Is Continuous Passive Motion Effective in Patients with Lymphedema? A Randomized Controlled Trial

Ramazan Kizil, Banu Dilek, Ebru S xahin, Onur Engin, Ali Can Soylu, Elif Akalin, and Serap Alper. Lymphatic Research and Biology 2018

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Is Continuous Passive Motion Effective in Patients with Lymphedema? A Randomized Controlled Trial

Ramazan Kizil, Banu Dilek, Ebru S xahin, Onur Engin, Ali Can Soylu, Elif Akalin, and Serap Alper. Lymphatic Research and Biology 2018

Background: In this randomized controlled study, we aimed to evaluate the effect of shoulder flexion exercise using continuous passive motion (CPM) on lymphedema during the treatment of breast cancer-related lymphedema (BCRL).

Methods: Thirty patients with BCRL were enrolled and completed the study. Fourteen patients were treated with complete decongestive therapy (CDT) and CPM in the intervention group, and 16 patients were treated with CDT alone (control group) for 15 sessions. The main outcome measures were included; the shoulder range of motion (ROM) assessed with a goniometer, limb volume difference measured using the water immersion method, function with the Disabilities of the Arm, Shoulder and Hand (DASH), and the quality of life using the Functional Assessment of Cancer Therapy for Breast Cancer (FACT-B4). Lymphedema volume measures were taken at baseline, on days 1, 2, 3, 4, 5, 10, and 15; and shoulder ROM, FACT-B4, and DASH were taken at baseline and on day 15.

Results: All subjects were similar at baseline. After treatment significant improvement was found in ROM, volumetric differences, DASH, and FACT-B4 scores in both groups. No significant differences were observed in the volumetric differences, ROM, and the DASH, and FACT-B4 scores between the groups, except for the FACT-B4 physical well-being subscores, which were better in intervention group.

Conclusion: Our study results showed that CPM did not contribute to the reduction of BCRL.

Main findings

  • The study involved a small sample size in patients with BCRL. Also future study may explore use of CPM in people with early stages of lymphedema, short-term effectiveness CPM to lymphoedema, and contribution of passive ROM exercise with CPM in direction of abduction.
  • Long-term effects of CPM should be investigated in further large-scale studies.
  • It may be beneficial to examine a particular subgroup of patients with lymphedema (e.g., patients with shoulder pain/hemiplegic shoulder and difficulty performing active exercise may benefit from passive ROM exercise using CPM).
  • CPM, when applied for 2 weeks, in combination with CDT, was no more effective than CDT alone. Both treatment groups demonstrated effectiveness in the reduction of lymphedema, improvement in shoulder ROM, quality of life, and function in patients with BCRL.