Yıldız Güvercin Ezgi, Eyigör Sibel, Çınar Ece, Tanıgör Göksel, Özgür İnbat Menekşe, Çalışkan Kabayel Sedef
Department of Physical Therapy and Rehabilitation, Tavşanlı State Hospital, Kütahya, Türkiye.
Department of Physical Medicine and Rehabilitation, Ege University Faculty of Medicine, İzmir, Türkiye.
Turk J Phys Med Rehabil. 2024 Oct 31;71(1):109-116. doi: 10.5606/tftrd.2024.14691. eCollection 2025 Mar.
The primary objective of this study was to assess and compare the response to the breast cancer-related lymphedema (BCRL) treatment with Breast Cancer-Related Lymphedema of the Upper Extremity (CLUE) scores, bioimpedance spectroscopy (BIS), and the volume-assessments /measurements. The secondary objective of the study was to investigate whether CLUE played a role in the treatment response and to examine its correlation with the other measures of lymphedema.
Between January 2019 and June 2019, a total of 40 patients (2 males, 38 females; mean age: 57.8±12.5 years; range, 45 to 70 years) who were diagnosed with unilateral Stage 2-3 BCRL and underwent treatment were included. The patients' upper extremity volumes were assessed and the patients were evaluated with the CLUE score, the Disabilities of the Arm, Shoulder, and Hand Outcome Measure (QuickDASH) score, BIS, and hand grip strength before and after the complete decongestive therapy.
Correlation analyses revealed that CLUE total score and BIS values were correlated with the reduction in the volumes (p=0.04 and p<0.001, respectively). The CLUE total score was also found to be positively correlated with the BIS values (p<0.001). Hand grip strength and QuickDASH scores were not found to be correlated with the changes in the volume and CLUE total scores.
The development of a structured clinical assessment such as CLUE provides clinicians for a standardized evaluation for BCRL. The diagnosis of subclinical lymphedema can be detected earlier by using the BIS and CLUE scale and lymphedema comorbidity and treatment costs can be reduced.
本研究的主要目的是使用上肢乳腺癌相关淋巴水肿（CLUE）评分、生物电阻抗光谱法（BIS）和体积评估/测量方法，评估并比较对乳腺癌相关淋巴水肿（BCRL）治疗的反应。本研究的次要目的是调查CLUE在治疗反应中是否起作用，并检验其与其他淋巴水肿测量指标的相关性。
2019年1月至2019年6月期间，共纳入40例诊断为单侧2-3期BCRL并接受治疗的患者（2例男性，38例女性；平均年龄：57.8±12.5岁；范围45至70岁）。在完全消肿治疗前后，评估患者的上肢体积，并使用CLUE评分、手臂、肩部和手部功能障碍结局测量（QuickDASH）评分、BIS和握力对患者进行评估。
相关性分析显示，CLUE总分和BIS值与体积减少相关（分别为p=0.04和p<0.001）。还发现CLUE总分与BIS值呈正相关（p<0.001）。未发现握力和QuickDASH评分与体积变化及CLUE总分相关。
CLUE等结构化临床评估的发展为临床医生提供了对BCRL进行标准化评估的方法。使用BIS和CLUE量表可更早检测到亚临床淋巴水肿，降低淋巴水肿合并症和治疗成本。
