Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Questions: When added to decongestive lymphatic therapy (DLT), what is the effect of fluoroscopy-guided manual lymphatic drainage (MLD) versus traditional MLD or placebo MLD for the treatment of breast cancer-related lymphoedema (BCRL)?
Design: Multicentre, three-arm, randomised controlled trial with concealed allocation, intention-to-treat analysis and blinding of assessors and participants.
Participants: At five hospitals in Belgium, 194 participants with unilateral chronic BCRL were recruited.
Intervention: All participants received standard DLT (education, skin care, compression therapy and exercises). Participants were randomised to also receive fluoroscopy-guided MLD (n = 65), traditional MLD (n = 64) or placebo MLD (n = 65). Participants received 14 sessions of physiotherapy during the 3-week intensive phase and 17 sessions during the 6-month maintenance phase. Participants performed self-management on the other days.
Outcome Measures: All outcomes were measured: at baseline; after the intensive phase; after 1, 3 and 6 months of maintenance phase; and after 6 months of follow-up. The primary outcomes were reduction in excess volume of the arm/hand and accumulation of excess volume at the shoulder/trunk, with the end of the intensive phase as the primary endpoint. Secondary outcomes included daily functioning, quality of life, erysipelas and satisfaction.
Results: Excess lymphoedema volume decreased after 3 weeks of intensive treatment in each group: 5.3 percentage points of percent excessive volume (representing a relative reduction of 23.3%) in the fluoroscopy-guided MLD group, 5.2% (relative reduction 20.9%) in the traditional MLD group and 5.4% (relative reduction 24.8%) in the placebo MLD group. The effect of fluoroscopy-guided MLD was very similar to traditional MLD (between-group difference 0.0 percentage points, 95% CI -2.0 to 2.1) and placebo MLD (-0.2 percentage points, 95% CI -2.1 to 1.8). Fluid accumulated at the shoulder/trunk in all groups. The average accumulation with fluoroscopy-guided MLD was negligibly less than with traditional MLD (-3.6 percentage points, 95% CI -6.4 to -0.8) and placebo MLD (-2.4 percentage points, 95% CI -5.2 to 0.4). The secondary outcomes also showed no clinically important between-group differences.
Conclusion: In patients with chronic BCRL, MLD did not provide clinically important additional benefit when added to other components of DLT.
Registration: NCT02609724.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jphys.2022.03.010 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
ICG Lymphography Confirms the Presence of an Alternative Lymph Drainage Pathway Following Long-Term Manual Therapy: A Case for Preserving Traditional MLD Approaches.
Reports (MDPI)
May 2025
Dr. Vodder School International, Vancouver, BC V7J 2P7, Canada.
: Breast cancer-related lymphedema (BCRL) is a chronic condition affecting up to 20% of breast cancer survivors. Manual lymphatic drainage (MLD) has traditionally included techniques to redirect lymph flow toward alternative pathways when axillary drainage is impaired. However, emerging imaging techniques suggest that most lymph continues to drain toward the ipsilateral axilla, and this has led to the widespread uptake of treatment protocols that exclude traditional redirecting movements, even in cases where personalized imaging is unavailable.
View Article and Find Full Text PDFSIC based RL for massive MIMO NOMA signal detection for different modulation schemes under diverse channel conditions.
Sci Rep
July 2025
Department of Computer Science, College of Computers and Information Technology, Taif University, P.O. Box 11099, 21944, Taif, Saudi Arabia.
Massive-multiple input and Multiple Outputs Non orthogonal multiple access (M-MIMO-NOMA) systems require efficient signal detection techniques to mitigate interference and enhance spectral efficiency, especially under diverse channel conditions and varying modulation schemes. This study investigates the performance of the Successive Interference Cancellation with Reinforcement Learning (SIC-RL) detector compared to conventional methods, including the Minimum Mean Square Error (MMSE), Maximum Likelihood Detection (MLD), Approximate Message Passing (AMP), Gauss-Seidel (GS), Conjugate Gradient (CG), and zero-forcing equalizer (ZFE). The analysis was conducted for 16-QAM, 64- Quadrature Amplitude Modulation (QAM), and 256-QAM in Rayleigh fading channels with 10% error.
View Article and Find Full Text PDFEffectiveness of isometric muscle training combined with manual lymphatic drainage on secondary lower extremity lymphedema following gynecologic cancer surgery.
Front Bioeng Biotechnol
May 2025
Department of Rehabilitation, Hangzhou Linping Hospital of Traditional Chinese and Western Medicine, Hangzhou, China.
Objective: To investigate the effects of isokinetic strength training combined with manual lymphatic drainage (MLD) on leg circumference, walking ability and muscle strength in patients with secondary lymphedema following gynecologic cancer surgery.
Design: Randomized controlled trial.
Setting: Inpatient rehabilitation department.
Efficient Design of Affilin Protein Binders for HER3.
Int J Mol Sci
May 2025
Nostrum Biodiscovery S.L., 08029 Barcelona, Spain.
Engineered scaffold-based proteins that bind to concrete targets with high affinity offer significant advantages over traditional antibodies in theranostic applications. Their development often relies on display methods, where large libraries of variants are physically contacted with the desired target protein and pools of binding variants can be selected. Herein, we use a novel combined artificial intelligence/physics-based computational framework and phage display approach to obtain ubiquitin based Affilin proteins targeting the human epidermal growth factor receptor 3 (HER3) extracellular domain, a relevant tumor target.
View Article and Find Full Text PDFTherapeutic effects and mechanisms of Fufang Longdan mixture on metabolic syndrome with psoriasis via miR-29a-5p/IGF-1R axis.
Front Pharmacol
May 2025
The First Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
Background: The occurrence of comorbid metabolic syndrome and psoriasis (MS-P) is owing to the complex interplay between metabolic dysregulation and inflammatory responses. However, current treatments have shown limited efficacy in improving the symptoms of both conditions simultaneously.
Objective: This study aimed to investigate the therapeutic efficacy of Fufang Longdan Mixture (FLM) in treating MS-P comorbidity, elucidate its mechanism through the miR-29a-5p/IGF-1R axis and evaluate treatment responses between APOE and C57BL/6 mice.