A RANDOMIZED STUDY COMPARING MANUAL LYMPH-DRAINAGE WITH SEQUENTIAL PNEUMATIC COMPRESSION FOR TREATMENT OF POSTOPERATIVE ARM LYMPHEDEMA

We compared manual lymph drainage (MLD) with sequential pneumatic comp ression (SPC) for treatment of unilateral arm lymphedema in 28 women p reviously treated for breast cancer. After 2 weeks of therapy with a s tandard compression sleeve (Part I) with maintenance of a steady arm v olume, each patient was randomly assigned to either one of two treatme nt regimens (Part II;). MLD was performed according to the Vodder tech nique for 45 min/day and SPC was performed with a pressure of 40-60 mm Hg for 2 hours/day. Both treatments were carried out for 2 weeks. Arm volume was measured by water displacement. Arm mobility, strength, and subjective assessments were also determined. Lymphedema was reduced b y 49 ml (7% reduction) (p=0.01) in the total group during Part I. Duri ng Part II, the MLD group decreased by 75 ml (15% reduction) (p<0.001) and the SPC group by 28 ml (7% reduction) (p=0.03). The total group r eported a decrease of tension (p=0.004) and heaviness (p=0.01) during Part I. During Part II; only the MLD group reported a further decrease of tension (p=0.01) and heaviness (p=0.008). MLD and SPC each signifi cantly decreased arm volume but no significant difference was detected between the two treatment methods.