• Journal of The Korean Society of Integrative Medicine
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• v.10 no.3
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• pp.73-84
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• 2022

Background : Lymphedema is a progressive disorder characterized by the impairment of lymph flow from tissues to the blood circulation system. This occurs as a result of damage to the lymphatic system. Complex decongestive therapy (CDT) is a multimodal, conservative therapeutic approach that is used for the management of lymphedema. CDT consists of a combination of compression therapy, manual lymphatic drainage, exercise, and skin care. Purpose : This study aimed to provide a review of available physical therapy interventions as well as general care guidelines for patients with lymphedema. Methods : The recommendations and guidelines for physical therapy management, medical management, and general information were reviewed from the following sources: 1) The American Physical Therapy Association, 2) The Norton School of Lymphatic Therapy, and 3) The International Society of Lymphology. This review contains general information, including the medical management and the importance of physical therapy in lymphedema. Physical therapy management should be based on an assessment of the patients' presenting impairments, including based on inclusion or exclusion of physical therapy interventions. This review also outlines a step-by-step approach that starts with disease diagnosis and progression all the way through to rehabilitation as an outpatient. Conclusion : Depending on the patients' journey to recovery and the requirement for rehabilitation, physical therapy interventions should focus on the patients' needs including pain, appearance, physical function and general rehabilitation. We hope that this review will provide information on evidence-based physical therapy and general care to patients with lymphedema.

• Physical Therapy Korea
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• v.30 no.4
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• pp.288-305
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• 2023

Background: The compression therapy, which is the standard treatment for lymphedema patients, may be difficult to implement and contraindicated to some patients depending on their health condition. Objects: The purpose of this study is to investigate whether kinesiology taping (KT) can be used effectively and safely in the management of lymphedema as an alternative treatment through systematic review and meta-analysis. Methods: In February 2023, the literature was systematically collected through eight search engines with a combination of terms, 'lymphedema' and 'kinesiology taping.' We qualitatively analyzed the differences and safety of KT methods, and quantitatively meta-analyzed the effects of volume reduction in edema, range of motion (ROM), and pain improvement using Review Manager ver. 5. 4. To assess the risk of bias in the randomized controlled trial (RCT) studies, Risk of Bias was used. Results: A total of 616 articles searched and 20 studies were selected, including 12 RCTs and eight case studies. KT intervention could not replace multilayer compression bandage (MLB), but it demonstrated similar or better results compared to compression garment (CG), with reduced pain and improved intervention comfort. Studies reported skin adverse events ranging from 2.5% to 20.68%, with a total adverse event incidence of 7.7%. There was no significant difference in the application method of KT. As a result of the meta-analysis from the 8 RCTs, the KT intervention showed a mean difference (MD) of -7.18 with a 95% confidence interval (CI) [-12.64 to -1.72] in the volume change of lymphedema, while the pain difference was MD 0.82 with CI 95% [0.50 to 1.15], in comparison to the MLB and CG intervention. Conclusion: KT therapy led to a reduction in edema size, volume, pain, and improved ROM and quality of life. KT may be a viable option for lymphedema patients who have trouble applying traditional compression therapies.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.156-162
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• 2005

Purpose: Lymphedema is edema developing mainly in the arms and legs due to an abnormal lymphatic system, over one hundred millions of patient worldwide suffer from it. At present, prevention is the best treatment. Thus, It is important to know which patient are more pone to develop it in order to prevent it. By evaluating the risk factor for lymphedema, we intended to find the effective prevention. Methods: We have investigated that outpatients who chiefly complained of lymphedema visited the lymphedema clinic at one university hospital from September 1 in 2003 to August 31 in 2005. We evaluated the risk factor for lymphedema by questionnaires. Questionnaire consists of demographic data, disease factor, treatment factor, posttreatment factor. We evaluated the correlation between lymphedema with each factor. Results: The total number of patients was 50, 19 patients with breast cancer and 31 patients with cervical cancer. In terms of stages of edema, 12 patients were below stage 1 and 38 patients were above stage 2. The incidence of lymphangitis was more frequent, more obese and the impairment of the site of edema site more severe, the stage of cancer was higher in the patients higher than stage 2 than in the patients below stage 1 (P>0.05). Conclusion: Lymphedema is more severe when the cancer stage in higher, accompanying more frequent infections, more obesity and more impairment at the site of edema site. Above all, cancer stage and the impairment of edema site are impossible to correct but obesity and infection may be corrected. Therefore we speculate that we are able to protect the aggravation of edema by weight reduction and infection control.

• Journal of Pharmacopuncture
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• v.12 no.4
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• pp.119-126
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• 2009

Purpose: In order to estimate clinical effects of acupotomy and venesection in a patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery. Methods: From 17th August, 2009 to 29th August 2009, 1 female patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery was treated with general oriental medicine therapy(acupuncture, moxibustion, cupping, physical therapy, herbal medication) and acupotomy with venesection. Results: The patient's chief complaints- Lt hand numbness, Lt arm edema, Lt. wrist flexion limitation - were notably improved. Conclusions : This study demonstrates that oriental medical treatment with acupotomy and venesection therapy has significant effect in improving symptoms of peripheral neuropathy and upper limb lymphedema following breast cancer surgery, as though we had not wide experience in this treatment, more research is needed.

• The Journal of Internal Korean Medicine
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• v.34 no.3
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• pp.322-328
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• 2013

Objectives : The purpose of this study was to report two cases which suggest Oryeongsan as a pharmacological treatement option for cancer-induced secondary lymphedema. Methods : The cases were two female patients with peripheral edema. The first was diagnosed with cervical cancer with paraaortic lymph node metastasis and suffered from bilateral edema of the lower extremities. The second was a breast cancer patient with right arm lymphedema, which was aggravated after a weekly regimen of chemotherapy. Oryeongsan was orally administered for 3-4 days to both patients. Results : The symptoms in lower extremities and body weight of the cervical cancer patient decreased. The breast cancer patient did not lose body weight, but pain in upper extremities was reduced. Conclusions : Oryeongsan may potentially be an option for secondary lymphedemas, including cancer-induced lymphedema.

• The Korean Journal of Pain
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• v.28 no.1
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• pp.61-63
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• 2015

Lymphedema of the upper limb after breast cancer surgery is a disease that carries a life-long risk and is difficult to cure once it occurs despite the various treatments which have been developed. Two patients were referred from general surgery department for intractable lymphedema. They were treated with stellate ganglion blocks (SGBs), and the circumferences of the mid-point of their each upper and lower arms were measured on every visit to the pain clinic. A decrease of the circumference in each patient was observed starting after the second injection. A series of blocks were established to maintain a prolonged effect. Both patients were satisfied with less swelling and pain. This case demonstrates the benefits of an SGB for intractable upper limb lymphedema.

• Physical Therapy Korea
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• v.14 no.3
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• pp.1-8
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• 2007

The purpose of this study was to determine whether aromatherapy massages with manual lymph drainage (MLD) are significantly more effective than sham massages with MLD in reducing edematous limb volume in lymphedema. This study was performed on 46 patients who had developed unilateral upper or lower lymphedema. Twenty-three patients served as the experimental group and were treated with complex decongestive physiotherapy (CDP) applications including aroma massages with MLD, multi layered compression bandages, remedial exercises and skin care. Twenty-three patients in the control group were treated with CDP applications including sham massages with MLD, bandages, exercises and skin care. Patients undergo a therapy program once a day; 5 days a week for 2 weeks. Percentage excess volume (PEV) and body mass index (BMI) were recorded before and after treatment. PEV and BMI were significantly decreased before and after treatment in the experimental as well as in the control groups (p<.05). However, the percentage excess volume and BMI were not significantly improved after treatment between the two groups (p>.05). This study there suggests that aroma massages is not effective in the edema of patients with lymphedema.

• Archives of Plastic Surgery
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• v.45 no.3
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• pp.275-279
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• 2018

Chronic lymphedema is caused by an impairment of the lymphatic system due to primary or secondary causes. Vascularized lymph node transplantation (VLNT) is currently the most promising and frequently used technique besides lymphaticovenous anastomosis. However, the vessel anatomy in the lateral thoracic region is sometimes quite variable. Based on our experiences with vascular anatomical inconstancy in the lateral thoracic region, we planned a lateral intercostal artery perforator flap for VLNT in a female patient with chronic stage II lymphedema of both legs after cervical cancer treatment. After surgery, the patient reported significant improvement in limb volume and the accompanying symptoms. The limb circumference was reduced by an average of 19.2% at 6 months postoperatively. Despite having a short pedicle and small vessel caliber, the lateral intercostal artery perforator flap can safely be used for VLNT in lymphedema patients with anatomical variants.

• Medical Lasers
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• v.10 no.4
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• pp.189-194
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• 2021

Breast cancer-related lymphedema (BCRL) is characterized by the persistent accumulation of interstitial fluid in the peripheral tissues after treatment for breast cancer. Photobiomodulation (PBM) therapy is widely used as supportive care for patients with BCRL. A search was performed in the PubMed database to find relevant articles published over the last 20 years. Randomized controlled trials that evaluated the efficacy of PBM therapy on BCRL were included. A total of 24 studies were identified through the PubMed database. Seven studies were used for the final analysis, after excluding items that did not meet the duplication and inclusion criteria. Although PBM showed some improvement in reducing arm circumference and the symptoms related to BCRL, the results of the meta-analysis did not show any significant benefit in alleviating lymphedema. Further studies are needed with the recruitment of more participants to evaluate the long-term efficacy and safety of PBM in the management of BCRL.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.899-902
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• 2011

Purpose: Lymphedema of the scrotum and penis is a functionally and emotionally incapacitating problem for patients. Patients suffer pain from swelling, chronic irritation, repeated infections, drainage, and sexual dysfunction. Although there are various methods for the treatment of scrotal and penial lymphedema, achieving a satisfactory reconstruction in severe cases still remains a challenge due to the lack of locally available tissue. Methods: A 33-year-old man sustained severe lymphedema of the scrotum and penis. He reported a history of swelling since 25 years, which had been intensified during the past few months. There was no history of irritation, surgery, trauma, infection or travel to endemic countries. The authors reconstructed the scrotum and penis using 4 scrotal flaps made by incising the enlarged scrotum crucially. Results: The postoperative course was uneventful. Histopathologic examination showed nonspecific chronic inflammation. The patient was followed up for 18 months and a good reconstructive result was obtained with no recurrence. Conclusion: The authors' method is safe and easy to perform. This method may be a convenient and reliable alternative for the treatment of severe lymphedema of the scrotum and penis.