Lasinski BB, McKillip Thrift K, Squire D, Austin MK, Smith KM, Wanchai A, Green JM, Stewart BR, Cormier JN, Armer JM, et al.
PM & R : the journal of injury, function, and rehabilitation. Date of publication 2012 Aug 1;volume 4(8):580-601.
1. PM R. 2012 Aug;4(8):580-601. doi: 10.1016/j.pmrj.2012.05.003.
A systematic review of the evidence for complete decongestive therapy in the
treatment of lymphedema from 2004 to 2011.
Lasinski BB(1), McKillip Thrift K, Squire D, Austin MK, Smith KM, Wanchai A,
Green JM, Stewart BR, Cormier JN, Armer JM.
Author information:
(1)Lymphedema Therapy and The Boris-Lasinski School, Woodbury, NY(⁎).
OBJECTIVE: To critically analyze the contemporary published research that
pertains to the individual components of complete decongestive therapy (CDT), as
well as CDT as a bundled intervention in the treatment of lymphedema.
DATA SOURCES: Publications were retrieved from 11 major medical indices for
articles published from 2004-2010 by using search terms for lymphedema and
management approaches. Literature archives of the authors and reference lists
were examined through 2011.
STUDY SELECTION: A research librarian assisted with initial literature searches
by using search terms used in the Best Practice for the Management of
Lymphoedema, plus expanded terms, for literature related to lymphedema. Authors
sorted relevant literature for inclusion and exclusion; included articles were
sorted into topical areas for data extraction and assessment of level of evidence
by using a published grading system and consensus process. The authors reviewed
99 articles, of which 26 met inclusion criteria for individual studies and 1 case
study did not meet strict inclusion criteria. In addition, 14 review articles and
2 consensus articles were reviewed.
DATA EXTRACTION: Information on study design and/or objectives, participants,
outcomes, intervention, results, and study strengths and weaknesses was extracted
from each article. Study evidence was categorized according to the Oncology
Nursing Society Putting Evidence into Practice level of evidence guidelines after
achieving consensus among authors.
DATA SYNTHESIS: Levels of evidence were only moderately strong, because there
were few randomized controlled trials with control groups, well-controlled
interventions, and precise measurements of volume, mobility and/or function, and
quality of life. Treatment interventions were often bundled, which makes it
difficult to determine the contribution of each individual component of treatment
to the outcomes achieved.
CONCLUSIONS: CDT is seen to be effective in reducing lymphedema. This review
focuses on original research about CDT as a bundled intervention and 2 individual
components, manual lymph drainage and compression bandages. Additional studies
are needed to determine the value and efficacy of the other individual components
of CDT.
Copyright © 2012 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.
DOI: 10.1016/j.pmrj.2012.05.003
PMID: 22920313 [Indexed for MEDLINE]
