Two Different Physiotherapy Programs in Lymphedema Following Head and Neck Cancer Treatment
Kľúčové slová
Abstrakt
Popis
Head and neck cancer (HNC) have been seen in 13.3/100,000 males and 2.8/100,000 in females in Turkey. HNC related treatments such as lymph node dissection, tumor excision, chemotherapy, radiotherapy, and cancer itself can cause head and neck lymphedema (HNL). The incidence of HNL due to HNC treatments (surgery, chemotherapy and chemoradiation) has been reported to be between 48% and 90%.
A recognition of HNL has been growing in recent years, but HNL is still much less recognized than upper and lower limb lymphedema and is easily ignored by both patients and health care providers. Therefore, in many cases, the diagnosis and treatment of HNL may be delayed, or patients cannot access treatment. In routine practice, after HNC, the self-absorption of HNL is generally expected. Clinical experiences have confirmed that HNL develops 2-6 months after cancer treatment and regresses in some patients over time.
A variety of physiotherapy approaches have been shown to prevent and minimize physical, functional, emotional, and social disorders resulting from HNL. However, complex decongestive physiotherapy (CDP) is considered a gold standard treatment method for lymphedema. This method consists of manual lymph drainage (MLD), skin care, compression therapy, and therapeutic exercises. Although there are many studies about the effects of CDP on upper and lower limbs, there is only a limited number of studies about HNL and CDP in the literature.
Termíny
| Naposledy overené: | 01/31/2020 |
| Prvý príspevok: | 02/23/2020 |
| Odhadovaná registrácia bola odoslaná: | 02/24/2020 |
| Prvý príspevok: | 02/26/2020 |
| Posledná aktualizácia bola odoslaná: | 02/24/2020 |
| Posledná aktualizácia bola zverejnená: | 02/26/2020 |
| Aktuálny dátum začatia štúdie: | 03/04/2018 |
| Odhadovaný dátum dokončenia primárneho okruhu: | 02/14/2019 |
| Odhadovaný dátum dokončenia štúdie: | 03/14/2019 |
Stav alebo choroba
Intervencia / liečba
Other: Complex decongestive physiotherapy program group
Other: Home program group
Fáza
Skupiny zbraní
| Arm | Intervencia / liečba |
|---|---|
| Active Comparator: Complex decongestive physiotherapy program group Manuel lymph drainage, compression mask, exercises and skin care | Other: Complex decongestive physiotherapy program group MLD was administered 5 days a week for 4 weeks, with each session lasting 30 minutes [25]. Compression therapy was applied to the patients by wearing a compression mask (FM Velcro Fastener, LIPOELASTIC), made of polyamide, cotton, viscose, and elastane, that covered the submandibular region, the masseter region, and the neck. The compression mask is specifically designed for the healing and recovery of tissues after plastic and aesthetic surgeries. The patients were advised to wear the compression masks for at least 4-6 hours per day for 4 weeks and gradually increase wearing time according to their tolerance. The patients were asked to perform skin care by themselves. Skin care was applied using a low pH skin lotion to moisturize the skin. Neck, face/mimic, tongue, and posture exercises were performed by patients while the compression mask was worn and under the supervision of a physiotherapist, with 10 repetitions 5 times a week for 4 weeks. |
| Active Comparator: Home program group Self-manuel lymph drainage and home exercises | Other: Home program group Self-MLD and exercises (neck, face/mimic, tongue, and posture exercises) were shown to the patients in this group. Self-MLD included self-administered lymph drainage of the axillary, posterior, lateral, and anterior neck areas; the pre- and retro-auricular regions; the lateral and anterior regions of the face; and the lower jaw region. Then the order is reversed back to the starting point [3]. A video of self-MLD and a text including exercise descriptions were shared with patients and their relatives to ensure that the self-MLD and exercises were performed accurately and regularly at home. Self-MLD was recommended to be applied once a day, and the exercises were advised to be performed for 10 repetitions each, 10 times a day for 4 weeks. The patients were called by phone during the second week after their first evaluation as a control and to motivate the patient for performing self-MLD and home exercises properly. |
| No Intervention: Control group No intervention |
Kritériá oprávnenosti
| Vek vhodný na štúdium | 22 Years To 22 Years |
| Pohlavia vhodné na štúdium | All |
| Prijíma zdravých dobrovoľníkov | Áno |
| Kritériá | Inclusion Criteria: - >18 years old - had unilateral/bilateral neck dissection - had received radiotherapy and/or chemotherapy - elapsed time of 3 or more months since cancer treatments - had secondary HNL Exclusion Criteria: - having metastases due to HNC or other primary cancers - receiving/having received treatment to regulate the lymph flow - having the diagnosis of neurological, orthopedic, or rheumatologic diseases that may cause circulation and movement in the head and neck region. |
Výsledok
Primárne výstupné opatrenia
1. Change from Baseline Internal Lymphedema at 4 weeks [At baseline and 4 weeks later]
2. Change from Baseline External Lymphedema at 4 weeks [At baseline and 4 weeks later]
3. Change from Baseline Staging Lymphedema at 4 weeks [At baseline and 4 weeks later]
4. Change from Baseline Characteristics of Tissue Changes (edema and/or fibrosis), The Anatomical Locations, and The Severity of The Identified Soft Tissue Abnormalities at 4 weeks [At baseline and 4 weeks later]
5. Change from Baseline 3D Surface Scanning and Volume Evaluation at 4 weeks [At baseline and 4 weeks later]
