Journal of Modern Rehabilitation 2016. 10(3):104-109.

Comparing the Effect of Complex Decongestive Physical Therapy with Combination of Intermittent Pneumatic Compression Pump and Complex Decongestive Physical Therapy on Secondary Upper Extremity Lymphedema Volume and Quality of Life in Patients with Breast
Hossein Bagheri, Ali Arab-Kheradmand, Ali Montazeri, Farnaz Razavi, Shiva Mousavi, Sepide Nafissih


Introduction: Breast cancer is one of the most common cancers among women. One complication after mastectomy following breast cancer is ipsilateral upper extremity lymphedema. This study aims to compare the effect of complex decongestive physical (CDP) therapy with a combination of intermittent pneumatic compression pump and CDP therapy on secondary upper extremity lymphedema volume and quality of life in patients after mastectomy following breast cancer.
Material and Methods: A total of 20 women with secondary upper extremity lymphedema after mastectomy following breast cancer were selected according to criteria. After the initial assessment, the patients were randomly divided into two groups. One group was treated with CDP therapy techniques, and another group was treated with intermittent compression pump in addition to CDP therapy techniques. These techniques were included manual lymphatic drainage, bandaging, therapeutic exercise, skin care, and intermittent compression pump. Patients were treated for 2 weeks and 5 days/week. Lymphedema volume and quality of life were evaluated before and after treatment. The quality of life was assessed by cancer-specific questionnaire (QLQ-C30) and breast cancer-specific quality of life questionnaire (QLQ-Br23), and lymphedema volume was measured by volumeter.
Results: The mean of lymphedema volume was significantly decreased after treatment as compared with before treatment in both groups (P < 0.050). The scores of all items of quality of life except of cognitive and sexual items of both questionnaires were significantly increased after treatment as compared with before treatment in both groups (P < 0.050). There was no significant difference in lymphedema volume and quality of life scores between two groups (P > 0.050).
Conclusion: The results of this study showed that the combination of CDP therapy and intermittent compression pump are useful for improving the affected limb lymphedema volume and quality of life.
Keywords: Upper extremity lymphedema; Complex decongestive physical therapy; Intermittent compression pump; Quality of life


Upper extremity lymphedema; Complex decongestive physical therapy; Intermittent compression pump; Quality of life

Full Text:



Sammarco A. psychosocial stages and quality of life of women with breast cancer. Cancer Nurs 2001; 24(4).

Deo SV, Ray S, Rath GK, Shukla NK, Kar M, Asthana S, et al. Prevalence and risk factors for development of lymphedema following breast cancer treatment. Indian J Cancer 2004; 41(1): 8-12.

Engel J, Kerr J, Schlesinger-Raab A, Sauer H, Holzel D. Axilla surgery severely affects quality of life: results of a 5-year prospective study in breast cancer patients. Breast Cancer Res Treat 2003; 79(1): 47-57.

Hayes S, Di Sipio T, Rye S, Lopez JA, Saunders C, Pyke C, et al. Prevalence and prognostic significance of secondary lymphedema following breast cancer. Lymphat Res Biol 2011; 9(3): 135-41.

Morgan PA, Franks PJ, Moffatt CJ. Health-related quality of life with lymphoedema: a review of the literature. Int Wound J 2005; 2(1): 47-62.

Hinrichs CS, Gibbs JF, Driscoll D, Kepner JL, Wilkinson NW, Edge SB, et al. The effectiveness of complete decongestive physiotherapy for the treatment of lymphedema following groin dissection for melanoma. J Surg Oncol 2004; 85(4): 187-92.

Velanovich V, Szymanski W. Quality of life of breast cancer patients with lymphedema. Am J Surg 1999; 177(3): 184-7.

Yamamoto R, Yamamoto T. Effectiveness of the treatment-phase of two-phase complex decongestive physiotherapy for the treatment of extremity lymphedema. Int J Clin Oncol 2007; 12(6): 463-8.

Koul R, Dufan T, Russell C, Guenther W, Nugent Z, Sun X, et al. Efficacy of complete decongestive therapy and manual lymphatic drainage on treatment-related lymphedema in breast cancer. Int J Radiat Oncol Biol Phys 2007; 67(3): 841-6.

Didem K, Ufuk YS, Serdar S, Zumre A. The comparison of two different physiotherapy methods in treatment of lymphedema after breast surgery. Breast Cancer Res Treat 2005; 93(1): 49-54.

Szolnoky G, Lakatos B, Keskeny T, Varga E, Varga M, Dobozy A, et al. Intermittent pneumatic compression acts synergistically with manual lymphatic drainage in complex decongestive physiotherapy for breast cancer treatment-related lymphedema. Lymphology 2009; 42(4): 188-94.

Shao Y, Qi K, Zhou QH, Zhong DS. Intermittent pneumatic compression pump for breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials. Oncol Res Treat 2014; 37(4): 170-4.

Gebruers N, Truijen S, Engelborghs S, De Deyn PP. Volumetric evaluation of upper extremities in 250 healthy persons. Clin Physiol Funct Imaging 2007; 27(1): 17-22.

Karges JR, Mark BE, Stikeleather SJ, Worrell TW. Concurrent validity of upper-extremity volume estimates: comparison of calculated volume derived from girth measurements and water displacement volume. Phys Ther 2003; 83(2): 134-45.

Montazeri A, Harirchi I, Vahdani M, Khaleghi F, Jarvandi S, Ebrahimi M, et al. The EORTC breast cancer-specific quality of life questionnaire (EORTC QLQ-BR23): translation and validation study of the Iranian version. Qual Life Res 2000; 9(2): 177-84.

Montazeri A, Harirchi I, Vahdani M, Khaleghi F, Jarvandi S, Ebrahimi M, et al. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC

QLQ-C30): translation and validation study of the Iranian version. Support Care Cancer 1999; 7(6): 400-6.

Karadibak D, Yavuzsen T, Saydam S. Prospective trial of intensive decongestive physiotherapy for upper extremity lymphedema. J Surg Oncol 2008; 97(7): 572-7.

Uzkeser H, Karatay S, Erdemci B, Koc M, Senel K. Efficacy of manual lymphatic drainage and intermittent pneumatic compression pump use in the treatment of lymphedema after mastectomy: a randomized controlled trial. Breast Cancer 2015; 22(3): 300-7.

Strossenreuther RHK, Deuss J, Hartogh-Seffers A, Klose G, Norton S. practical instruction for therapists manual lymph drainage according to Dr.E. Vodder. In: Foldi M, Foldi E, editors. Foldi's textbook of lymphology. 2nd ed. Munich, Germany: Urban and Fischer; 2006 .p 1-50.

Zaleska M, Olszewski WL, Cakala M, Cwikla J, Budlewski T. Intermittent pneumatic compression enhances formation of edema tissue fluid channels in lymphedema of lower limbs. Lymphat Res Biol 2015; 13(2): 146-53.

Gurdal SO, Kostanoglu A, Cavdar I, Ozbas A, Cabioglu N, Ozcinar B, et al. Comparison of intermittent pneumatic compression with manual lymphatic drainage for treatment of breast cancer-related lymphedema. Lymphat Res Biol 2012; 10(3): 129-35.

Kwan W, Jackson J, Weir LM, Dingee C, McGregor G, Olivotto IA. Chronic arm morbidity after curative breast cancer treatment: prevalence and impact on quality of life. J Clin Oncol 2002; 20(20): 4242-8.


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.