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Cebicci MA, Sutbeyaz ST, Goksu SS, Hocaoglu S, Oguz A, Atilabey A, et al.
Archives of physical medicine and rehabilitation. Date of publication 2016 Sep 1;volume 97(9):1520-1525.
1. Arch Phys Med Rehabil. 2016 Sep;97(9):1520-1525. doi: 10.1016/j.apmr.2016.02.019. Epub 2016 Mar 15. Extracorporeal Shock Wave Therapy for Breast Cancer-Related Lymphedema: A Pilot Study. Cebicci MA(1), Sutbeyaz ST(2), Goksu SS(3), Hocaoglu S(2), Oguz A(3), Atilabey A(2). Author information: (1)Department of Physical Therapy and Rehabilitation, Kayseri Training and Research Hospital, Kayseri, Turkey. Electronic address: maykaccebicci@gmail.com. (2)Department of Physical Therapy and Rehabilitation, Kayseri Training and Research Hospital, Kayseri, Turkey. (3)Department of Medical Oncology, Kayseri Training and Research Hospital, Kayseri, Turkey. OBJECTIVE: To investigate the clinical effect of extracorporeal shock wave therapy (ESWT) in patients with secondary lymphedema after breast cancer treatment. DESIGN: Prospective clinical pilot study. SETTING: Education and research hospital. PARTICIPANTS: Women with a diagnosis of lymphedema secondary to breast cancer (N=11). INTERVENTIONS: Patients were treated for 12 sessions of ESWT with 2500 impulses each. The treatment frequency was 4Hz in multiple shock mode. The energy flow density during treatment was equal to a working pressure of 2 bar. MAIN OUTCOME MEASURES: The primary outcome measure was volumetric measurements. The secondary outcome measures were the short version of the Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH) and the brief version of the World Health Organization Quality of Life (WHOQOL-BREF). Assessments were conducted by the same investigator at baseline, posttreatment, and at 1, 3, and 6 months after treatment for all patients. RESULTS: Significant reduction was found in the amount of lymphedema with ESWT treatment in all patients, and this reduction was maintained for 6 months. A statistically significant reduction was observed in volumetric measurements for the follow-up period (P=.001). The mean volume displacement of the affected upper extremity before treatment was 870.45±384.19mL at 6 months, and after the treatment it was 604.54±381.74mL. In addition, improvements were observed in the QuickDASH functional assessment tool and in the physical health domain of the WHOQOL-BREF questionnaire (P=.002 and P=.007, respectively). CONCLUSIONS: ESWT was shown to provide a reduction in the amount of lymphedema in patients with lymphedema secondary to breast cancer. Also, a marked improvement was observed in the functional status and quality of life of study patients. Treatment efficacy was maintained in the long term. As a noninvasive, novel, and effective method, ESWT is a promising treatment modality for the treatment of lymphedema, which is a chronic, progressive, and refractory condition. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.apmr.2016.02.019 PMID: 26987620 [Indexed for MEDLINE]
Appears in following Topics:
Lymphedema - Introduction and Assessment
Lymphedema - Treatment and Emerging Strategies for Prevention