Xing Naifang, Liu Daiqing, Chen Lufeng, Wang Guorong, Tian Yuan, Yang Chen, Leng Yingjie, Jiang Xin, Li Chengxiang, Xie Ruonan, Nie Zhuomiao, Zhang Tian
School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China.
Breast Cancer Res Treat. 2025 Feb;210(1):95-103. doi: 10.1007/s10549-024-07540-2. Epub 2024 Nov 4.
To quantify the pressure levels necessary for effective Manual Lymphatic Drainage (MLD) in managing Breast Cancer-Related Lymphedema (BCRL) across various stages, and to contribute to the development of standardized protocols for MLD therapy.
The study included 42 patients with BCRL (Stages I-III) and 14 certified lymphedema therapists. Forearms and upper arm circumferences were measured pre and post a 21-day MLD intervention. A tactile sensor system recorded the applied pressure during treatment. The data were preprocessed and statistically analyzed to assess pressure patterns and their stage-specific impacts on lymphedema.
The mean age of the patients was 52.4 years, and that of the therapists was 39.1 years. A statistically significant reduction in arm circumference was observed post-MLD treatment (P < 0.05). The pressure applied varied across stages: I 16.5-20.1 mmHg, I 16.1-20.7 mmHg; II 16.6-19.8 mmHg, II 19.7-23.8 mmHg; III 29.3-34.3 mmHg, III 29.7-34.3 mmHg. No statistically significant difference was found between forearm and upper arm treatment pressures within Stages I (P = 0.283) and III (P = 0.08), while Stage II exhibited a significant difference (P < 0.001). Across the same treatment area, pressures for Stages I and II in the forearm were significantly lower than those in Stage III (P < 0.001). The treatment pressure differences between forearm stages I and II were not statistically significant (P > 0.05). Differences in upper arm treatment pressures across Stages I, II, and III were also statistically significant (P < 0.001).
The study provides quantitative evidence on the pressure ranges needed for MLD across different stages of BCRL. It highlights the importance for stage-specific pressure adjustments to optimize treatment outcomes. These findings contribute to the existing body of knowledge on MLD and offer valuable data that could inform the development of rehabilitation technologies, including intelligent robots and visualization systems, as well as enhance therapist training programs.
量化在不同阶段管理乳腺癌相关淋巴水肿（BCRL）时有效进行手动淋巴引流（MLD）所需的压力水平，并为MLD治疗标准化方案的制定做出贡献。
该研究纳入了42例BCRL患者（I - III期）和14名认证淋巴水肿治疗师。在为期21天的MLD干预前后测量前臂和上臂周长。触觉传感器系统记录治疗期间施加的压力。对数据进行预处理和统计分析，以评估压力模式及其对淋巴水肿的阶段特异性影响。
患者的平均年龄为52.4岁，治疗师的平均年龄为39.1岁。MLD治疗后观察到手臂周长有统计学意义的减小（P < 0.05）。不同阶段施加的压力有所不同：I期16.5 - 20.1 mmHg，I期16.1 - 20.7 mmHg；II期16.6 - 19.8 mmHg，II期19.7 - 23.8 mmHg；III期29.3 - 34.3 mmHg，III期29.7 - 34.3 mmHg。在I期（P = 0.283）和III期（P = 0.08），前臂和上臂治疗压力之间未发现统计学显著差异，而II期表现出显著差异（P < 0.001）。在相同治疗区域，前臂I期和II期的压力显著低于III期（P < 0.001）。前臂I期和II期之间的治疗压力差异无统计学意义（P > 0.05）。上臂I、II、III期治疗压力的差异也具有统计学意义（P < 0.001）。
该研究提供了关于BCRL不同阶段MLD所需压力范围的定量证据。它强调了针对特定阶段进行压力调整以优化治疗效果的重要性。这些发现为现有的MLD知识体系做出了贡献，并提供了有价值的数据，可为康复技术的发展提供参考，包括智能机器人和可视化系统，以及加强治疗师培训项目。
