Article

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.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS