Ann Rehabil Med.  2013 Oct;37(5):683-689. 10.5535/arm.2013.37.5.683.

Ultrasonographic Evaluation of Therapeutic Effects of Complex Decongestive Therapy in Breast Cancer-Related Lymphedema

• Lee JH
• Shin BW
• Jeong HJ
• Kim GC
• Kim DK
• Sim YJ

• KMID: 2266586
• DOI: http://doi.org/10.5535/arm.2013.37.5.683

Abstract

OBJECTIVE
To evaluate the usefulness of ultrasonography as a follow-up tool for evaluating the effects of complex decongestive physiotherapy (CDPT) in breast cancer-related lymphedema (BCRL).
METHODS
Twenty patients with BCRL were enrolled in this study. All patients had undergone therapy in the CDPT program for 2 weeks. Soft tissue thickness of both the affected and unaffected upper limb was measured before and after CDPT. The measurements were taken at 3 points (the mid-point between the medial and lateral epicondyles at the elbow level, 10 cm proximal and 10 cm distal to the elbow) with and without pressure. We then calculated the compliance of soft tissue before and after CDPT. Circumferences of both the affected and unaffected upper limb were also measured before and after CDPT at the 3 defined points.
RESULTS
After 2 weeks of the CDPT program, the circumference and soft tissue thickness of the unaffected upper limb did not significantly change. In the affected upper limb, the circumference was significantly reduced in the 3 point, when compared with measurements taken prior to treatment. Additionally, soft tissue thickness was significantly reduced at the elbow and 10 cm proximal to the elbow. After CDPT, compliance at each of the 3 points had increased, but this trend was not significantly different.
CONCLUSION
Our results showed that arm circumference and ultrasonography-derived soft tissue thickness was useful as a way of assessing therapeutic effects of CDPT.

Keyword

Lymphedema; Ultrasonography; Complex decongestive physiotherapy

MeSH Terms

Arm
Breast*
Compliance
Elbow
Follow-Up Studies
Humans
Lymphedema*
Ultrasonography
Upper Extremity

Figure

• 

  Fig. 1 A photograph illustrating the measurement sites on a patient's upper limb. Mid-point of the wrist crease, the mid-point between the medial and lateral epicondyles at the level of the elbow, and the bicipital groove were marked. These three points were connected linearly, and the 3 measuring sites were marked: (A) the mid-point at the elbow (elbow), (B) above the mid-point at the elbow level (proximal), and (C) below the mid-point at the elbow level (distal).

• 

  Fig. 2 Ultrasonographic images measuring below the mid-point at the elbow level on both upper limbs. (A) Affected side without compression, (B) affected side with compression, (C) unaffected side without compression, and (D) unaffected side with compression.

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