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- Brorson, Håkan, et al.
(författare)
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Controlled compression and liposuction treatment for lower extremity lymphedema.
- 2008
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Ingår i: Lymphology. - 0024-7766. ; 41:2, s. 52-63
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Tidskriftsartikel (refereegranskat)abstract
- In 1987 we noticed excess adipose tissue in a patient with arm lymphedema and later, objective studies confirmed this clinical finding in patients with non-pitting arm lymphedema following breast cancer. A prospective study was begun in 1993, and its long-term results (15 years) shows overall complete reduction of the excess volume in patients with non-pitting arm lymphedema and that adipose tissue dominates the excess volume. Encouraged by these results we operated on a patient with primary and secondary elephantiasis of the leg. The edema was first transferred from a pitting to a non-pitting state by controlled compression therapy. Then liposuction was performed to remove the remaining excess adipose tissue, and complete reduction was finally achieved. The patient wears compression garments continuously and during the 11 years of followup, no recurrence has occurred. This paper explains our philosophical approach: a pitting lymphedema first should be treated conservatively to remove excess fluid, then liposuction can be performed to remove remaining excess volume bothersome to the patient.
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- HYLLANDER KLERNÄS, PIA, et al.
(författare)
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Assessment of quality of life in lymphedema patients: validity and reliability of the Swedish version of the Lymphedema Quality of Life Inventory (LQOLI)
- 2010
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Ingår i: Lymphology. - 0024-7766. ; 43:3, s. 135-145
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Tidskriftsartikel (refereegranskat)abstract
- The Lymphedema Quality of Life Inventory (LQOLI) is an instrument developed for patients with different types of lymphedema. It contains physical, emotional, social, and practical dimensions and consists of 58 items, each with three sub items concerning life quality, daily life changes, and difficulties of changing and two items concerning life quality in general and in relation to lymphedema. The purpose of this study was to adapt the Australian LQOLI to Swedish conditions and to test it for clarity, face validity, content validity, construct validity, and reliability. Content and face validity was completed by experts (n=11) and patients with different types of lymphedema (n=16). For construct validation the SF-36 (n=63) was used. Test-retest reliability was evaluated with lymphedema patients (n=58) answering the questionnaire twice, within median 3 weeks. Three items were added in the Swedish version of LQOLI (SLQOLI). The kappa coefficients in test-retest for all items and sub items varied (range=0.25-0.83). Construct validity showed moderate correlation with SF-36. The SLQOLI is adapted and valid, with moderate reliability, and it can be used in clinic to describe life quality for patients with lymphedema. In this study, 67% of the patients experienced an effect on life quality within the physical dimension and 54-58% within the emotional, social, and practical dimensions.
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- Johansson, K., et al.
(författare)
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A historical account of the role of exercise in the prevention and treatment of cancer-related lymphedema
- 2020
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Ingår i: Lymphology. - 0024-7766. ; 53:2, s. 55-62
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Tidskriftsartikel (refereegranskat)abstract
- In the absence of guidance from scientific evidence, a range of lymphedema prevention and management, guidelines were developed by relevant organizations around the world. These became publicly available, promoted and endorsed, particularly to women with breast cancer. The recommendations advised avoidance of any activity that could overload or restrict the lymphatic system and need for caution when participating in specific physical activities. However, over the past 20 years evidence has accumulated which has significantly challenged the safety of these recommendations, in particular for those with cancer. There now exists consistent and compelling evidence in support of exercise following a diagnosis of cancer. Participating in exercise during and following cancer treatment improves function and quality of life, reduces treatment-related morbidity, and may improve survival. Further, exercise, including resistance exercise at moderate or high load, is considered safe for those at risk- or with lymphedema. That is, exercise has not been shown to cause or worsen cancer-related lymphedema. This article provides a historical account of the advice given to patients in the prevention and management of lymphedema and how this advice has evolved.
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- Johansson, Karin, et al.
(författare)
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A Home-Based Weight Lifting Program for Patients with Arm Lymphedema Following Breast Cancer Treatment: A Pilot and Feasibility Study
- 2014
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Ingår i: Lymphology. - 0024-7766. ; 47:2, s. 51-64
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Tidskriftsartikel (refereegranskat)abstract
- It is well documented that resistance exercise can be performed by patients with breast cancer-related arm lymphedema. The aim of this pilot study was to evaluate the feasibility and safety of a 12-week self-administered weight lifting program for arm and shoulder, and its influence on arm lymphedema status, upper extremity muscle strength, and disability. Twenty-three patients with breast cancer-related arm lymphedema performed the program 3 times/week. The weight resistance levels were individually adjusted for shoulder flexion and adduction, and elbow extension and flexion corresponding to a repetition range of 8-12 repetition maximum. A log book was used to evaluate adherence to the program, wearing of compression sleeve and perceived exertion. Measurements were performed before a 2-week control period without intervention, and before and after intervention, and with arm volume measurements every fortnight to check for adverse events. Results revealed no significant changes during the control period. Adherence to the intervention program was excellent, and two adverse events were registered during the first weeks. After intervention, an increase of shoulder and arm strength (measured by an isometric muscle strength device) was found in all exercises (p=0.001-0.003). A reduction of excess volume was shown, in ml (p=0.03) and percentage (p=0.005), measured by water displacement method. A tendency towards reduction (p=0.07) of fat tissue in the upper arm (n=10) in both arms was found measured by MRI. In this pilot study, we concluded that a home-based weight-lifting program performed by patients with breast cancer-related arm lymphedema is feasible and safe providing that the program includes regular follow-up for safety.
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