Assignment 3: Lymphedema Article
Brian Smith
Touro College DPT Class of 2020
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What problems did the researchers set out to study, and why?
Breast-cancer-related lymphedema (BCRL) is a common complication following mastectomies and lumpectomies. BCRL has no known treatment, however numerous interventions have been proposed to manage symptoms. Conventionally, patients would receive physical therapy, perform exercises, elevate involved extremities, wear compression garments and receive pneumatic pump therapy. Recently, Low-Level Laser Therapy (LLLT) has been proposed as a valuable method for treating BCRL. LLLT reduces the excess amount of fluid located in the involved area by increasing lymphatic flow. The researchers aimed to examine the efficacy of Low Level Laser Therapy as a treatment for Breast-Cancer-Related Lymphedema in addition to conventional physical therapy.

Who participated in this study?
This study included 17 women between the ages of 44-64 that were diagnosed with BCRL after undergoing breast cancer surgery. All of the subjects had tried at least one of the previously mentioned traditional forms of therapy, but not did not have much success with these treatment methods. LLLT was added to their existing treatment plans. Prior to beginning the treatment, the subjects varied between stages 1-2, and grades I-IV of lymphedema. They also varied in surgeries they had (modified radial mastectomy or lumpectomy with an axillary lymph node dissection) as well as which arm was affected by the lymphedema (dominant vs non-dominant limb).
What new information does this study offer?
This study exemplifies the benefit of Low-level laser therapy for treating breast-cancer related lymphedema, especially with use of 2 cycles to deliver the LLLT. The circumference of the affected limb decreased significantly after each cycle of LLLT for all of the patients. This decrease was more substantial in subjects who had early stage/low grade lymphedema. Nearly all of the subjects reported a reduction in pain with moving the affected limb following LLLT sessions as well. Additionally scar tissue mobility and shoulder range of motion was improved in the majority of subjects. Unfortunately, one subject did develop cellulitis during the LLLT.

What new information does this study offer for patients?
LLLT offers a relief of the symptoms that patients with BCRL may not receive from traditional therapies. This reduction in circumference of the affected limb as well as the improvement in perceived pain levels and improved range of motion could improve the function of these patients. LLLT can be effectively used in addition to the treatment modalities they are already receiving especially if the subjects have early stage/low grade lymphedema.

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