Is Complex Decongestive Physical Therapy Safe for Median Nerve at the Level of Carpal Tunnel in Breast Cancer Related Lymphedema?
| Autor: | Atilla Soran, Melek Aykut, Hakan Genç, F Figen Ayhan, Başak Mansız Kaplan |
|---|---|
| Přispěvatelé: | Uşak Üniversitesi |
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Complex decongestive therapy Breast Cancer Lymphedema Breast Neoplasms breast cancer-related lymphedema Electromyography 030204 cardiovascular system & hematology Nerve entrapments 03 medical and health sciences 0302 clinical medicine Quality of life Compression Bandages medicine Humans Carpal tunnel Prospective Studies Exercise Aged Ultrasonography medicine.diagnostic_test business.industry Carcinoma Ductal Breast Middle Aged Skin Care Carpal Tunnel Syndrome Median nerve Surgery Median Nerve complex decongestive therapy medicine.anatomical_structure Manual Lymphatic Drainage Treatment Outcome 030220 oncology & carcinogenesis Arm Quality of Life Neuralgia Female Cardiology and Cardiovascular Medicine Tissue pressure business Breast Cancer Related Lymphedema |
| Zdroj: | Lymphatic research and biology. 17(1) |
| ISSN: | 1557-8585 |
| Popis: | PubMed ID: 30358471 Background: Multilayer bandaging used in complex decongestive therapy (CDT) may increase tissue pressure resulting in nerve entrapments. The aim of this study was to discover if median nerve damage is a consequence of CDT in patients with breast cancer-related lymphedema (BCRL). Methods and Results: Eighty-two arms of 41 patients with BCRL were included. Mean age was 56.05 (8.16) years and all stages of lymphedema were equally included. Fifteen sessions of CDT was applied to all patients. The calculated volume of extremities, the quality of life (cancer adaptation of Ferrans-Powell), neuropathic pain (NP; Douleur Neuropathique 4), and disability (quick disabilities of arm, shoulder, and hand [Q-DASH]) tests were recorded before and after therapy. Skin and subcutaneous tissue thicknesses of volar and dorsal sides and median nerve cross-sectional area (CSA) at the level of carpal tunnel were measured using ultrasonography (US), before and after therapy. Carpal tunnel syndrome (CTS; 41.37%) and polyneuropathy (10.34%) were common findings confirmed by electromyography. Neuropathic pain profile was also found in 34.14% of patients. The arm volume of affected side, quality of life, and skin and subcutaneous tissue thicknesses were improved after therapy (p < 0.05). However, median nerve CSA, the NP, and Q-DASH scores were not changed after therapy. Conclusions: Although lymphedema is a painless condition, NP and CTS should not be ignored in patients with BCRL. US is an alternative, precise, and high technological method for evaluating treatment response. CDT is an effective and safe treatment according to volumetric calculations, US measurements of tissue thicknesses, and median nerve size. © 2019 Mary Ann Liebert, Inc., publishers. |
| Databáze: | OpenAIRE |
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