Nalan, İpekten Funda, Akbayrak Türkan

机构信息

Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara 06100, Turkey.

Department of Biostatistics, Faculty of Medicine, Erciyes University, Kayseri 38039, Turkey.

出版信息

Healthcare (Basel). 2023 Nov 11;11(22):2949. doi: 10.3390/healthcare11222949.

Abstract

Remedial exercises are an important part of the treatment for lymphedema, but there is little evidence to support the acute effects of remedial exercises with or without compression. The aim of this study was to investigate whether and how daily (performed within 24 h) remedial exercises with and without compression bandaging acutely affect the severity of lymphedema and its symptoms in breast-cancer-related lymphedema (BCRL). In total, 34 patients with BCRL completed three sets of remedial exercises (within 24 h) with and without compression bandaging in a randomized order separated by a 3-day wash-out period. The severity of lymphedema and extracellular water ratio were assessed before and 24 h post exercise by using bilateral circumferential measurements and bioimpedance spectroscopy (in L-dex score), respectively, and the severity of self-reported symptoms (swelling, heaviness, and tightness) was assessed using a visual analogue scale. While there was no difference in all outcomes at 24 h post exercise without compression ( > 0.05), all outcomes decreased significantly compared to baseline at 24 h after the exercise with compression ( < 0.001). The remedial exercises performed in the absence of compression within 24 h do not acutely increase the lymphedema and symptoms in BCRL. These are important preliminary findings, which can be used to inform future prospective evaluation of the long-term effects of remedial exercise performed without compression.

摘要

康复训练是淋巴水肿治疗的重要组成部分,但几乎没有证据支持有或没有压力治疗的康复训练的急性效果。本研究的目的是调查每日(在24小时内进行)有或没有加压包扎的康复训练是否以及如何急性影响乳腺癌相关淋巴水肿(BCRL)的淋巴水肿严重程度及其症状。总共34例BCRL患者以随机顺序完成了三组有或没有加压包扎的康复训练(在24小时内),每组训练间隔3天的洗脱期。分别在训练前和训练后24小时通过双侧周径测量和生物电阻抗光谱法(以L-dex评分表示)评估淋巴水肿的严重程度和细胞外水比例,并使用视觉模拟量表评估自我报告症状(肿胀、沉重感和紧绷感)的严重程度。在没有压力治疗的训练后24小时,所有结果均无差异(>0.05),但在有压力治疗的训练后24小时,所有结果与基线相比均显著降低(<0.001)。在24小时内无压力治疗情况下进行的康复训练不会急性加重BCRL的淋巴水肿和症状。这些是重要的初步发现,可用于为未来对无压力治疗的康复训练长期效果的前瞻性评估提供参考。

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