A randomized controlled trial comparing two types of pneumatic compression for breast cancer-related lymphedema treatment in the home

• Published in: Supportive care in cancer 2012-12, Vol.20 (12), p.3279-3286
• Main Authors: Fife, Caroline E., Davey, Suzanne, Maus, Erik A., Guilliod, Renie, Mayrovitz, Harvey N.
• Format: Article
• Language: English
• Subjects: Aged; Arm - pathology; Breast cancer; Breast Neoplasms - complications; Cancer; Care and treatment; Clinical trials; Compression Bandages; Compression therapy; Drug therapy; Electric properties; Female; Health aspects; Humans; Intermittent Pneumatic Compression Devices - statistics & numerical data; Lymphatic system; Lymphedema; Lymphedema - etiology; Lymphedema - therapy; Medical equipment; Medicine; Medicine & Public Health; Middle Aged; Musculoskeletal Manipulations - methods; Nursing; Nursing Research; Oncology; Original; Original Article; Pain Medicine; Prospective Studies; Rehabilitation Medicine; Self Care - methods; Toy industry; Treatment Outcome
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-012-1455-2

Purpose Pneumatic compression devices (PCDs) are used in the home setting as adjunctive treatment for lymphedema after acute treatment in a clinical setting. PCDs range in complexity from simple to technologically advanced. The objective of this prospective, randomized study was to determine whether an advanced PCD (APCD) provides better outcomes as measured by arm edema and tissue water reductions compared to a standard PCD (SPCD) in patients with arm lymphedema after breast cancer treatment. Methods Subjects were randomized to an APCD (Flexitouch system, HCPCS E0652) or SPCD (Bio Compression 2004, HCPCS E0651) used for home treatment 1 h/day for 12 weeks. Pressure settings were 30 mmHg for the SPCD and upper extremity treatment program (UE01) with standard pressure for the APCD. Thirty-six subjects (18 per group) with unilateral upper extremity lymphedema with at least 5% arm edema volume at the time of enrollment, completed treatments over the 12-week period. Arm volumes were determined from arm girth measurements and suitable model calculations, and tissue water was determined based on measurements of the arm tissue dielectric constant (TDC). Results The APCD-treated group experienced an average of 29% reduction in edema compared to a 16% increase in the SPCD group. Mean changes in TDC values were a 5.8% reduction for the APCD group and a 1.9% increase for the SPCD group. Conclusion This study suggests that for the home maintenance phase of treatment of arm lymphedema secondary to breast cancer therapy, the adjuvant treatment with an APCD provides better outcomes than with a SPCD.