Turkish Journal of Physical Medicine and Rehabilitation 2021 , Vol 67 , Num 2

The efficacy of different bandaging methods in patients with breast cancer-related lymphedema: A prospective, randomized study

Ayşegül Yaman 1 ,Pınar Borman 2 ,Adeviye İnanlı 3 ,Fatma Kul 3 ,Sevilay Karahan 4
1 Department of Physical Medicine and Rehabilitation, Gülhane Training and Research Hospital, Ankara, Turkey
2 Department of Physical Medicine and Rehabilitation, Ankara City Hospital, Ankara, Turkey
3 Department of Physical Medicine and Rehabilitation, University of Hacettepe Faculty of Medicine, Ankara, Turkey
4 Department of Biostatistics, University of Hacettepe Faculty of Medicine, Ankara, Turkey
DOI : 10.5606/tftrd.2021.6287 Objectives: The aim of this study was to evaluate the comparative efficacy of 3M™ Coban™ 2 layer system and conventional multi-layer shortstretch bandaging in terms of volume reduction, ultrasonographic measurements, functional status, and quality of life (QoL) in the treatment of patients with breast cancer-related lymphedema (BCRL).

Patients and methods: This prospective, single-blind, randomized study included a total of 60 BCRL patients (60 females; mean age 54.9±9.6 years; range, 30 to 73 years). The patients were randomly allocated to Group 1 (n=30) and Group 2 (n=30). Both groups received complex decongestive therapy (CDT) including skin care, lymphedema exercises, and manual lymphatic drainage (MLD) combined with traditional multi-layer short-stretch bandaging five times per week for three weeks in Group 1 and with 3M™ Coban™ 2 layer system bandaging two times per week for three weeks in Group 2. Differences in volumes, excess volumes, ultrasonographic measurements, QoL, and functional assessment scores were evaluated at baseline, after three weeks of intensive treatment period, and at two months of follow-up. Functional status was evaluated by the Quick Disability of Arm Shoulder and Hand Questionnaire (Q-DASH), while the QoL was assessed using the Turkish version of Lymphedema Quality of Life Questionnaire-Arm (LYMQOL-Arm). The duration and easiness of applying bandages by physiotherapists and comfortableness of bandages according to patients and physiotherapists were also evaluated using a questionnaire.

Results: The demographic and clinical properties were similar between the groups. There were significant improvements in the volumes, excess volumes, ultrasonographic measures, functional scores, and QoL scores in both groups at the end of treatment. The improvements were sustained at two months of follow-up.

Conclusion: The 3M™ Coban™ 2 layer bandaging as a part of CDT twice a week for a period of three weeks can significantly reduce the volume and improve the disability and impaired QoL, similar to conventional short-stretch multi-layer bandages. In addition, treatment with this layer system enables a time-efficient, easy, and comfortable application of bandaging with increased mobility of the upper extremity. Keywords : Bandaging, function, lymphedema treatment, quality of life, ultrasonography