Effect of Physiotherapy in the Prevention and Relief of Secondary Lymphoedema in Subjects with Postoperative Breast Cancer- A Systematic Review of Randomised Controlled Trials
Effect of Physiotherapy in the Prevention and Relief of Secondary Lymphoedema in Subjects with Postoperative Breast Cancer- A Systematic Review of Randomised Controlled Trials
复制标题
物理治疗在预防和缓解乳腺癌术后继发性淋巴水肿中的效果 - 随机对照试验的系统评价
DOI：
10.7860/jcdr/2021/45745.14815
复制
发表时间：
2021
影响因子：
0.2
通讯作者：
Kundan Kumar
中科院分区：
文献类型：
--
作者：
M. Naik;Priyanka Nayak;Kundan Kumar
乳腺癌是女性最常见的癌症类型，也是第二大死亡原因。乳腺癌的治疗包括手术、化疗、放射治疗、激素治疗或这些治疗的组合。淋巴水肿是最重要的并发症之一，四分之一的妇女会出现这种情况。物理治疗在提高对继发性淋巴水肿的认识、预防、早期诊断和治疗方面发挥着重要作用。已经完成的系统性综述仅关注淋巴水肿的一种干预或两种或两种以上干预的组合，伴或不伴其他乳腺癌相关并发症。目的：系统回顾随机对照试验，以评价各种物理治疗干预措施用于预防和缓解乳腺癌术后继发性淋巴水肿的效果。材料与方法：通过PubMed、科克伦、EMBASE和Google Scholar数据库检索了2004年（1月）至2020年（3月）的相关研究。搜索的语言是英语。用于检索的关键词为乳腺癌、干预、物理治疗、术后、继发性淋巴水肿、治疗、预防。根据纳入标准，共纳入14项随机对照试验。这些试验包括手动淋巴引流（MLD），压迫疗法，运动范围（ROM）练习和按摩等干预措施。结果：共检索到相关文献244篇，纳入随机对照试验14篇。MLD作为单独干预或与其他干预相结合，对淋巴水肿的预防和治疗具有积极作用。压缩袖/紧身胸衣也显示出对淋巴水肿的积极作用。抗阻训练没有诱发或增加淋巴水肿的风险。肩关节程序显示，一周后延迟肩关节活动有利于减少淋巴水肿。物理刺激通过增加淋巴流量和速度对淋巴水肿有积极作用。结论：物理治疗干预，如MLD，压缩服装，伸展和加强，阻力练习和ROM练习在治疗和预防继发性淋巴水肿方面具有潜在的影响。
Introduction: Breast Cancer is the most common type of cancer in women and the 2nd leading cause of death. The treatment of breast cancer includes surgery, chemotherapy, radiation therapy, hormone therapy or combination of these treatments. One of the most important complications which occurs in one out of four women is lymphoedema. Physiotherapy plays an important role in creating awareness, prevention, early diagnosis and treatment of secondary lymphoedema. The systematic reviews which were already done focused on only one intervention or combination of two or more interventions for lymphoedema with or without other complication related to breast cancer. Aim: To systematically review the randomised controlled trials to evaluate the effect of various physiotherapy interventions that are used in the prevention and relief of secondary lymphoedema in postoperative breast cancer patients. Materials and Methods: Relevant studies were retrieved through PubMed, Cochrane, EMBASE and Google Scholar databases ranging from the year 2004 (January) to 2020 (March). The language of search was English. The keywords used for the search were breast cancer, interventions, physiotherapy, postoperative, secondary lymphoedema, treatment, prevention. Total 14 randomised controlled trials were included in this study according to the inclusion criteria. The trials included interventions like Manual Lymphatic Drainage (MLD), compression therapy, Range of Motion (ROM) exercises and massage. Results: A total of 244 relevant articles were found out of which 14 Randomised Controlled Trials (RCTs) were included in this study. MLD showed positive effects on lymphoedema prevention and treatment as an individual intervention or in combination with other interventions. Compression sleeves/corsets also showed positive effect on lymphoedema. Resistance exercises showed no risk of precipitating or increasing lymphoedema. Shoulder programs showed that delayed mobilisation of shoulder after one week is beneficial for reduction of lymphoedema. Physiotherapeutic stimulation showed positive effects on lymphoedema by increasing the lymphatic flow and velocity. Conclusion: Physiotherapy interventions like MLD, compression garments, stretching and strengthening, resistance exercises and ROM exercises have a potential effect in the treatment and prevention of secondary lymphoedema.