Abstract

Objective: To determine the effectiveness of Kinesio taping compared to compression garments during maintenance phase of complex decongestive therapy for breast cancer–related lymphedema.

Design: Randomized, cross-over, controlled trial.

Setting: Outpatient tertiary-level hospital rehabilitation setting.

Subjects: Randomized sample of 30 women with breast cancer–related lymphedema.

Interventions: Participants received two interventions, Kinesio taping and compression garment, both lasting four weeks, whose order was randomized by blocks. A four-week washout period was established prior to the interventions and between them.

Measurements: The main outcome was the lymphedema Relative Volume Change. Secondary outcomes were range of motion of arm joints, self-perception of comfort, and lymphedema-related symptoms (pain, tightness, heaviness, and hardness).

Results: The decrease in the Relative Volume Change was greater in the Kinesio taping intervention (–5.7%, SD = 2.0) compared to that observed using compression garments (–3.4%, SD = 2.9) (P < 0.001). The range of motion of five upper-limb movements increased after applying taping (between 5.8° and 16.7°) (P < 0.05), but not after compression (P > 0.05). In addition, taping was perceived as more comfortable by patients (between 2.4 and 3 points better than compression in four questions with a 5-point scale (P < 0.001)) and further reduced lymphedema-related symptoms compared to compression (between 0.96 and 1.40 points better in four questions with a 6-point scale (P < 0.05)).

Conclusion: Kinesio taping was more effective than compression garments for reducing the lymphedema volume, with less severe lymphedema-related symptoms, better improvement of upper-limb mobility, and more comfort.

Main findings

• Clinical messages provided by the authors:
  • Kinesio taping reduces the volume of breast cancer–related lymphedema during its maintenance phase more than compression garments.
  • After applying Kinesio taping, certain ranges of motion of upper-limb improve moderately.
  • Kinesio taping is perceived as more comfortable than compression garments.
  • Pain, tightness, heaviness, and hardness improve using Kinesio taping.
• The average daily hours of usage (6.7 hours) of compression garments by the participants was significantly lower than that of Kinesio taping (24 hours), which may have resulted in the lower effectiveness of the compression garment therapy. This low adherence to compression garments is far from the recommended 14–16 daily hours,5 but it is in agreement with that by Daubert et al. (8.2 hours/day) and others that reported losses to follow-up of 21%–59% of patients in the daily use of compression garments.
• There are some limitations to be considered in this trial. First, although the proposed sample size was reached, its small size could be a limitation. Second, the patients were not blinded to the treatment. Another limitation is that there was no record of whether participants were at stage IIa or IIb of lymphedema. In addition, there was also no registration of whether there were changes in the lymphedema stage of each participant during the study. Finally, it was not evaluated whether the changes with the therapies were maintained over time.
• Extreme caution must be taken when detaching the tape from the patient’s skin, as injuries can occur during this maneuver, and its use in patients with repeated erysipelas must be avoided. In addition, the prolonged use of Kinesio taping for more than four weeks is not recommended to prevent damages to the skin until further longer-term research is conducted.
• Health professionals must try to get patients to wear the compression garment more frequently when no other treatment is being applied since it improves the volume of lymphedema.